Acquiring the values of medical professionalism has become a critical issue in medical education (Hendelman & Byszewski, 2016). Stern (2006) states that as health professionals we are to illustrate these values of medical professionalism by aiming to demonstrate principles of excellence, accountability altruism, caring, respect, ethics and communication. I by all means tried to work hand in hand with other health disciplines with the aim of achieving optimal health and wellness in the individuals I had been treating over the past year at all selected clinical placements. I did this in preparation for next year when I’m no longer a student and actually have to take initiative to include other disciplines and work as a multidisciplinary team. A lot of the clinical experience this year was to adequately prepare me for the kind of professional I aspire to be next year and the years to follow.
The experiences of this year have brought to my attention that evaluation of professionalism is a component of clinical competence and this has helped me to adequately evaluate my conduct in the clinical setting (Hendelman & Byszewski, 2016). It has helped me to critically evaluate myself. Ultimately how I evaluated myself was the line between whether I bettered myself or whether I stagnated because I didn’t feel a need for improvement, because I felt I was competent enough. However I knew that I was not entirely competent enough, and that was not even a problem for me as I was in still in the process of learning and bettering myself. Furthermore, if there was one attribute I upheld throughout the year it’s that of professionalism. The way in which I had conducted myself throughout the year more especially towards the end of this year reflected tramendous professional growth. The manner in which I addressed my patients and even authorities whether they were in the right or wrong reflected my maturity over the year.
Even in morally and ethically compromising situations I managed to remain professional and uphold the morals and values that define me. I always asked myself what I would be achieving by being unprofessional anyway. My unprofessionalism in the clinical setting would have only been a reflection of my character and that was not the type of character I wanted to build upon. I refused to be a sponge to unethical and unmoral behaviour.
You may ask what professionalism is. Well “Professionalism aspires to altruism, accountability, excellence, duty, service, honour, integrity and respect for others” (Stern 2006). However regardless of the above mentioned traits of professionalism I have seen how abuse of power, arrogance, greed, misrepresentation, impairment, lack of conscientiousness, and conflict of interest in the clinical setting has challenged or diminish the previously identified elements of professionalism. It is the above mentioned that challenged me to be a better student and more importantly a health professional, not for my supervisors or clinicians but for me and for my personal growth. I challenged myself for the future, the physiotherapist I aspire to be and refused to conform to the behaviours which tarnished my professionalism.
As a young health professional-in-training I faced arduous tasks this past year. Knowledge had to be be absorbed, and skills had be mastered. Becoming a young physiotherapist is a moral as well as an intellectual task (Press 1998). In this year I realised that the attitudes and values that I as a young health professional adopted determined the way I practice in the future. I had to quickly realize that I have become a young adult in training and that although I was and still am a student in a few months I will be a qualified physiotherapist. Is that not what the ethics module is preparing us for? How to act in the workplace as responsible professional adults? My biggest goal was to maintain a firm image of myself and self-awareness of my values and inner feelings .
Within virtually every critical incident this year there was a moral or ethical issue, which generally occurred in the context that encouraged my professional development. Ethics deals with right and wrong conduct, what we ought to do and what we should refrain from doing (“Basic Concepts in Medical Ethics”, 2016). In my previous post regarding basic principals of ethics i reflected on how all i could think about was my marks. I never really put my patients first. It was all about how their condition and their conduct could help me get a good mark or even just help me pass. That waas extremely unethical of me. I definitly do not possess all the characteristics of a professional but as compared to previous years i definitly strived to be better than i was then.
I found myself in so many compromising situations this, however one of them still vividly replays in my mind. I was torn between doing what is right and sweeping the situation under the carpet and just treat my patient and move on. I was treating a young girl who had been in a motor vehicle accident. In treating her I found out she had been sexually abused by the man she called her father. I witnessed him kiss her inappropriately and I just stood there and didn’t know what to do. That split second determined whether I would walk away and pretend I saw nothing or whether I would look into the situation. I needed to be very sensitive and I was, sensitive and cautious as to how I went about this situation. I contacted the social worker and explained the situation to her I told her that if the dad came again we would stand at a distance and watch his behaviour. To our surprise the dad walked in hours before visiting hours and we stood at a distance and watched. The social worker could not stand what she was seeing and politely approached the father as I stood at a distant. She politely asked him to please leave the ward as it was not visiting hours yet, she then told me she will follow up the story. This incident was just too close to home, she was a young lady like myself. Also i knew what it is like being a young lady and not having a voice to speak out for you and protect you. I knew what it was like not having the one man who is meant to protect you, protecting you. So i could not just stand and watch as this young girl silently go through such torment. I had to be her voice. I was very proud of how professionally and maturely I handled the situation. These are the kinds of qualities I aspire to uphold as I venture on into the “big bad world” as some call it.
