Educational Solutions for Workforce Development Professionalism and Revalidation Day release 3/11/09

Educational Solutions for Workforce Development

Perspectives “Professional men they have no cares; whatever happens they get theirs” Ogden Nash “All professions are conspiracies against the laity” George Bernard Shaw Pearly gates

Educational Solutions for Workforce Development TASK! Professionalism: what do you understand by it? List & describe attributes or qualities which make up professionalism Come up with a definition of professionalism What do you think the public understands by professionalism?

Educational Solutions for Workforce Development Professionalism-what is it? Medical professionalism signifies a set of values, behaviours, and relationships that underpins the trust the public has in doctors Medicine is a vocation in which a Dr’s knowledge, clinical skills, and judgement, are put in the service of protecting and restoring human well-being. This purpose is realised through a partnership between patient & Dr, one based on mutual respect, individual responsibility,& appropriate accountability Royal College of Physicians 2005

Educational Solutions for Workforce Development In their practice, Drs are committed to: Integrity Compassion Altruism Continuous improvement Excellence Working in partnership with members of the wider healthcare team RCP 2005

Educational Solutions for Workforce Development What’s in a word? Professional: Opposite of amateur-paid Military-ruthless efficiency Hitman-as above Sport-”professional” foul

Educational Solutions for Workforce Development Hippocrates “father of medicine” Practised around 420BC Closed societies on island of Cos-medicine competed Oath contains elements of the Dr as an altruistic healer Also reinforces idea of the closed shop-mysteries of health only to be known by the privileged few

Educational Solutions for Workforce Development North America Defines professionalism in education & practice Since 1999 all specialist training has incorporated professionalism as a core competency

Educational Solutions for Workforce Development NHS report by the National Clinical Assessment Service 2009 Professionalism is comprised of 6 domains: Competency; encompassing knowledge, skills & ethics, & their application in practice Personal relationships; communication, teamworking Professional boundaries; awareness, conflicting roles, friends Consistency & reliability of practice; mistakes (no. or judgement) Reflection & learning; for the Dr & delegated tasks Commitment to service; private behaviour, personal beliefs

Educational Solutions for Workforce Development Ct “In conclusion, professionalism is more than being competent & must cover all domains as well as leadership & integrity; it should be embedded in policy, standards & guidelines to ensure compliance. Managing perceived deficiencies in professionalism requires expertise, & a structured, transparent process, paying proper regard to the rights of all involved, who themselves should receive the support they need” NCAS 2009

Educational Solutions for Workforce Development Professionalism under threat Due to: Incidents-Bristol, Shipman Expectations-public, government, new developments Demand-politics, population changes, innovations Managerial control-strategies, targets, budgets Teamworking-loss of control, appropriate delegation Legislation-working hours, equality & diversity

Educational Solutions for Workforce Development

Licensure A regulative bargain whereby: “Society grants the profession autonomy in return for the profession guaranteeing standards of care and safety” Because………… There is such an unusual degree of knowledge of skill that non professionals are not equipped to evaluate or regulate Professionals are responsible A profession will take regulatory action in cases of incompetent or unethical practice

Educational Solutions for Workforce Development So.. What do we expect of professionals Good at their day to day job (performance) Able to deal with rarer and more unusual facets (keeping up to date) Someone we can trust (the right sort of person) “An individual who acts on behalf of another in situations of complexity and uncertainty”

Educational Solutions for Workforce Development Can it be measured? Day to day work – GPs diagnose and manage. (audit, SEA) Deal with rare but important – knowledge test / CPD Can be trusted - views of patients / colleagues / complaints

Educational Solutions for Workforce Development For what purpose? To attest those on the Specialty Register have the knowledge, skills and behaviours required of their discipline To encourage excellence / CQI To determine when targeted help is needed To build public confidence in the system

Educational Solutions for Workforce Development Assessment of professionalism Students moral reasoning Not measured=not valued Context Include conflict Resolve dilemmas-rarely black & white Formative/summative Multiple raters/triangulation: clinical competence/communication skills/ethical & legal understanding as foundation. Excellence/humanism/accountability/altruism as pillars. All leading to professionalism

Educational Solutions for Workforce Development Darzi (NHS next stage review) Over regulation can damage morale Dismiss regulation as an organising principle Replace regulation with quality, as defined by clinical effectiveness, patient safety & patient experience Devolve power to regions Use professionalism as a lever to raise standards Reduce professional boundaries Innovation & research Leadership development to make the NHS work

Educational Solutions for Workforce Development TASK Dilemmas/scenarios