Medical Ethics and Professionalism
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Questions and Answers

Medical professionalism does not vary across time periods.

False

The Oath of Hippocrates emphasizes patient benefit as a key principle.

True

Resilience is one of the learning objectives of the lecture.

True

All students must complete the Academic Integrity Course even if they have done it previously.

<p>True</p> Signup and view all the answers

Thomas Percival wrote about medical ethics during the Industrial Revolution.

<p>True</p> Signup and view all the answers

There were no personal causes leading to the closure of the fever ward in 1791.

<p>False</p> Signup and view all the answers

Students are required to save their certificate of completion in their laptop.

<p>True</p> Signup and view all the answers

The RCSI Professional Code of Conduct is irrelevant for students.

<p>False</p> Signup and view all the answers

Disruptive behavior can compromise patient safety.

<p>True</p> Signup and view all the answers

Medical error is one of the leading causes of death in the USA.

<p>True</p> Signup and view all the answers

The Bristol Royal Infirmary experienced low death rates after cardiac surgery in the 1990s.

<p>False</p> Signup and view all the answers

A lack of leadership was identified as a contributing factor in the Bristol Inquiry.

<p>True</p> Signup and view all the answers

Unprofessional behavior has no impact on the quality of care.

<p>False</p> Signup and view all the answers

There were approximately 12,000 studies included in the systematic review on unprofessional behavior.

<p>True</p> Signup and view all the answers

The Bristol inquiry found that there was adequate monitoring by management.

<p>False</p> Signup and view all the answers

An old boys' culture among doctors was mentioned in the findings of the Bristol inquiry.

<p>True</p> Signup and view all the answers

Robert K Merton is credited with the term 'Role Model'.

<p>True</p> Signup and view all the answers

A Community of Practice refers to a temporary gathering of unrelated individuals.

<p>False</p> Signup and view all the answers

Clinical Learning Environment only includes physical spaces.

<p>False</p> Signup and view all the answers

The Oath and White Coat Ceremony symbolizes the transition from student to healthcare professional.

<p>True</p> Signup and view all the answers

Learning in a clinical context is considered secondary to the role of healthcare systems.

<p>False</p> Signup and view all the answers

Merton hypothesized that individuals do not compare themselves with reference groups.

<p>False</p> Signup and view all the answers

An effective and supportive Clinical Learning Environment contributes to patient care quality.

<p>True</p> Signup and view all the answers

The RCSI White Coat Ceremony was conducted in person during the Covid-19 Pandemic.

<p>False</p> Signup and view all the answers

Caring is one of the main elements of good practice.

<p>True</p> Signup and view all the answers

Confidentiality is not a pillar of professionalism.

<p>False</p> Signup and view all the answers

Competence is required for performance in medical practice.

<p>True</p> Signup and view all the answers

Integrity is one of the 3 pillars of professionalism.

<p>True</p> Signup and view all the answers

Teaching and training medical students is part of performance.

<p>True</p> Signup and view all the answers

Medical professionalism includes values, behaviours, and attitudes that harm public trust.

<p>False</p> Signup and view all the answers

Personal and Professional Identity (PPId) is unrelated to professional identity formation.

<p>False</p> Signup and view all the answers

Professional identity formation leads to thinking and acting like a physician.

<p>True</p> Signup and view all the answers

The University can escalate to a Level 3 response if there is a significant risk to a student's well-being.

<p>True</p> Signup and view all the answers

Medical professionalism has remained static over the years.

<p>False</p> Signup and view all the answers

Resilience is described as one of the learning objectives of the talk.

<p>True</p> Signup and view all the answers

Professional Identity Formation is not discussed in the talk's conclusions.

<p>False</p> Signup and view all the answers

The RCSI Professional Code of Conduct is important for medical students.

<p>True</p> Signup and view all the answers

The relationship between Personal and Professional Identity is excluded from the discussion.

<p>False</p> Signup and view all the answers

The Medical Leadership Competency Framework is irrelevant to medical professionals.

<p>False</p> Signup and view all the answers

The document includes references to external publications regarding medical professionalism.

<p>True</p> Signup and view all the answers

Thomas Percival's Medical Jurisprudence was published in 1803.

<p>True</p> Signup and view all the answers

Beneficence refers to actions aimed at harmful consequences.

<p>False</p> Signup and view all the answers

Kant argued that individuals have no duty to be beneficent.

<p>False</p> Signup and view all the answers

Exceptional beneficence is categorized as obligatory actions.

<p>False</p> Signup and view all the answers

The normative science of ethics judges human conduct as either right or wrong.

