What does professionalism

mean for trainers?

Professor Ed Peile

30th September 2010

Outline

• Meanings of Professionalism

• “I know one if I see one”.

• Assessing professionalism

• Teaching Professionalism

• Role Modelling

• The professionalism of trainers

Meanings of Professionalism

CANMEDS

7 roles expected of the competent specialist:

medical expert,

communicator,

collaborator,

manager,

health advocate,

scholar

professional

RCP LondonWorking Party on Medical Professionalism

„a set of values, behaviours and

relationships that underpin the trust the

public has in doctors, with doctors being

committed to integrity, compassion,

altruism, continuous improvement,

excellence and teamwork‟.

RCP London

• Attributes of professionals:

• Integrity,

• compassion,

• altruism,

• continuous improvement,

• excellence,

• partnership

ABIM Project Professionalism

Six components:

• altruism,

• accountability,

• excellence,

• duty,

• honour/integrity

• respect.

Continuum of Professionalism

After Ottowa 2010

Macro –social level

Social responsibility Morality

Interpersonal

Interactions with people Interactions with contexts

Individual

attributes Capacity, behaviours

I know one if I see one

Capturing a fluid concept

• Professionalism as a concept varies across time

and across contexts

• Many educators believe that only concrete

operationalisable definitions can underpin

defensible assessments

• Professionalism relates to the social

responsibility of medical profession

• Therefore what professionalism is and how it will

be taught should be clearly articulated in

dialogue between profession & public• Ottowa 2010

Teaching professionlism

Multiple perspectives

• Diversity of „lenses‟ essential for

researching and assessing professionalism.

– Eg psychology, sociology, anthropology

• Culture of continuous improvement

predicates formative assessment with

feedback and remediation

Learning Professionalism cycle

Different Animals?

Creativity consultants

Sounding Boards

Strategic Planners

Supervisors

Lifestyle gurus

Therapists

Counsellors

Befrienders

Coaches

Trainers

Tutors

Mentors

Coaching & Mentoring

• Understanding which does what

• Essential attributes of the processes

• Determining the boundaries in

supervision

Coaching

..works best when the need is the

acquisition of skills.

It is best carried out by a one-to-one trainer

who sees the person's work and can give

immediate feedback and guidance, or by a

colleague in the same function.

Mentoring

• works best when the need is the acquisition of

wisdom.

• In this context, wisdom means the ability to to

achieve insight and understanding into the

issues discussed.

• It is best carried out by an independent fellow

professional who is able to maintain a broad

perspective and be (more) objective.

Counselling

…works best when the individual faces a

- personal crisis

- an important decision

- or a difficult dilemma

It is best carried out by an independent

practitioner.

Supporting learning

Without

appropriate

scaffolding....

the construction of

learning can

feel unsafe

0

10

20

30

40

50

60

70

80

90

100

Support

Ch

all

en

ge

Learner 1

Learner 2

Support and Challenge

Matching Learner Stages to Teacher Styles

Self-directed

learner

Severe

mismatch

Mismatch Near match Match

Involved

learner

Mismatch Near match Match Near match

Interested

learner

Near match Match Near match Mismatch

Dependent

learner

Match Near match Mismatch Severe

mismatch

Authority,

expert

Salesperson,

motivator

Facilitator Delegator

Gerald Grow,

1991

Assessing professionalism

Summative judgements

• Necessary for „Fitness to Practise‟

• Triangulated, evidences, and multi-

perspective.

• If it sounds unprofessional, feels

unprofessional, looks unprofessional...

.....It needs investigating!

Assessment format

• Need to assess at individual, interpersonal

and societal levels

• “The overall assessment programme is

more important than the individual tools.

Best programmes use a variety of tools in

a safe climate, provide rich feedback,

anonymity (where appropriate) and follow-

up of behaviour change over time.”Ottowa 2010

Tracking & modelling professionalism

after Cameron and Simpson, Edinburgh (2009)

PPD

• Process to develop

individual

• Attention to

professionalism

• Attention to own values/

lifestyle/drivers

• Often aided by a mentor

Professionalism

• Emphasis on the needs

of the patients & (NHS)

employers

• Evaluated by employers/

line managers/trainers

Role Modelling

Role Modelling

• What do you understand by role

modelling?

What the modeller can do

• Be aware that every aspect of what we do is a

legitimate focus for student attention

• Make explicit why we behave the way we do

• Understand the difference between

responsibility to the learner and responsibility for

the learner

• Encourage “style spectrum”

What “modellees” need

• Self awareneness: an understanding of

the lens through which they are looking at

role modellers.

• Critical appraisal skills – to look at

behaviours in their complexity.

• Space and encouragement to try on new

hats

• Wise supervision and supervised

responsibility

Supportive supervision

• Understanding the learning environment -

especially the roles of others

• Understanding the learner‟s needs

• Understanding own strengths and

limitations

• Promising less: delivering more.

Professionalism as a trainer

Values and the Curriculum

• Values are deeply held views that act as guiding

principles for individuals and organisations.

• When they are declared and followed they are the

basis of trust.

• When they are left unstated they are inferred from

observable behaviour.

• When they are stated and not followed trust is

broken.

Pendleton & King BMJ 2002;325:1352-1355

Leading the curriculum

• Leadership begins by defining a purpose: a compelling future for an aligned community of likeminded and committed individuals who encourage one another towards their aims. Leadership inspires and then focuses effort.

Pendleton & King BMJ 2002;325:1352-1355

The Servant Leader

"It begins with the natural feeling that one

wants to serve, to serve first.

Then conscious choice brings one to aspire

to lead…

The difference manifests itself in the care

taken by the servant-first to make sure that

other people‟s highest priority needs are

being served. Greenleaf (1977)

The test of Servant Leadership

“Do those served grow as

persons, do they grow while

being served, become healthier,

wiser, freer, more autonomous,

more likely themselves to

become servants?"

10 characteristics of servant

leadership• listening,

• empathy,

• healing,

• awareness,

• persuasion,

• conceptualization,

• foresight,

• stewardship,

• commitment to the growth of others,

• building community Morgan & Sørensen (1999).

Professional Development

Standards : Themes

1. Values of Educational Professionals

2. Educational Scholarship

3. Teaching & supporting learners

4. Assessment & feedback to learners

5. Design & planning of learning activities

6. Educational Management and Leadership

Core Values

• Professional integrity

• Respect for patients

• Respect for learners

• Continuing professional development

• Equality of opportunity and diversity

• Commitment to medical education

Further Information

Email:Ed.Peile@warwick.ac.uk

Website: www.medicaleducators.org