Odontología Pediátrica en Latinoamérica: Celebrando Logros y Desafiando Estereotipos / Odontologia Pediátrica na América Latina: Celebrando conquistas e desafiando estereotipos / Pediatric Dentistry in Latin America: Celebrating Achievements and Challenging Stereotypes¹Presidente de la Sociedad Chilena de Odontopediatría

El siguiente texto reconoce la importancia de nuestra especialidad, y plantea la preocupación por el riesgo de infantilizar nuestro ejercicio al trabajar con niños: somos una profesión científica que debe ejercerse basada en altos estándares de profesionalismo, evitando actuar como niños sólo porque son nuestro sujeto material de estudio. Esto, sin olvidar que debemos adaptarnos al proceso de crecimiento y desarrollo bio-psico-social de nuestros pacientes

O seguinte texto reconhece a importância da nossa especialidade, e levanta a preocupação com o risco de infantilizar nosso exercício ao trabalhar com crianças: somos uma profissão científica que deve ser exercida baseada em altos padrões de profissionalismo, evitando agir como crianças apenas porque são nosso sujeito material de estudo. Isso, sem esquecer que devemos nos adaptar ao processo de crescimento e desenvolvimento bio-psico-social de nossos pacientes.

The following text recognizes the importance of our specialty, and raises concern about the risk of infantilizing our practice when working with children: we are a scientific profession that must be practiced based on high standards of professionalism, avoiding acting like children just because they are our material subject study. This, without forgetting that we must adapt to the process of growth and bio-psycho-social development of our patients.

An ophthalmology professionalism survey tool: Outcomes from a multi-center study in Central India

Purpose: To describe a professionalism survey tool and its use to assess knowledge of medical professionalism in ophthalmology training programs in Central India. Settings and Design: Multi?center survey study. Methods: A validated 33?question, scenario?based survey addressing professionalism attributes was administered at five centers in central India. The attributes tested included “personal characteristics,” “physician–patient relationships,” “workplace practice and relationships,” and “socially responsible behaviors.” A mean attribute score (%) was calculated and compared to “gold standard” responses by a group of expert senior ophthalmologists (100% agreement for responses). Results: A total of 225 participants completed the survey; 124 residents, 47 fellows, and 54 consultants (98.4% response rate). The total mean attribute score was 80.7 ± 9.1 (min 16.67, max 100). There was variation in the mean attribute score by professionalism attribute (P < 0.001), and a trend toward higher mean attribute scores for consultants compared to trainees across all attribute groups. The scores for “personal characteristics” (93 ± 9.7) and “physician?patient relationship” (82 ± 15.8) were the highest, whereas scores for “socially responsible behaviors” (73.9 ± 18.6) and “workplace practices” were low (72 ± 13). Conclusions: There is a generally high level of professionalism knowledge among ophthalmologists in central India. The results suggest that experience does impact knowledge of professionalism. Potential for improvement in professionalism exists in around "workplace practices", and around "socially responsible behaviors". These findings may serve as a valuable discussion starter and teaching tool to enhance professionalism in ophthalmology training programs.

Percepções de fonoaudiólogos sobre modelo profissional (role model) / Perceptions of speech language pathologists and audiologists on professional model (role model) / Percepciones de los logopedas sobre el modelo profesional (role model)

Objetivo: Identificar a percepção de egressos de um curso de Fonoaudiologia sobre modelos profissionais (role model) importantes durante a prática profissionalizante na graduação. Método:Estudo transversal aprovado pelo Comitê de Ética e Pesquisa (parecer nº 4.188.795). Foram incluídos como voluntários 106 egressos de Fonoaudiologia de uma instituição pública do interior do estado de São Paulo que receberam um instrumento (Google Forms) composto por afirmativas relacionadas ao modelo profissional em escala de resposta psicométrica do tipo Likert (1-5). Os dados foram tabulados e analisados por estatística não paramétrica. Resultados: Os participantes identificaram docentes e preceptores como sendo os seus principais modelos profissionais. Os atributos referentes às habilidades clínicas obtiveram um maior grau de importância, enquanto as habilidades de pesquisa foram consideradas menos representativas de um modelo profissional. Conclusão: Os atributos relacionados a um bom modelo profissional encontrados neste estudo poderão contribuir no desenvolvimento profissional dos docentes e preceptores e na formação de um ambiente de aprendizagem favorável ao aluno. (AU)

