Cultural similarities and differences in medical professionalism: a multi-region study
Cultural similarities and differences in medical professionalism: a multi-region study
复制标题
DOI：
10.1111/j.1365-2923.2011.04153.x
复制
发表时间：
2012-03-01
影响因子：
6
通讯作者：
Gibson, John
中科院分区：
文献类型：
--
作者：
Chandratilake, Madawa;McAleer, Sean;Gibson, John
在过去的二十年里，许多医学教育者试图定义专业精神。这样做的最初尝试集中在以一种允许普遍同意的方式定义专业精神。这一探索后来转变为“理解专业主义”的努力，因为许多研究人员意识到专业主义是一种社会建构，是文化敏感的。然而，确定对专业精神的理解中的文化差异的研究很少，可能是因为这样做的实际困难。在这个多地区的研究中，我们说明了医学专业的普遍和文化具体方面，因为它是由医疗从业者感知。方法通过查阅文献，确定46个专业属性。共有代表英国、欧洲、北美和亚洲的584名医生参加了一项调查，他们在调查中指出了这些属性的重要性。我们使用内容有效性指数，辅以kappa统计，确定了不同地理区域中每个属性的“必要性”。结果：在可接受的共识水平上，所有区域组确定了29个属性为“必要”，从而表明这些专业属性的普遍性，6个属性为非必要。其余部分的重要性因区域集团而异。结论本研究有助于识别专业主义理解的区域异同，根据文化维度和文化价值理论，大部分可以用文化差异来解释。然而，区域间的某些不和谐很可能是由社会经济因素造成的。一些反应似乎是反文化的，并表明从业者的热情，克服文化障碍，以提供更好的病人护理。
CONTEXT Over the last two decades, many medical educators have sought to define professionalism. Initial attempts to do so were focused on defining professionalism in a manner that allowed for universal agreement. This quest was later transformed into an effort to 'understand professionalism'as many researchers realised that professionalism is a social construct and is culture- sensitive. The determination of cultural differences in the understanding of professionalism, however, has been subject to very little research, possibly because of the practical difficulties of doing so. In this multi- region study, we illustrate the universal and culture- specific aspects of medical professionalism as it is perceived by medical practitioners.METHODS Forty- six professional attributes were identified by reviewing the literature. A total of 584 medical practitioners, representing the UK, Europe, North America and Asia, participated in a survey in which they indicated the importance of each of these attributes. We determined the 'essentialness' of each attribute in different geographic regions using the content validity index, supplemented with kappa statistics.RESULTS With acceptable levels of consensus, all regional groups identified 29 attributes as ` essential', thereby indicating the universality of these professional attributes, and six attributes as non- essential. The essentialness of the rest varied by regional group.CONCLUSIONS This study has helped to identify regional similarities and dissimilarities in understandings of professionalism, most of which can be explained by cultural differences in line with the theories of cultural dimensions and cultural value. However, certain dissonances among regions may well be attributable to socio- economic factors. Some of the responses appear to be counter- cultural and demonstrate practitioners'keenness to overcome cultural barriers in order to provide better patient care.