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Professionalism and Revalidation

Professionalism and Revalidation. Day release 3/11/09. Perspectives. “Professional men they have no cares; whatever happens they get theirs” Ogden Nash “All professions are conspiracies against the laity”

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Professionalism and Revalidation

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  1. Professionalism and Revalidation Day release 3/11/09

  2. Perspectives • “Professional men they have no cares; whatever happens they get theirs” • Ogden Nash • “All professions are conspiracies against the laity” • George Bernard Shaw • Pearly gates

  3. TASK! • Professionalism: what do you understand by it? • List & describe attributes or qualities which make up professionalism • Come up with a definition of professionalism • What do you think the public understands by professionalism?

  4. Professionalism-what is it? • Medical professionalism signifies a set of values, behaviours, and relationships that underpins the trust the public has in doctors • Medicine is a vocation in which a Dr’s knowledge, clinical skills, and judgement, are put in the service of protecting and restoring human well-being. This purpose is realised through a partnership between patient & Dr, one based on mutual respect, individual responsibility,& appropriate accountability • Royal College of Physicians 2005

  5. In their practice, Drs are committed to: • Integrity • Compassion • Altruism • Continuous improvement • Excellence • Working in partnership with members of the wider healthcare team • RCP 2005

  6. What’s in a word? • Professional: • Opposite of amateur-paid • Military-ruthless efficiency • Hitman-as above • Sport-”professional” foul

  7. Hippocrates • “father of medicine” • Practised around 420BC • Closed societies on island of Cos-medicine competed • Oath contains elements of the Dr as an altruistic healer • Also reinforces idea of the closed shop-mysteries of health only to be known by the privileged few

  8. North America • Defines professionalism in education & practice • Since 1999 all specialist training has incorporated professionalism as a core competency

  9. NHS report by the National Clinical Assessment Service 2009 • Professionalism is comprised of 6 domains: • Competency; encompassing knowledge, skills & ethics, & their application in practice • Personal relationships; communication, teamworking • Professional boundaries; awareness, conflicting roles, friends • Consistency & reliability of practice; mistakes (no. or judgement) • Reflection & learning; for the Dr & delegated tasks • Commitment to service; private behaviour, personal beliefs

  10. Ct • “In conclusion, professionalism is more than being competent & must • cover all domains as well as leadership & integrity; it should be embedded • in policy, standards & guidelines to ensure compliance. Managing • perceived deficiencies in professionalism requires expertise, & a • structured, transparent process, paying proper regard to the rights of all • involved, who themselves should receive the support they need” • NCAS 2009

  11. Professionalism under threat • Due to: • Incidents-Bristol, Shipman • Expectations-public, government, new developments • Demand-politics, population changes, innovations • Managerial control-strategies, targets, budgets • Teamworking-loss of control, appropriate delegation • Legislation-working hours, equality & diversity

  12. Licensure • A regulative bargain whereby: • “Society grants the profession autonomy in return for the profession guaranteeing standards of care and safety” • Because………… There is such an unusual degree of knowledge of skill that non professionals are not equipped to evaluate or regulate Professionals are responsible A profession will take regulatory action incases of incompetent or unethical practice

  13. So.. What do we expect of professionals • Good at their day to day job (performance) • Able to deal with rarer and more unusual facets (keeping up to date) • Someone we can trust (the right sort of person) • “An individual who acts on behalf of another in situations of complexity and uncertainty”

  14. Can it be measured? • Day to day work – GPs diagnose and manage. (audit, SEA) • Deal with rare but important – knowledge test / CPD • Can be trusted - views of patients / colleagues / complaints

  15. For what purpose? • To attest those on the Specialty Register have the knowledge, skills and behaviours required of their discipline • To encourage excellence / CQI • To determine when targeted help is needed • To build public confidence in the system

  16. Assessment of professionalism • Students moral reasoning • Not measured=not valued • Context • Include conflict • Resolve dilemmas-rarely black & white • Formative/summative • Multiple raters/triangulation: clinical competence/communication skills/ethical & legal understanding as foundation. Excellence/humanism/accountability/altruism as pillars. All leading to professionalism

  17. Darzi (NHS next stage review) • Over regulation can damage morale • Dismiss regulation as an organising principle • Replace regulation with quality, as defined by clinical effectiveness, patient safety & patient experience • Devolve power to regions • Use professionalism as a lever to raise standards • Reduce professional boundaries • Innovation & research • Leadership development to make the NHS work

  18. TASK • Dilemmas/scenarios

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