Professional Identity Flashcards
What is professionalism
“A set of values, behaviours, and relationships that underpins the trust the public has in doctors”
What is a profession
= A profession can be defined as a vocation or ‘calling’, especially one involving a degree of skill, learning or science. Another helpful description is that of “a trade or occupation pursued for higher motives, to a proper standard”
What is a professional identity
= “A representation of self, achieved in stages over time during which the characteristics, values, and norms of the medical profession are internalised, resulting in an individual thinking, acting, and feeling like a physician.”
What does the GMC make a good doctor
Make the care of your patient your first concern
Be confidence and keep your professional knowledge and skills up to date
Take prompt action if you think patient safety is being compromised
Establish and maintain good partnerships with your patients and colleagues
Maintain trust in you and the profession by being open, honest and acting with integrity
What does someones personal identity depend upon
One’s personal identity is dependent upon both genetic and environmental factors
What are the most powerful factors affecting identity
role models
mentors
experiential learning in both clinical and nonclinical situations (reinforced by reflection)
What does full participation in the community entail
in the community entails a series of personal negotiations with one’s self and the community as the norms can conflict with personal habits or beliefs
What are the core beliefs in medicine that make up their community
competence,
caring and compassion,
honesty and integrity,
confidentiality
- These are essentially nonnegotiable
What are the tensions and challenges in the medical community
- Differential attainment
- Bias against BME doctors in terms of complaints and how they are responded to (eg: Bawa-Garba)
- Racism, sexism and class problems in medicine
- Hidden curriculum
- (Junior) doctor working conditions
- Risk aversion
- Patient safety vs systemic pressures
- Blame and scapegoating
- Oscillation between hero and villain
- Burnout and perfectionism
- “Resilience”
- Social media
- Climate change and doctors as activists
What is the hidden curriculum
the difference between what is being taught and what is being learned, or the explicit vs implicit
Describe the hidden curriculum
- Hafferty described the hidden curriculum generally as the “‘understandings,’ customs, rituals, and taken-for-granted aspects of what goes on in the life-space we call medical education”
Gerada describes the “medical matrix” made real through doctors’ shared education, cultural, social and linguistic experiences.
It is reinforced by the collective spaces which doctors inhabit—e.g. medical schools, hospitals and doctors’ messes.
The matrix has its own (often hidden) goals, patterns of communication and power structure
What is a wounded healer
- idea that wounds makes us good at our jobs - Only thing about others and don’t attend to our selves then this can be problematic
- The nature of the wound may influence our choice to become healers
What are defence mechanisms
Unconscious processes which protect us from anxiety and unacceptable thoughts and feelings
Why are defence mechanisms necessary
Entirely necessary for existence, and more specifically doctoring, to prevent over-identification, maintain patent-centredness, and professional boundaries
When can defence mechanisms become problematic
But, others, eg: projection, repression are more problematic and even “mature” defense mechanisms can be dangerous
What is perfectionism a defence against
Defence against anxiety, uncertainty
What did a study on perfectionism find in the past 27 years
A large study of medical students over the past 27 years found that levels of self-oriented, socially prescribed, and professionally determined perfectionism had all increased
- linked to mental health issues
What is healthy and unhealthy perfectionism and what is the difference between them
Healthy described as useful, related to conscientiousness but under extreme stress can become dysfunctional
Unhealthy related to inability to delegate, accept failure, forgive others for mistakes
What is the triad of perfectionism
“chronic doubt, chronic shame and exaggerated sense of responsibility”
What is perfectionism relieved by
Mitigated by good leadership, team working, sharing of responsibilities
What is empathy
ability to sense, feel, and understand another’s emotions
What is compassion
emotional response to another’s pain or suffering involving an authentic desire to help
What is compassion associated with
Associated with improved patient outcomes, adherence to treatment, reduces anxiety
Also associated with lower burnout, and higher satisfaction with work
What is a toxic state to be in
Empathy without compassion
What has studies showed that empathy and compassion do over the years of medical school
Studies have demonstrated that empathy and compassion decline during both medical school and residency training
When do compassion and empathy get turned of
Compassion and empathy gets turned off in a person is under threat (fight-flight etc)
Containment for feelings of helplessness, disgust, fear, anger
What does blame culture prevent and preserves
Blame culture prevents learning, but preserves status quo
What is shame
powerful emotion which occurs in response to negative evens such as making mistakes or experiencing mistreatment
What is the difference between shame and guilt
Person experiencing guilt would say, “I did a bad thing,” the person experiencing shame would say, “I am bad.”
What is guilt
feel unhappy because you think that you have done something wrong or have failed to do something which you should have done.
What does the triggering event of shame lead to
Triggering event is attributed to a global sense of self as devalued, defective, unworthy
What is the problem with shame
Social isolation and impaired sense of belonging
Disengagement
Diminished psychological wellbeing and physical wellness
Emotional blunting and disconnection
Relationship with low mood and suicidal thoughts
Relationship with imposter syndrome
Implications for speaking up about patient concerns or errors
What are the most of complaints about healthcare relate to
Most complaints about healthcare relate to a lack of kindness or thoughtlessness
