BMD Extended essay Name: Oren Surname: Strul Registration number: 2688 Module: Pedagogy An unprofessional use of smartphones in the hospital Professionalism, in my opinion, is one of the most important qualities a doctor should master and possess. It affects the doctor-patient relationship, the communication with the patient, and the quality of the group work of the doctor and his colleges. Therefore, I chose to do the extended essay on professionalism in the pedagogy module and review a dilemma arising with the accessibility of technology today. The topic I chose to write on in the essay is the functions and values of professionalism in a reallife situation- the unprofessional use of smartphones in hospitals. In this essay, I will discuss the following two questions: Can the use of smartphones affect the professionalism of health care workers in the hospital? Which functions and values of professionalism are being violated in an unresponsible use of smartphones in the hospital? I chose this subject because at the beginning of the first semester, after one of the first lectures, there was an after-lecture assignment to watch a couple of videos on the unprofessional behavior of doctors. While watching those videos, I remembered a debate I once read, whether doctors and health care workers should be allowed to use their cellphones for personal use and whether it affects their professionalism1. In My opinion, the use of the smartphone could be considered unprofessional in some situations and can affect the professional image of the doctor. The professional image of the doctor is essential for the patient to trust the doctor, his knowledge, and his medical opinion. What is professionalism? According to the Edmund D. Pellegrino MD. (The Mount Sinai Journal of Medicine) the definition of professionalism is “a watchword for those qualities and modes of conduct proper to professions.”2 In the literature, two aspects of the meaning of the qualities and modes of the medical profession can be found. One aspect of definition to those words can be found in the Good Medical Practice GMC 2001. The GMC gives us a behavioral aspect to the definition of medical professionalism. The GMC state 14 main behavioral approaches a professional doctor must follow3: 1. make the care of your patient your first concern 2. treat every patient politely and considerately 3. respect patients’ dignity and privacy 4. listen to patients and respect their views 5. give patient information in a way they can understand 6. respect the right of the patient to be fully involved in decisions about their care 7. recognized the limits of your professional competence 8. keep your professional knowledge and skills up to date 9. be honest and trustworthy 1 Dafna Izenberg, Ryan Hinds, Ngozi Iroanyah, “Should hospital staff be allowed to use their phones for personal reasons?”, Healthydebate, November 12, 2018, https://healthydebate.ca/2018/11/topic/cellphones-in-the-hospital/ 2 Edmund D. Pellegrino MD., “professionalism and the virtues of the good physician”, The Mount Sinai Journal of Medicine vol. 69, no. 6 (November 2002) 3 Good Medical Practice, GMC (2001), (medical professionalism 2020 theoretical perspective-2) 10. respect and protect confidential information 11. make sure that your personal beliefs do not prejudice your patients’ care 12. act quickly to protect patients from risk if you have good reason to believe that you and your colleagues may not be fit to practice 13. avoid abusing your position as a doctor 14. work with colleagues in the way that best serve patients’ interests The other approach is values, as the McGill university gives us. McGill university state that the values expected for medical professionalism are: “Autonomy, Self-regulation, association, institutions, responsibility to the society and teamwork” McGill also give us values expected of a healer: “Caring, insight, openness, respect for the healing function, respect the dignity, presence and accompany.” In addition to the healer values and the professionalism values, McGill university also states values that are common for both: “competence, commitment, confidentiality, trust, worthy, altruism, honesty, code of ethic, morality and responsibility to the profession.” A real-life example of the topic could be: A doctor needs to perform a simple medical procedure on a patient, a procedure such as blood withdrawal or giving fluid. While doing so, the doctor gets a message on his smartphone and starts reading the message. In my opinion, two main guidelines of the GMC are being violated in this situation. The first one is “Make the care of the patient your first concern”- the patient may still be the doctor’s primary concern, but he’s not showing it to the patient at