Purpose: To identify the perception of graduates of a Speech, Language and Hearing Sciences course at a public university about important professional models (role models) during their professional practice in undergraduate courses. Methods: A questionnaire with a Likert scale (1-5) was completed by 106 graduates and analyzed quantitatively. Results: Participants identified professors and preceptors as their main professional models. Attributes referring to clinical skills had a higher degree of importance, while research skills were considered less representative of a professional model. Conclusion: The attributes related to a good professional model found in this study may contribute to the professional development of teachers and preceptors and to the formation of a favorable learning environment for the student. (AU)

Objetivo: Identificar la percepción de los egresados de un curso de logopedia sobre modelos profesionales importantes (role model) durante la práctica profesional en la graduación. Método:Estudio transversal aprobado por el Comité de Ética e Investigación (Dictamen nº 4.188.795). Los voluntarios incluyeron 106 graduados de Logopedia de una institución pública del interior del estado de São Paulo que recibieron un instrumento (Google Forms) compuesto por declaraciones relacionadas con el modelo profesional en una escala de respuesta psicométrica del tipo Likert (1-5) . Los datos fueron tabulados y analizados utilizando estadísticas no paramétricas. Resultados: Los participantes identificaron a los profesores y preceptores como sus principales referentes profesionales. Los atributos referidos a habilidades clínicas obtuvieron un mayor grado de importancia, mientras que las habilidades investigativas se consideraron menos representativas de un modelo profesional. Conclusión: Los atributos relacionados con un buen modelo profesional encontrados en este estudio pueden contribuir para el desarrollo profesional de profesores y preceptores y para la creación de un ambiente de aprendizaje favorable para el estudiante. (AU)

Barriers and facilitators of professional autonomy of clinical nurses in Iran: A qualitative study

Religious, economic, political, social, and cultural factors influence professional autonomy in nursing, and differ from country to country. The aim of this study was to explain barriers and facilitators of professional autonomy in the experience of clinical nurses. This qualitative study was conducted on 19 clinical nurses and nursing managers selected based on purposive sampling from January 2018 to December 2019. Data were collected through semi-structured interviews, which continued until data saturation was reached. Conventional content analysis based on the Graneheim and Lundman approach was used to analyse the data. Data were categorised into 34 subcategories, 8 main categories, and two main themes, which were titled as facilitators of professional autonomy (professional, organisational, and individual factors, and effective communication) and barriers to professional autonomy (professional, organisational, and personal barriers, and inappropriate communications). The results discussed a set of facilitators and barriers faced by Iranian nurses in clinical settings. Professional organisations can play a key role by enhancing professional autonomy facilitators and increasing professional support for nurses. Another finding was the importance of training nursing staff to be competent and autonomous, beginning right from the college years.

3. Lectures at Tokyo Medical University / 医学教育

In 2015, Tokyo Medical University launched Medical Professionalism for 2nd, 3rd, and 4th year medical students to study professionalism in a sequential manner. The lecture for the 2nd year students was taught together with a representative of LGBTQ support groups. The lecture for the fourth-year students was taught together with a urologist who was a representative of a transgender support group. In summarizing the reports of the fourth-year students who took the lecture in 2021, many students thought that learning about LGBTQ was necessary from the early grades and wanted a more active learning experience. It is necessary to consider more effective learning by devising class content and methods.

