Taiwanese and Sri Lankan students’ dimensions and discourses of professionalism

Abstract

ContextThe definition of medical professionalism poses a challenge to global medical educators. This is especially pronounced in settings where professionalism frameworks developed in the west are transferred into different cultures. Building upon our previous study across Western contexts, we examine Taiwanese and Sri Lankan medical students’ conceptualisations of professionalism in terms of what professionalism comprises (i.e. dimensions) and how it is linguistically framed (i.e. discourses).MethodsA qualitative group interview study was undertaken comprising 26 group interviews with 135 participants from one Taiwanese (n = 64; Years 4–7) and one Sri Lankan medical school (n = 71; Years 2–5). Through thematic framework analysis we examined the data for explicit dimensions of professionalism. Through discourse analysis we identified how participants constructed professionalism linguistically (discourses).ResultsThirteen common dimensions across Taiwanese and Sri Lankan talk were identified, with the dimensions (contextual, integration and internalised self) being identified only in Sri Lankan data. Professionalism as knowledge and patient‐centredness were dominant dimensions in Taiwan; in Sri Lanka, attributes of the individual and rules were dominant dimensions. Participants in both countries used four types of discourses previously identified in the literature. Individual and interpersonal discourses were dominant in Taiwanese talk; the collective discourse was dominant in Sri Lankan talk. Findings were compared with our previous data collected in Western contexts.ConclusionsDespite some overlap in the dimensions and discourses identified across both this and Western studies, Taiwanese and Sri Lankan students’ dominant dimensions and discourses were distinct. We therefore encourage global medical educators to look beyond a one‐size‐fits‐all approach to professionalism, and to recognise the significance of context and culture in conceptualisations of professionalism.

Medical students’ attitudes toward interactions with the pharmaceutical industry: a national survey in Japan

“…Finally, the results may not be generalizable to medical education in other settings. Some research suggests that cultural differences need to be taken into account when considering education on medical professionalism [ 41 ], as relationships with the pharmaceutical industry are likely to be influenced by social and cultural background. Drawing on experiences from Western countries is helpful when considering educational interventions and implementation of regulations, but such experiences may not always apply to East Asian countries because of different cultural backgrounds.…”

Preliminary study of the relationship between career choice motivation and understanding of professionalism in newly enrolled medical students in China: a cross-sectional study

“…First-year medical students’ understandings of professionalism were obtained using an open-ended question: ‘What do you think professionalism in healthcare encompasses?’ Using open-ended questions to measure professionalism removed potential ceiling effects that may seriously affect survey results and could more accurately reflect students’ true views on professionalism. 18 …”

Using a consensus approach to develop a medical professionalism framework for the Sri Lankan context

“…Sri Lanka possesses a rich and diverse cultural heritage. British ideologies in particular appear to influence local medical education (Uragoda, 1987), and the conceptualisation of professionalism (Babapulle, 1992;Monrouxe et al, 2017), resulting in a strong emphasis on ethical behaviour. Sri Lanka is widely acknowledged to have a 'religious' background.…”

“…The study has responded to calls for culture-specific discourse on professionalism (Monrouxe et al, 2017) and prioritisation of essential qualities in terms of professionalism (Jha, Bekker, Duffy, & Roberts, 2007). Many studies seeking to define professionalism have drawn on the views of particular stakeholder groups in isolation; few have attempted to collate the views of the many groups (Ho et al, 2011;Leung et al, 2012;Pan et al, 2013).…”

“…Chandratilake et al (2012) provided a degree of insight while comparing cultural similarities and dissonances in conceptualising professionalism among doctors of several nations. Monrouxe, Chandratilake, Gosselin, Rees, and Ho (2017) built on this work with their analysis of professionalism as viewed by local medical students. The sole regulatory authority of the medical profession in the country, the Sri Lanka Medical Council (SLMC, 2009) has delineated what it expects in terms of professionalism, by outlining the constituents of 'good medical practice', many of which converge with elements of professionalism described in the literature.…”