what does professionalism mean for trainers? ed... · 2011. 2. 10. · •the professionalism of...
TRANSCRIPT
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