A cross‐cultural study of students’ approaches to professional dilemmas: sticks or ripples

Ho, Ming‐Jung; Lin, Chi‐Wei; Chiu, Yu‐Ting; Lingard, Lorelei; Ginsburg, Shiphra

doi:10.1111/j.1365-2923.2011.04149.x

Cited by 50 publications

(59 citation statements)

References 26 publications

(34 reference statements)

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“…In addition, Ho et al ( , 2012 reported that while Western frameworks dichotomized physicians' professional and personal lives, Taiwanese stakeholders were influenced by Confucian cultural traditions toward harmonizing these roles. These divergent perspectives called for further studies beyond the Western frameworks.…”

Section: Practice Pointsmentioning

confidence: 99%

Building a professionalism framework for healthcare providers in China: A nominal group technique study

et al. 2013

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Background: Medical professionalism is valued globally. However, Western frameworks of medical professionalism may not resonate with the cultural values of non-Western countries. Aims: This study aims to formulate a professionalism framework for healthcare providers at Peking Union Medical College (PUMC) in China. Methods: This study was conducted using nominal group technique (NGT) in a convenient sample of 97 participants at PUMC in November and December, 2011. Participants were sorted into 13 occupational groups, each discussing and ranking categories of medical professionalism. The authors compared the results of each group's ranked categories and analyzed meeting transcripts. Results: A pre-existing framework provided eight categories: clinical competence, communication, ethics, humanism, excellence, accountability, altruism, and integrity. Participants created four categories: teamwork, self-management, health promotion, and economic considerations. Clinical competence and communication ranked highly among most groups. Only hospital volunteers and resident physicians included self-management in their top-ranked items. Only public health experts prioritized health promotion. Standardized patients were unique in mentioning ''economic considerations.'' Medical students and attending physicians both referenced Chinese traditional values. Conclusions: Our study was able to document effects of East Asian cultural influences and conflicts between Western ideologies and Asian traditions that led to divergent interpretations of medical professionalism.

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Section: Practice Pointsmentioning

confidence: 99%

Building a professionalism framework for healthcare providers in China: A nominal group technique study

et al. 2013

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“…[30][31][32] However, behavior is underpinned by complex, "hidden" variables, including an individual's attitudes and social norms. 33 Examining hidden determinants of professionalism, such as context, 34,35 interpersonal relationships, social norms, and local cultures, [36][37][38] then allows us to develop a richer understanding of unprofessional behavior. 29,36 Given this, there is a need for a theoretically driven framework to facilitate decision making among staff involved in FTP procedures.…”

Section: 29mentioning

confidence: 99%

“…It contextualizes behavior, accounting for factors such as cultural influences 36,37 and medical school environments (i.e., the hidden curriculum 49,50 ). For example, student C behaved inappropriately in a different cultural context; while this may not mitigate his misconduct, it needs to be acknowledged as a determinant of this lapse in professionalism.…”

Section: Strengths Of the Tpbmentioning

confidence: 99%

A Framework for Understanding Lapses in Professionalism Among Medical Students: Applying the Theory of Planned Behavior to Fitness to Practice Cases

2016

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Fitness to practice decisions are often based on a student's digression from the regulations, with limited exploration of the reasoning behind the student's behavior. However, behavior is underpinned by complex, "hidden" variables, including an individual's attitudes and social norms. Examining hidden determinants of professionalism, such as context, interpersonal relationships, social norms, and local cultures, then allows medical educators to develop a richer understanding of unprofessional behavior.In this article, the authors propose the use of the theory of planned behavior (TPB) as a framework to help evaluate unprofessional behavior in students. The TPB is a deliberative processing model that explains how an individual's behavior is underpinned by his or her cognitions, with behavior being primarily dependent on the intention to perform the behavior (behavioral intention). Intention, in turn, is determined by three variables: attitude, subjective norm, and perceived behavioral control.To understand the practical use of the TPB, the authors present four complex, anonymized case studies in which they employed the TPB to help deal with serious professionalism lapses among medical students. The outcomes of these cases as well as the student and program director perspectives, all explained via the TPB variables, are presented. The strengths and limitations of the TBP are discussed. 4Internationally, regulatory bodies dictate that graduating medical students' outcomes move beyond acquisition of knowledge and skills to include appropriate professional attitudes and behaviors, 1-5 requiring students not just to behave professionally but also to become professional. [6][7][8] The importance of recognizing lapses in professionalism early is borne out by studies showing unprofessional behavior by medical students predicts subsequent misconduct. 9-13 Consequently, teaching and assessing professionalism is gaining momentum globally, 14-17 with approaches varying among nations from consensus statements (e.g., UnitedStates and Canada) 5,18 to medical student licensure (e.g., Australia When a student's fitness to practice (FTP) is called into question, educators undertake a complex decision-making process: collecting evidence, evaluating the nature and severity of the misconduct, and deciding whether to refer the student to an FTP panel. FTP panels make decisions based on the evidence, with students who are in breach of professional behavior being subject to sanctions ranging from formal warnings to expulsion from the program.Often these decisions are based on the student's digression from the regulations, with limited exploration of the reasoning behind the student's behavior. [30][31][32] However, behavior is underpinned by complex, "hidden" variables, including an individual's attitudes and social norms. 33 Examining hidden determinants of professionalism, such as context, 34,35 interpersonal relationships, social norms, and local cultures, 36-38 then allows us to develop a richer understanding of unprofession...

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“…5,6 For example, research in Taiwan found that Confucian values influenced the conception of professionalism in that nation. 7,8 Other studies have revealed differing values of professionalism not present in the Western framework. For example, physicians in Japan perceive a professional obligation to accept responsibility for a subordinate's mistake, 9 and physicians in Saudi Arabia conceptualize physician autonomy as part of professionalism.…”

Section: Introductionmentioning

confidence: 99%

Contextualizing the Physician Charter on Professionalism in Qatar: From Patient Autonomy to Family Autonomy

Al‐Khal

Tekian

et al. 2016

Journal of Graduate Medical Education

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A cross‐cultural study of students’ approaches to professional dilemmas: sticks or ripples

Cited by 50 publications

References 26 publications

Building a professionalism framework for healthcare providers in China: A nominal group technique study

Building a professionalism framework for healthcare providers in China: A nominal group technique study

A Framework for Understanding Lapses in Professionalism Among Medical Students: Applying the Theory of Planned Behavior to Fitness to Practice Cases

Contextualizing the Physician Charter on Professionalism in Qatar: From Patient Autonomy to Family Autonomy

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