<p>True</p> Signup and view all the answers

David Hume's moral-sentiment theory states that benevolence is a secondary principle of human nature.

<p>False</p> Signup and view all the answers

Medical Ethics includes principles related to hospital and general practice.

<p>True</p> Signup and view all the answers

The appendix of Thomas Percival's work includes a discourse on hospital duties.

<p>True</p> Signup and view all the answers

Disruptive behaviors in healthcare settings can increase the likelihood of medical errors.

<p>True</p> Signup and view all the answers

Sexual orientation is not considered a protected ground against discrimination.

<p>False</p> Signup and view all the answers

Only aggressive behaviors are considered disruptive in a healthcare environment.

<p>False</p> Signup and view all the answers

It's legal to discriminate against individuals based on their family status.

<p>False</p> Signup and view all the answers

Intimidating behaviors are often reported and addressed promptly in healthcare settings.

<p>False</p> Signup and view all the answers

77% of surveyed participants reported witnessing disruptive behaviour by nurses.

<p>False</p> Signup and view all the answers

Disruptive behaviours in healthcare settings are believed to contribute to patient mortality.

<p>True</p> Signup and view all the answers

Only 2-4% of healthcare professionals regularly engage in disruptive behaviour.

<p>True</p> Signup and view all the answers

High-stress specialties such as surgery, obstetrics, and cardiology are least prone to disruptive behaviours.

<p>False</p> Signup and view all the answers

The Disruptive Behaviours Survey included 4530 participants from 200 hospitals in the USA.

<p>True</p> Signup and view all the answers

Administrative executives did not participate in the Disruptive Behaviours Survey.

<p>False</p> Signup and view all the answers

Disruptive behaviours were found to be rarely linked to medical errors according to participants.

<p>False</p> Signup and view all the answers

Verbal abuse of staff members was the most common form of disruptive behaviour reported.

<p>True</p> Signup and view all the answers

Robert K Merton is associated with the concept of 'Role Model' as a person whose behavior can be emulated by others.

<p>True</p> Signup and view all the answers

The Clinical Learning Environment is solely focused on physical spaces used for training.

<p>False</p> Signup and view all the answers

The Oath and White Coat Ceremony signifies the transition from healthcare professional to lay-student.

<p>False</p> Signup and view all the answers

A Community of Practice is defined as a temporary gathering of individuals with no shared interests.

<p>False</p> Signup and view all the answers

An effective Clinical Learning Environment is crucial to the quality of patient care.

<p>True</p> Signup and view all the answers

Merton hypothesized that individuals compare themselves with reference groups to which they do not aspire.

<p>False</p> Signup and view all the answers

Learning in a clinical context is considered less important than the work required by healthcare systems.

<p>False</p> Signup and view all the answers

The RCSI White Coat Ceremony was conducted virtually due to the Covid-19 Pandemic.

<p>True</p> Signup and view all the answers

Irish Medical Students are subject to the IMC Fitness to Practise processes.

<p>False</p> Signup and view all the answers

Developing professional competence is not a requirement according to the RCSI Code of Conduct.

<p>False</p> Signup and view all the answers

Maintaining professional knowledge is a key principle of the Code of Conduct.

<p>True</p> Signup and view all the answers

Students must demonstrate core required academic, clinical, and professional competencies to avoid a fitness to study review.

<p>True</p> Signup and view all the answers

RCSI's relevant policies may refer unprofessional behavior for further actions.

<p>True</p> Signup and view all the answers

Conducting oneself in a manner that enhances societal services is irrelevant for medical students.

<p>False</p> Signup and view all the answers

The RCSI Fitness to Study Policy does not define reasonable accommodations.

<p>False</p> Signup and view all the answers

The principles of the RCSI Code of Conduct can be disregarded if a student thinks they are not applicable.

<p>False</p> Signup and view all the answers

Disruptive behaviors among healthcare professionals are primarily observed in low-stress specialties like pediatrics and family medicine.

<p>False</p> Signup and view all the answers

The majority of healthcare professionals admit to engaging in disruptive behaviors regularly.

<p>False</p> Signup and view all the answers

77% of survey participants reported witnessing disruptive behaviors specifically exhibited by physicians.

<p>True</p> Signup and view all the answers

Verbal abuse of colleagues is an uncommon form of disruptive behavior in hospitals.

<p>False</p> Signup and view all the answers

A significant number of healthcare professionals believe disruptive behaviors are linked to medical errors.

<p>True</p> Signup and view all the answers

The Disruptive Behaviors Survey included only nurses and physicians as participants.

