I have found it hard to evaluate a construct as huge and overarching and yet also, nebulous, as 'professionalism.' Several organizations have outlined numerous constructs to be subsumed by the term 'professionalism.
- The Accreditation Council for Graduate Medical Education (ACGME) has identified Professionalism as a core competency for all residents. These specific competencies are expected: "Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:
- compassion, integrity, and respect for others;
- responsiveness to patient needs that supersedes self-interest;
- respect for patient privacy and autonomy;
- accountability to patients, society and the profession; and,
- sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.
- The Gold Humanism Foundation promotes the concept of a humanistic physician as ones who demonstrates integrity, excellence, compassion, altruism, respect, and service.
- The UTMB Professionalism Charter outlines a set of commitments expected of every employee: commitment to responsibility, service , diversity, competence, confidentiality, honesty, responsible use of resources improving access to education and health car, quality, maintaining appropriate relations, managing conflicts of interest, and knowledge.
It has been suggested that it is not sufficient to say "You'll know it when you see it and you'll know when it is absent." While considering this concept in the context of a residency program, I worked with a team that used a childrearing analogy to emphasize the value of specificity when talking about professionalism.
Niebuhr, Luk, Gonzalez, and Khilnani (2007) stated. "... we advise families to avoid telling children to "be good" and instead to state specific expectations. Similarly, we believe it is insufficient and ineffective to strive to "be professional" or to globally evaluate "professionalism." It is necessary to identify and define the component behaviors and attitudes of professionalism.
We use a prism analogy to note that, just diffuse light can be broken into component parts (i.e. a rainbow), so, too, professionalism can be broken into component parts.
The CHARACTER acronym can be used as a prism for breaking the construct into its component parts.
While I cannot very well observe, much less evaluate, 'professionalism,' I find I can much more easily observe, and evaluate, examples of the nine component parts listed here.
Take a moment now to reflect back on the past month, searching for behaviors in yourself and your colleagues and staff which are examples of the presence or absence of these nine constructs.
PAUSE TO REFLECT BEFORE PROCEEDING