29 Sep, 14 | by Toby Hillman
Professionalism is one of those peristent themes that run through medical education, and through the comments that are passed whenever there are concerns about clinical performance – be that the perceived clock watching engendered by the EWTD, or the failings at Mid Staffs.
Very often the term is used to highlight either a failing, or an upstanding quality in an individual and when I think of examples of high levels of professionalism, I tend to think of individuals and their reactions to particular situations, how they conduct themselves, or their dedication or discipline within the workplace – be that on the international sporting arena, at work, or in the headlines for other reasons.
What I hadn’t really considered (and perhaps this is a failing unique to me) is that professionalism is a team game. However, I am having my eyes opened to the concept of professionalism as more of an active team game. A paper published in the current PMJ discusses the results of an experimental series of 90 minute group discussions about professional matters in a safe environment or ‘legitimate space’ where talk of professionalism was deemed to be valid.
The paper is an exploration of the themes that the discussion groups generated over the course of 6 months, and their impact on the participants. Key findings the authors draw out of the data are that the ‘storying’ of experiences related to professionalism within a legitimate space may help to foster professionalism within organisations, that the act of discussing the nature of professionalism can encourage the development a form of professionalism that considers not just the individual, but the team, work, and culture of an organisation, and that simply having a group to focus on professionalism enables discussion and learning about the subject that simply isn’t possible the the normal routine of daily work.
The ideas that caught my imagination within this paper though, were those of professionalism being a collective practice. This may seem to be so obvious as to not warrant comment, but I think a little further consideration is due. There is an interesting tension within the common definition of professionalism as listed in dictionaries eg: “The competence or skill expected of a professional.” that is – the expectation of a standard of behaviour defined, or set by a group, but expected of the individual.
This paper highlights the success of the intervention to foster a feeling that professionalism can be more than just individual actions/conduct, but is a collective venture. Professionalism is one of those ideas that when a group comes together, and discusses it intently, can glow brightly like coals in a fire, but when the individuals are taken out of that context, it falls to the background as the slightly nebulous concept that characterises a certain approach to situations, and the glow fades a little. By bringing the implicit presence of professionalism into the legitimate space created by these groups, the concept of professionalism becomes more valid, and the trials and tribulations that everyone faces on a day to day basis can be used to learn lessons, share experiences and plan for the future.
The connections between individuals that are generated by this recognition of a professional basis to practice are could well hold the key to starting to change the cultures of organisations – the professionalism of one individual is a stimulant to professional behaviours and attitudes in others, and so the ripples continue ( I have blogged elsewhere on positive conversations in organisations.)
So what next – what will this do for me and my practice? I don’t necessarily have the resource and time to start up a series of group events to foster professionalism within my teams, but I have been reminded of my potential impact as a role model for junior members of my team, the positive and negative ripples that I can generate, the interconnectedness of modern medical practice, and the need to sometimes bring slightly hidden concepts of professionalism to the fore – as the main subject for discussion. With this, I hope I will be more effective in developing and fostering professionalism within my sphere of influence.