<p>False</p> Signup and view all the answers

65% of healthcare professionals reported witnessing disruptive behavior among nurses.

<p>True</p> Signup and view all the answers

There is no correlation between disruptive behaviors and patient mortality as per the findings of the survey.

<p>False</p> Signup and view all the answers

Integrity is defined as showing consistent and uncompromising adherence to flexible moral and ethical principles.

<p>False</p> Signup and view all the answers

Compassion implies a desire to relieve the suffering of others.

<p>True</p> Signup and view all the answers

Altruism is primarily focused on self-interest and personal gain.

<p>False</p> Signup and view all the answers

Unprofessionalism is defined as characteristic behaviors associated with a profession.

<p>False</p> Signup and view all the answers

Continuous improvement is one of the core values of medical professionalism.

<p>True</p> Signup and view all the answers

Egoism is considered a selfless concern for the well-being of others.

<p>False</p> Signup and view all the answers

Compassion is synonymous with pity that inclines one to spare or to succour.

<p>True</p> Signup and view all the answers

Psychological altruism is focused on the goal of increasing one's own welfare.

<p>False</p> Signup and view all the answers

Resilience is defined as the capacity to apply knowledge and skills to deal positively with adversity.

<p>True</p> Signup and view all the answers

The Penn Resilience Programme is a treatment programme aimed at addressing mental health issues.

<p>False</p> Signup and view all the answers

Self-efficacy is a cognitive process that contributes to emotional competence.

<p>True</p> Signup and view all the answers

The PRP curriculum includes teaching ten key skills to develop resilience.

<p>False</p> Signup and view all the answers

Training provided under the collaboration with UPenn is delivered in large lecture formats.

<p>False</p> Signup and view all the answers

Students exhibiting unprofessional behavior are less likely to face disciplinary action.

<p>False</p> Signup and view all the answers

Plato's Allegory of the Cave suggests that sensory knowledge is equivalent to true knowledge.

<p>False</p> Signup and view all the answers

The systematic review identified 30 different descriptors of unprofessional behaviours.

<p>True</p> Signup and view all the answers

The concept of 'poor self-awareness' was noted as one of the themes of unprofessional behavior.

<p>True</p> Signup and view all the answers

Apathy and poor initiative were correlated with a heightened level of improvement.

<p>False</p> Signup and view all the answers

There were 205 descriptors of unprofessional behaviour categorized into five themes.

<p>False</p> Signup and view all the answers

Knowledge gained through philosophical reasoning is considered less valuable than sensory knowledge in Plato's theory.

<p>False</p> Signup and view all the answers

The Allegory of the Cave illustrates the limitations of human perception.

<p>True</p> Signup and view all the answers

The skill of thinking traps is covered in a 90-minute session during Year 1.

<p>False</p> Signup and view all the answers

Resilience is emphasized as a key factor in the Medical Leadership Competency Framework.

<p>False</p> Signup and view all the answers

Katie Piper suggests that individuals can control their narrative by transforming negative experiences.

<p>True</p> Signup and view all the answers

The reflection process known as 'What? So what? Now what?' is used to enhance future practice.

<p>True</p> Signup and view all the answers

Strong followership allows leaders to emerge during shared leadership in healthcare.

<p>True</p> Signup and view all the answers

The Medical Leadership Competency Framework prioritizes provider priorities over patient-centered values.

<p>False</p> Signup and view all the answers

A cognitive process that helps in coping with future situations is known as critical reflection.

<p>True</p> Signup and view all the answers

The introduction to resilience and well-being takes place in a 120-minute session.

<p>False</p> Signup and view all the answers

Study Notes

Ancient Origins of Professionalism

  • The Oath of Hippocrates, written in ancient Greece, outlines ethical principles for physicians.
  • It emphasises patient benefit, confidentiality, and consequences for violating ethical conduct.

Professionalism in the Modern Era

  • Thomas Percival's "Medical Ethics" was written in 1789 during a typhus epidemic in Manchester, highlighting the importance of professionalism in managing public health crises.
  • Unprofessional behaviour can undermine patient safety.
  • A national survey (US) in 2008 found that disruptive behaviour in healthcare settings led to compromised patient safety and quality of care.
  • Medical error is considered the third leading cause of death in the United States (2016).
  • The Bristol Heart Scandal (1990s) involved high death rates in children following heart surgery at Bristol Royal Infirmary. An inquiry revealed staff shortages, lack of leadership, an "old boy’s culture" among doctors, and a lax approach to safety. The inquiry found the medical profession failed at self-regulation.