the moment, and the second is “Treat every patient politely and considerately”- the patient might interpret this as impoliteness of the doctor. Moreover, the values given by McGill university that are being violated are: self -regulation- the doctor needs to check his own behavior and avoid doing unprofessional deeds, commitment- the doctor doesn’t show his commitment to the profession in this case, responsibility to the profession- the doctor is distracted and acting in an irresponsible way. The points that are being violated in this scenario have high importance for the doctor to gain the trust of the patient. The information the doctor has comes from what the patient decides to share with him. Therefore the trust has a major role here. Moreover, the doctor will need the patient’s trust and consent for continuing the treatment and taking the supportive treatment that might be needed. On the other hand, smartphones can make today’s doctors more professional. The smartphone allows better teamwork and better communication between the different parts of the hospital and between the doctor and his colleagues. The accessibility of information and articles these days, even on smartphones, is incredible and the ability of the doctor to be updated with the most recent research articles allows him to give the patient the best treatment possible. Therefore, the presence of the smartphone in the daily routine can make the doctor more professional and knowledgeable. To conclude, smartphones can have an impact on professionalism, both positively and negatively. The positive impact is that it can improve communication, the quality of teamwork and give access to the doctor on the most recent knowledge. The negative effect of smartphones on professionalism is that they can distract the doctor or damage the professional image of the doctor if used in an irresponsible way. The consequences of unprofessional use of smartphones can be damage to the patient-doctor relationship and communication, and it may even lead to a mistake that can hurt the patient. I believe that with all the advantages smartphones give us, the importance of self-regulation is increasing, and it’s up to the medical worker to enjoy the advantages of the smartphone without damaging the professional image. When I think about how this topic can relate to me as a medical student, I think of two aspects. One is at present, to avoid using the smartphone unprofessionally in lectures and other important university studying activities. The second is an individual goal I set to myself during the writing and researching of the topic, to gain clear boundaries (as much as possible) of professionalism in a wide variety of everyday situations. This is an important goal for me since the importance of professionalism is great and realizing its boundaries will give a good basis for self-regulation, an essential value of professionalism. I believe I can achieve this goal by researching (in assignments like this), observing, and accepting criticism, and learning from mistakes in the clinical years. Bibliography - Cruess R.L., S. R. Cruess, “The cognitive base of Professionalism” in Cruess R.L., Cruess S. R., Steinert, Y. Teaching medical Professionalism, Cambridge, 2009 – Chapter 1 - Tsou AY, Creutzfeld CJ, Gordon JM, “The good Doctor in the 21st century”, Handbook of Clinical Neurology, 2013, v.118; pp. 119-132 - Cruess R.L., Cruess S.R., Boudreau J.D, Snell L., Steinert Y, Reframing Medical Education to Support Professional Identity Formation, Academic Medicine, Nov 89(11); pp. 1146-51 - Van der Vosse M. et al., Descriptors for unprofessional behaviours of medical students: a systematic review and categorisation, 2017, BMC Medical Education, 17; 17 - Wynia M.K. et al., More than a list of values and desired behaviours: a foundational understanding of medical professionalism, Academic Medicine, 2014; 89: pp. 712-714 - Eklund JH, Meranius MS, Toward a consensus on the nature of empathy: A review of reviews, Patient Education and Counseling (2020) doi: https://doi.org/10.1016/j.pec.2020.08.022 - Mills J, Chapman M. Compassion and self-compassion in medicine: Self-care for the caregiver. AMJ 2016;9 (5):87–91. http://dx.doi.org/10.4066/AMJ.2016.2583 - Dafna Izenberg, Ryan Hinds, Ngozi Iroanyah, “Should hospital staff be allowed to use their phones for personal reasons?”, Healthydebate, November 12, 2018, https://healthydebate.ca/2018/11/topic/cellphones-in-the-hospital/ - Edmund D. Pellegrino MD., “professionalism and the virtues of the good physician,” The Mount Sinai Journal of Medicine vol. 69, no. 6 (November 2002). - Good Medical Practice, GMC (2001) - Professor Licia Montagna, “medical professionalism 2020 theoretical perspective-2”, professionalism lecture.
