Professionalism in Context: Insights From the United Arab Emirates and Beyond

Ming-Jung Ho; Mohamed Al-Eraky

摘要

Over the past decades, professionalism education has become a key competency in the medical education continuum. The rising focus on professionalism has been paralleled by an increasing interest in competency-based medical education in graduate medical education globally. However, as professionalism reflects a contract between the medical profession and society, the definition of professionalism in globally accepted competency frameworks developed in Anglo-Saxon contexts may not reflect the societal expectations of other cultures. In this issue of the Journal of Graduate Medical Education, Abdel-Razig and colleagues1 reported a qualitative study to develop a locally derived consensus definition of medical professionalism for the United Arab Emirates (UAE). They used an innovative combination of methods, including world café, nominal group technique, the Delphi method, and interpretive thematic analysis. The main finding was that 9 professionalism attributes derived from their consensus definition overlapped considerably with known Western definitions. However, 3 important differences were noted: (1) the primacy of social justice; (2) the role of personal faith in guiding professional practices; and (3) the extension of professional attributes to personal life. While the study of Abdel-Razig et al1 is limited by the small number of participants, it invites us to consider professionalism beyond Arab cultural contexts. The study concludes that the definitions of professionalism and the contract between the society and the profession made up of expectations and obligations between both parties should be relevant to local, social, and cultural contexts.2 For decades, Western models2 have been adopted as the benchmark for conceptualizing professionalism globally. Yet the study by Abdel-Razig and colleagues1 serves as an important reminder that these models may not be applicable to non-Western cultures. For instance, the third attribute not found in Western frameworks (the extension of professional attributes to personal life) resonates well with the traditional role of Arab physicians, as they are expected to act as community leaders, not only as health providers. Studies of stakeholders' expectations of professionalism from Taiwan and China that report the influence of Confucian values also support the argument that, when it comes to the definition of professionalism, one size does not fit all.3 Furthermore, although some elements of professionalism are informed by universal humanistic values, interpretations vary across cultures. For instance, an aspect of humanism is respect for patients. However, different interpretations of these values are evident in aspects of medical practice, such as varying physician-patient relationships. For example, in Western models the interpretation of respect emphasizes patient autonomy, in which patients make their own medical decisions. In contrast, paternalistic models convey respect to patients by entrusting physicians to make decisions, as professionals, on behalf of patients. For instance, Arab physicians are perceived as “masters” who are supposed to know and decide what is best for their patients; they are perceived to lack confidence if they express diagnostic uncertainty.4,5 This paternalistic model of patient care is not exclusive to the Arabian context, and is also reported in studies from Pakistan,6 Ughanda,7 Malaysia, and India.8 These models are based on different interpretations of humanism, specifically respect toward patients, in comparison to models prioritizing patient autonomy. The study by Abdel-Razig et al1 invites us to pay attention to the roles of faith, values, and history in shaping professionalism in various cultures. Studies from Japan, Taiwan, and the Arab world support these roles. For instance, the 7 virtues of Bushido, a Japanese code of personal conduct originating from the ancient samurai warriors, have been used to interpret professionalism in Japan.9 In Taiwan a

机译：在过去的几十年中，专业教育已成为医学教育连续体的关键能力。在全球研究生医学教育的竞争力的医学教育日益增长的兴趣日益增长的兴趣，对专业精神的兴起已经平行。然而，由于专业精神反映了医学界和社会之间的合同，在盎格鲁 - 撒克逊语境中开发的全球公认能力框架的专业性的定义可能不会反映其他文化的社会期望。在这个问题上，在研究生医学教育杂志中，阿卜杜勒 - 拉齐格和同事造成了对阿拉伯联合酋长国（阿联酋）的医学专业职能的定义定义进行了定性研究。他们使用了一种创新的方法组合，包括世界咖啡馆，标称小组技术，Delphi方法和解释性专题分析。主要观点是，与已知的西方定义相比重复的共识定义，9个专业精神属性。但是，注意到了3个重要差异：（1）社会正义的首要地位; （2）个人信仰在指导专业实践方面的作用; （3）将专业属性的延伸到个人生活。虽然Abdel-Razig等人的研究受到少数参与者的限制，但它邀请我们考虑在阿拉伯文化环境之外的专业性。该研究的结论是，职业主义和社会之间的契约的定义和双方之间的期望和义务弥补了双方的期望和义务，应与当地，社会和文化背景有关.2数十年来，西方模式2已被通过作为基准为了在全球概念化专业性。然而，Abdel-Razig和同事的研究是一个重要提醒，这些模型可能不适用于非西方文化。例如，在西方框架中未发现的第三个属性（专业属性扩展到个人生活）与阿拉伯医生的传统作用很好地共鸣，因为它们有望充当社区领导者，不仅是卫生供应商。利益相关者对台湾职业主义的期望，报告儒家价值观的影响也支持这一论点，即涉及职业主义的定义，虽然有一些专业化的要素被告知通过普遍的人文价值观，解释各种各样的文化。例如，人文主义的一个方面是尊重患者。然而，在医疗实践方面，如不同的医生患者关系，这些价值观的不同解释是显而易见的。例如，在西方模型中，尊重的解释强调患者自治，其中患者做出自己的医学决策。相比之下，家长式模型通过委托医生向患者传达对患者的尊重，以代表患者作为专业人士做出决定。例如，阿拉伯医师被认为是“硕士”，应该知道并决定最适合他们的病人;如果他们表达诊断性不确定性，他们被认为是缺乏信心.4,5这种患者护理的家长式模型并不是阿拉伯背景，并在巴基斯坦，6乌鹤，7马来西亚和印度的研究中报道.8这些模型与优先考虑患者自主权的模型相比，基于对人文主义的不同解释，特别是对患者的尊重。 Abdel-Razig et al1的研究邀请我们注意信仰，价值观和历史在各种文化中塑造专业性的作用。日本，台湾和阿拉伯世界的研究支持这些角色。例如，Bushido的7美德是源自古代武士勇士武士的日本个人行为准则，已被用来解释日本的专业精神.9在台湾A

Professionalism in Context: Insights From the United Arab Emirates and Beyond

摘要

著录项

相似文献

相关主题

期刊订阅