Systematic Review of Unprofessional Behaviour

  • A systematic review of 11,963 studies found 46 that met inclusion criteria, suggesting unprofessional behaviour is a significant issue in healthcare.

Role Models

  • Sociologist Robert K Merton coined the term "role model" to describe individuals whose behavior, example, or success is emulated by others.
  • Merton hypothesized that individuals compare themselves to groups they aspire to be a part of.

Clinical Learning Environment

  • The Macy Foundation (2018) defines a clinical learning environment (CLE) as a combination of social interactions, organizational cultures, structures, and physical and virtual spaces.
  • Effective CLEs balance the needs for learning and work in healthcare systems, ensuring the quality and safety of patient care, promoting the well-being of medical professionals, and supporting trainee learning.

The Oath and White Coat Ceremony

  • RCSI's Oath and White Coat Ceremony symbolizes the transition for medical, pharmacy, and physiotherapy students from layperson to healthcare professional in training.
  • The ceremony was conducted virtually during the Covid-19 pandemic.

Community of Practice

  • A community of practice is a social network where individuals share and develop overlapping knowledge, beliefs, values, history, and experiences around a common practice.
  • Caring, confidentiality, promoting patient safety, integrity, self-care, practice management, use of resources, and conflicts of interest are all elements of good practice.

Irish Medical Council Definition of Professionalism

  • The Irish Medical Council defines professionalism as encompassing partnership, practice, and performance.
  • Performance involves behaviours and processes that underpin good care, requiring competence, reflective practice, and acting as role models, including teaching and training.

Medical Professionalism at RCSI

  • RCSI defines medical professionalism as values, behaviours, and attitudes that promote professional relationships, public trust, and patient safety.

Personal and Professional Identity (PPId)

  • Professional Identity Formation is the process of internalising the characteristics, values, and norms of the medical profession, resulting in an individual thinking, acting, and feeling like a physician.

Conclusions

  • Medical professionalism is crucial in upholding ethical standards, maintaining public trust, and ensuring patient safety.
  • The RCSI Professional Code of Conduct is essential for students in their journey to becoming healthcare professionals.

Medical Ethics

  • Defined as: The science of judging human behaviour in societies as right or wrong, good or bad.
  • Key principles: Autonomy, Beneficence, Justice, Non-maleficence.

Beneficence

  • Actions or rules aimed at benefitting others.
  • Characterized by mercy, kindness, generosity, and charity.
  • David Hume's theory: Benevolence is the central principle of human nature.
  • John Stuart Mill's theory: "Greatest happiness" principle, right if it leads to beneficial consequences.
  • Kant's view: Duty to be beneficent.
  • Exceptional Beneficence: Beyond obligation, doing more than required.

Disruptive Behaviours

  • Adversely affect team functioning.
  • Linked to medical errors and patient mortality.
  • Examples: Sexual Harassment, Intimidation, Bullying, Rudeness, Criticism, Demanding, and Lateness.
  • Survey Findings: 77% of staff witnessed disruptive behaviour by physicians, 65% by nurses.
  • High-Stress Specialties: Surgery, Obstetrics, and Cardiology are most prone.
  • Overall Impact: Only 2–4% of healthcare professionals regularly engage in disruptive behaviour.

Role Models

  • Defined by Robert K Merton: A person whose behaviour, example, or success is emulated.
  • Merton's Hypothesis: Individuals compare themselves to those in their desired social roles.

Clinical Learning Environment

  • Defined by Macy Foundation: The social interactions, organizational cultures, and physical spaces shaping learning experiences.
  • Balancing Learning and Work: Learning in a clinical context is foundational, Healthcare systems require learners for service.
  • Importance: Effective CLE promotes quality & safety of patient care, health & well-being of the medical workforce, and trainee learning.

Oath and White Coat Ceremony

  • RCSI Ceremony: Symbolizes the transition for medical, pharmacy, and physiotherapy students from "lay-student" to "healthcare professional in training".
  • Ceremony during Covid-19: Conducted virtually.

Community of Practice

  • Defined: A persistent social network where individuals share and develop knowledge, beliefs, values, and experiences focused on a common practice.

IMC Guidelines for Medical Schools

  • Ethical Standards and Appropriate Behaviour: Set for Irish Medical Students.
  • Discipline: University Medical School handles student disciplinary procedures.
  • IMC Fitness to Practise: Not applicable to students.

