2018, Number 4
<< Back Next >>
Arch Med Fam 2018; 20 (4)
Professionalism and medical training of excellence: Challenges found in the academy and in clinical practice
Moreto G, Polesel FV, Rodrigues SV, Marcondes PF, Blasco PG
Language: Portugués
References: 30
Page: 183-189
PDF size: 170.59 Kb.
ABSTRACT
Currently, a terminology widely used to characterize medical quality is professionalism, which consists of principles and commitments to create relationships characterized by integrity, ethics, social justice and teamwork with the goal of achieving excellence. The late nineteenth and early twentieth centuries began the era of specialization in medical education. However, some losses also occurred, such as patient integration and disease. In this way, the appropriate, competent, up-to-date and professional doctor is the challenge of the beginning of the 21st century. Within the humanistic and professional context, empathy is important in the patient medical relationship. Thus, the patient better exposes their complaints and concerns, providing a better diagnosis and treatment. However, the current doctor is afraid of, by being empathic they could lose their judgment and ability to judge, besides suffering with patients, generating non-involvement with them. Such ability can be achieved through recognition and reflection on one's own emotions to foster constructive and elevated feelings that will result in professionalism, ethical behavior, and humanized behavior. However, few components in the medical school are focused on the emotions. When the student does not have the opportunity to reflect on emotions, he/she can develop an emotional rejection, seeking support technique that is too overvalued in its formation. The teacher's model in this educational process of empathy is essential, and it is his/her responsibility to allow the student to share his or her feelings by achieving an affective maturity and consequently a excellent doctor-patient relationship.
REFERENCES
Blasco PG, Moreto G. Teaching Empathy through Movies: Reaching Learners’ Affective Domain in Medical Education. Journal of Education and Learning. 2012; 1: 2012. 22-34
Swick HM. Toward a Normative Definition of Medical Professionalism. Acad Med 2000; 75(6): 612-16.
Borrel-Carrio, F; Epstein, RM; Alenta, HP. Profesionalidad y professionalism: fundamentos,contenidos, praxis y docencia. Med Clin. 2006; 127(9): 337-342
Flexner A. Apêndice in Ordine N. “La utilidad de lo inutil. Manifesto”. Acandilado. Barcelona. 2013
Halpern J. From Detached Concern to Empathy: Humanizing Medical Practice. New York, NY: Oxford University Press.2001
De Benedetto MAC, Blasco PG, Gallian DMC. Narrativas de estudantes de Medicina e Enfermagem: o que elas revelam? RBM. Revista Brasileira de Medicina (Especial Oncologia). 2013; 70(3): 11-17.
Moreto G. Avaliação da empatia de estudantes de medicina em uma universidade na cidade de São Paulo utilizando dois instrumentos. 2015. Tese Doutoral em Medicina (Ciências Médicas) Universidade de São Paulo, USP, Brasil. Disponível em: http://www.teses.usp.br/teses/disponiveis/5/5169/tde-19062015-154448/pt-br.php
Aderman D, Berkowitz L. Self-concern and the unwillingness to be helpful. Soc Psychol Q 1983;46:293-301
Kay J. Traumatic deidealization and future of medicine. JAMA 1990;263:572-573
Silver HK, Glicken AD. Medical student abuse: Incidence, severity, and significance. JAMA 1990;263:527-532.
Authier J. Showing warmth and empathy. In: Hargie O, ed. A Handbook of Communication Skills. London: Croom Helm; 1986. p. 441-465.
Lara JRL, Moral RR, Campayo JG. ¿Por qué algunos médicos se vuelven poco éticos (malvados) con sus pacientes? Atención Primaria 2009;41(11):646-649.
Edwards MT, Zimet CN. Problems and concerns among medical students. J Med Educ 1976;51:619-625.
Bauer, J. Warum ich fu¨ hle, was Du fu¨ hlst. Intuitive Kommunikation und dasGeheimnis der Spiegelneurone (Why I feel what you feel. Intuitive communication and the mystery of the mirror neurons). Hamburg: Hoffmann und Campe. 2005
Hojat M. Empathy in Patient Care. Antecedents, Development, Measurement, and Outcomes. New York, NY: Springer; 2007
Eisenberg N. Empathy and related emotional response. São Francisco: Jossey Bass 1989
Spiro H. The Practice of Empathy. Academic Medicine. 2009; 84(9): 1177-1179
Neumann M, Bensing J, Mercer J, Ernstmann N, Ommen O, Pfaff H. Analyzing the “nature” and “specific effectiveness” of clinical empathy: A theoretical overview and contribution towards a theory-based research agenda. Patient Education and Counseling. 2009;74: 339-346.
Moreno M, Satre G, Lear A , Busquets M D. Falemos de Sentimentos: A afetividade como um tema transversal. São Paulo: Moderna, 2003.
McWhinney, I. A textbook of Family Medicine. New York. Oxford University Press. 1997
Shapiro J. Does Medical Education Promote Professional Alexithymia? A Call for Attending to the Emotions of Patients and Self in Medical Training. Acad Med 2011; 86: 326-332
Hammer RR. An education that pierces what the knife cannot: A student perspective. Anat Sci Educ. 2010;3:151-153
Rucker L, Shapiro J. Becoming a physician: Students’ creative projects in a third-year IM clerkship. Acad Med. 2003;78:391-397
Shapiro J. The Inner World of Medical Students: Listening to Their Voices in Poetry. New York, NY: Radcliffe Medical Press; 2009.
Larson EB, Yao X. Clinical Empathy as Emotional Labor in Patient-Physician Relationship. Jama. 2005; 293(9): 1100-1106.
Moreto G, González-Blasco P, Craice-De Benedetto MA. Reflexiones sobre la enseñanza de la empatía y la educación médica. Aten Fam. 2014; 21(3):94-97.
Angoff NR. A piece of my mind: Crying in the curriculum. JAMA. 2001; 286:1017–1018
Shapiro J: Walking a mile in their patients' shoes: empathy and othering in medical students' education. Philosophy, Ethics, and Humanities in Medicine 2008; 3:10
Benedetto MAC, Moreto G, Janaudis MA, Levites MR, Blasco PG. Educando as emoções para uma atuação ética: construindo o profissionalismo médico. RBM. Revista Brasileira de Medicina (Rio de Janeiro). 2014;71:15-24.
Bayne HB. Training medical students in empathic communication. J Spec Group Work. 2011;36:316–329.