Becoming a young health professional in many ways involved building a professional identity. It was also just about finding the best ways of interacting with my patients. These include various degrees of empathy or detachment, willingness to listen or not, wanting to hear patients’ perspectives, and so forth. My only concern and fear was the possibility that I will create narrow professional identities that leave out much of what we call “humanism” (Hendelman & Byszewski, 2016). I put in constant effort throughout the year to keep alive core values, validate their importance, and learn to incorporate these into professional work. This enabled me to include my natural warmth, empathy and understanding in my professional identity.
Besides just my clinical encounters and experiences I personally feel the ethics module has paid sufficient attention to my development of professional standards and to the immediate ethical dilemmas that I as students face. (Branch, 2000). I was able to reflect throughout the year on my experiences and challenges. It also enabled me the opportunity to learn about my fellow classmate’s challenges and experiences. Reflecting on my experiences throughout the year has helped point out weakness I could work on such as time management, properly planning patient setting improving on soap notes and constantly expanding my knowledge on conditions I knew very little on. I learnt that is so much I don’t know and so much learning I still need to do. I also learnt that this learning process will be a life long journey. There are so many ways of treating different kinds of patients and this year has definitely taught me that I should not be rigid in my ways
I have acquired and learnt many things over the past year in the clinical setting. In fact my learning started two years ago when I started clinical practice in my third year. All the encounters, challenging and memorable had left me with something I was able to carry throughout this process of learning.
I learnt that to practice as a healthcare professionals, I would need to understand the basic principles of ethics. These entail the simple acts which include, autonomy to honour the patient’s right to make their own decision. Beneficence which is to help the patient advance his/her own good. Non-maleficence: the moral principle that one should refrain from harming others. Justice which entails being fair and treating like cases alike. Fairness and truthfulness (“Vermont Ethics Network”, 2011). So I made a conscious decision to adequately inform myself about these principles as they would ultimately help me in my way forward, and it sure did help me knowing the what ethics is and what it means to me and how this knowledge would impact my practices as a future qualified physiotherapist.
Ethical decisions are not universal, they depend on many different outliers. Society, culture, media, and unpleasing circumstances can be a large determinate of ethical and moral values. The countless formative experiences I’ve encountered have shaped the ethical and moral values I uphold in the clinical setting towards both staff and patients.
I believe that good clinical practice cannot be separated from professional and ethical behaviour that depends on moral maturity (Branch, 2000).
My greatest highlight in this year was that of growth. Growth in all aspects of my clinical journey. The realisation that I still have so much to learn and the willing to learn took me by surprise. I took all kinds of criticism with my hands wide open constructive and destructive but it was mostly constructive criticism. I am still just a student however also a young adult and in a few months I’m going to be thrown in the deep end. The kind of deep end that would need me to be smart and cautious about the decisions I make. This year has been a real stepping stone for me. A step in the right direction.
In closing I quote “Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, talented, fabulous? Actually, who are you not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that other people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory of God that is within us. It’s not just in some of us; it’s in everyone. And as we let our own light shine, we unconsciously give other people permission to do the same. As we are liberated from our own fear, our presence automatically liberates others.” (Shirley Kaiser, 1992).
The following a short and sweet vidoe on professionalism have a look:
Basic Concepts in Medical Ethics. (2016). Med.uottawa.ca. Retrieved 5 August 2016, from http://www.med.uottawa.ca/sim/data/Ethics_e.htm
Branch, W. (2000). Supporting the moral development of medical students. Journal of General Internal Medicine. Retrieved 6 November 2016, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495481/
Hendelman, W. & Byszewski, A. (2016). Formation of medical student professional identity: categorizing lapses of professionalism, and the learning environment. BioMed Central. Retrieved 6 November 2016, from http://bmcmededuc.biomedcentral.com/articles/10.1186/1472-6920-14-139
J, B. (1991). Medical students’ professional ethics: defining the problems and developing resources. – PubMed – NCBI. Ncbi.nlm.nih.gov. Retrieved 6 November 2016, from https://www.ncbi.nlm.nih.gov/pubmed/1750947
Press, B. (1998). “Professional and Moral Development in Medical Students: The Ethics of Caring for Patients” by William T. Branch, Jr. Md, MACP. Works.bepress.com. Retrieved 6 November 2016, from https://works.bepress.com/william_t_branch_jr/14/
Shirley Kaiser, S. (1992). Our Deepest Fear is not that we are inadequate, by Marianne Williamson, Nelson Mandela incorrectly. A Return To Love: Reflections on the Principles of A Course in Miracles, Quotes – Inspirational, Motivational, Spiritual, Religious, Philosophical Quotations, Quotes, Spirituality and Alternative Healing Articles, Alternative Medicine, Health, Internet Resources, SKDesigns. Skdesigns.com. Retrieved 7 November 2016, from http://skdesigns.com/internet/articles/quotes/williamson/our_deepest_fear/
Stern, D.T. (2006). Measuring Medical Professionalism. Oxford University Press. New York, NY.
Vermont Ethics Network. (2011). Vtethicsnetwork.org. Retrieved 5 August 2016, from http://www.vtethicsnetwork.org/ethics.html