RCSI Code of Conduct

  • Six Core Principles:
    • Prioritize patient health, well-being, care, and safety.
    • Develop professional competence and bring health gain to society.
    • Be honest, trustworthy, and respectful of others.
    • Conduct yourself in a manner that enhances service and maintains professional reputation.
    • Maintain professional knowledge and competence.
    • Be aware of Code of Conduct obligations and avoid breaches.
  • Breach Handling: Behaviour failing to meet standards may be referred according to RCSI policies and regulations.

RCSI Fitness to Study Policy

  • Concerns: Students receiving reasonable accommodation but failing to demonstrate required competencies or refusing supports may be referred for a review.

Medical Professionalism

  • Medical Professionalism: a set of values, behaviors, and relationships that underpin public trust in doctors. It embodies the core principles of Integrity, Compassion, Altruism, Continuous Improvement, Excellence, and Working in Partnership.

Integrity

  • Defined as being honest and showing consistent adherence to strong moral and ethical principles.
  • Doing the right thing, even when no one is looking, even when it comes at a personal cost.

Compassion

  • The feeling or emotion of being moved by the suffering or distress of another, leading to a desire for relief.
  • Characterized by fellow-feeling, sympathy, pity, and taking pity.

Altruism

  • A disinterested and selfless concern for the well-being of others.
  • Derived from the French word "autrui," meaning "other people."

Unprofessionalism

  • Not pertaining to the characteristics of a profession.
  • The Joint Commission, responsible for accrediting hospitals and government health insurance schemes in the USA, defines unprofessionalism as any behavior that does not adhere to the standards of a profession.

Disruptive Behaviors

  • A 2008 survey of 4530 healthcare professionals in 100 US hospitals found that 77% witnessed disruptive behavior by physicians and 65% witnessed it by nurses.
  • Most common disruptive behavior: verbal abuse of staff members.
  • High-stress specialties like surgery, obstetrics, and cardiology were most prone to disruptive behaviors.
  • Only 2-4% of healthcare professionals regularly engage in disruptive behavior.
  • Disruptive behavior is linked to adverse events and medical errors.
  • Disruptive behavior is linked to patient mortality.

Student Behaviours

  • Medical students exhibiting unprofessional behavior in medical school were three times more likely to undergo disciplinary action.
  • Key factors contributing to disciplinary action: severe irresponsibility and diminished capacity for improvement.
  • Apathy and poor initiative were also correlated with unprofessional behavior.

Resilience

  • Capacity to maintain well-being and work performance under pressure.
  • An Emotional Competence: can be translated into skills and behaviors acquired during training.
  • A Cognitive Process: encompasses four dimensions:
    • Self-efficacy: confidence in the ability to do something.
    • Planning.
    • Self-regulation: self-control.
    • Resilience: ability to bounce back from challenges.

RCSI Definition of Resilience

  • The capacity to apply knowledge and skills to deal positively with adversity.
  • The ability to learn and grow from challenging situations .

Penn Resilience Programme (PRP)

  • A skills program designed to support and enhance well-being.
  • Not a treatment program or a substitute for mental health support.
  • Draws on cognitive behavioral psychology and positive psychology.

PRP Content Overview

  • Focuses on teaching nine key skills for facilitating resilient responses to challenges:
    • Optimistic mindset.
    • Thinking traps.
    • Deliberate breathing.
    • Mental cues.
    • Real-time resilience.
    • Put it in perspective.
    • Positive emotions.
    • IDEAL (maintaining relationships during difficult conversations).
    • Active constructive responding.

PRP Content Delivery in THEP2

  • PRP shown to have maximum effect when sustained over time.
  • Year 1:
    • Module: Intro to Resilience & Well-Being (90 minutes).
    • Skill 1: Optimistic Mindset (120 minutes).
    • Skill 2: Thinking Traps (120 minutes).

The Importance of Resilience

  • Resilience is essential for staying positive and thriving in challenging situations.

Medical Leadership Competency Framework

  • Developed by the Academy of Medical Royal Colleges & NHS Institute for Innovation and Improvement for use in medical curricula.
  • Essential Leadership Competencies for Doctors:
    • Shared Leadership.
    • "Followership": participation allows others to lead.
    • Strong Values: patient-centered, not provider priorities.

Reflective Practice: Core Skill in PPId Assessment

  • A cognitive process that helps gain insights, rethink practice, learn from experiences, and cope with similar situations in the future.
  • "What? So what? Now what?" is a framework for reflective practice.

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Description

Explore the historical and modern perspectives on medical professionalism, beginning with the Oath of Hippocrates and extending to contemporary issues in healthcare. This quiz examines significant events and principles that emphasize the critical nature of ethical conduct in medicine and its impact on patient safety.

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