Evaluating Physiciansʼ Professionalism and Humanism

Abstract

Physicians' professionalism and humanism have become central foci of the efforts of medical educators as the public, various accrediting and licensing agencies, and the profession itself have expressed concerns about the apparent erosion of physicians' competency in these aspects of the art, rather than the science, of medicine. Of the many obstacles to enhancing trainees' skills in these domains, one of the most significant is the difficulty in assessing competency in physicians' professionalism and humanism. The author suggests that the assessment of these aspects of the art of medicine has more in common with the approaches used in criticism of the arts than with the quantitative assessment tools appropriate to the scientific method and the medical model. Quantitative and semi-quantitative tools, so effective in elucidating the etiology, pathophysiology, and treatment of disease, are often in-appropriate and invalid when applied to evaluation of professional and humanistic competencies. The author proposes that humanism "connoisseurs" be employed to qualitatively evaluate medical trainees' professionalism and humanism. Such connoisseurs would possess expert knowledge, training, and experience in the interpersonal aspects of the art of medicine, allowing them to deconstruct concepts such as empathy, compassion, integrity, and respect into their respective key elements while evaluating physicians' behaviors as an integrated, cohesive whole. Through the use of a rich descriptive vocabulary, humanism connoisseurs would provide valid formative and summative feedback regarding competency in medical professionalism and humanism. In the process, they would serve to counteract the relative marginalization of professionalism and humanism in the informal and lived curricula of medical trainees.

Defining professionalism in medical education: A systematic review

“…Humanism in medicine (Markakis et al 2000;Marcus 1999;Misch 2002) has been defined variously as "the application of science in recognition of human values and in service of human needs" (Kumagai 2008, p.653) and "the physician's attitudes and actions that demonstrate interest in and respect for the patient and that address the patient's concern's and values" (Branch et al 2001(Branch et al , p. 1067. Swick (2007) offers a conceptualisation that emphasises that each can enrich the other as complementary (but distinct) attributes of excellence in medical practice, each enriching the other.…”

Capturing Medical Students' Idealism

“…32,33 Whereas open-ended postelective evaluation questions can provide rich narrative information, few reliable, valid, and practical tools to measure attitudes and changes in those attitudes have been developed, adequately studied, or both. 34 There is a critical need for research directed at developing and validating appropriate tools.…”

Os diferentes olhares na avaliação de alunos em estágio clínico supervisionado

“…Esse resultado pode demonstrar que a maioria dos estudantes atingiu satisfatoriamente o nível de competência esperada no Módulo Atenção Integral à Saúde ou ainda sugerir um efeito de leniência entre os supervisores/docentes, especialmente para os domínios humanísticos. De fato, a literatura aponta para uma tendência entre os docentes de supervalorizarem as habilidades técnicas e serem mais condescendentes na avaliação das habilidades humanísticas 9 . Além disso, parece ser mais difícil justificar notas baixas em aspectos não cognitivos do que apontar e explicar o que precisa ser melhorado dentre os atributos técnicos 10 .…”