Validation of the brazilian version of the Penn State College of Medicine Professionalism Questionnaire / Validação da versão brasileira do Questionário de Profissionalismo da Penn State College of Medicine

Abstract Introduction: Assessing professionalism represents a challenge for medical educators given the nature of its construct, which comprises diverse values, beliefs, and principles. Understanding this psychological phenomenon is fundamental for reaching the goals in medical education. Objective: This study aimed to translate into Brazilian Portuguese and to validate the Penn State College of Medicine Professionalism Questionnaire. Method: The questionnaire was translated, and cross-culturally adapted into Brazilian Portuguese using data from 249 medical students. An exploratory factor analysis was conducted, using a polychoric matrix and the Robust Diagonally Weighted Least Squares method of extraction. The following model adequacy indexes and criteria were used: Root Mean Square Error of Approximation (RMSEA) adjustment indexes <0.08, Comparative Fit Index (CFI) and Tucker-Lewis Index (TLI) >0.90. Result: The exploratory factor analysis obtained a KMO = 0.920, and a significant Bartlett's test of sphericity (2719.0, gl = 630; P <0.001). The parallel analysis yielded a three-factor solution, which showed adequate levels of reliability: Professional-Patient Relationship, Professional Development and Ethical Commitment. The three-factor solution was the best one found to represent the data. Conclusion: The questionnaire evidenced good psychometric properties and appropriateness to evaluate medical students' professionalism, contributing to reach more desirable ethical standards in medical education.

Resumo Introdução: Avaliar o profissionalismo representa um desafio para os educadores médicos dada a natureza de seu construto que compreende diversos valores, crenças e princípios. A compreensão desse fenômeno psicológico é fundamental para o alcance dos objetivos da educação médica. Objetivo: Este estudo teve como objetivos traduzir para o português brasileiro e validar o Questionário de Profissionalismo da Penn State College of Medicine. Método: O questionário foi traduzido e adaptado transculturalmente para o português brasileiro com dados de 249 estudantes de Medicina. Na condução da análise fatorial exploratória, utilizaram-se uma matriz policórica e o método de extração Robust Diagonally Weighted Least Squares. Os seguintes índices e critérios de adequação do modelo foram usados: índices de ajuste da raiz quadrada da média do erro de aproximação (RMSEA) < 0,08, índice de ajuste comparativo (CFI) e índice de Tucker-Lewis (TLI) > 0,90. Resultado: A análise fatorial exploratória obteve um KMO = 0,920 e um teste de esfericidade de Bartlett significativo (2719,0, gl = 630; P < 0,001). A análise paralela resultou em uma solução de três fatores que apresentou níveis adequados de confiabilidade: relacionamento profissional-paciente, desenvolvimento profissional e compromisso ético. A solução de três fatores foi considerada a melhor para representar os dados. Conclusão: O questionário evidenciou boas propriedades psicométricas e adequação para avaliar o profissionalismo dos estudantes de Medicina, contribuindo para o alcance de padrões éticos mais desejáveis na educação médica.

Construcción y atributos del profesionalismo en una escuela de enfermería en chile

Objetivo: Construir una definición consensuada de profesionalismo que contenga los atributos esenciales del ser profesional en una Escuela de Enfermería. Material y Método: Diseño descriptivo cualitativo, que utilizó el análisis de contenido en tres fases secuenciales: 1) Revisión integrativa entre los años 2009 y 2019 en las bases de datos Pubmed, CINAHL, Nursing (Proquest), en referencias de los estudios seleccionados y en páginas de sociedades científicas internacionales, sin límites de idioma. De los 33 textos completos seleccionados, se identificaron definiciones de profesionalismo y sus atributos por medio de las cinco etapas propuestas por Whittemore y Knafl; 2) Exploración con enfoque cualitativo, cuya muestra intencionada fue con informantes claves de la carrera de Enfermería: estudiantes de último año, académicos, egresados y empleadores; 3) Integración de la información recolectada a través de una construcción grupal, generando registros de definiciones y atributos comunes que se relacionaron bajo un sistema de categorías hasta lograr la saturación. Finalmente, se planteó una propuesta de la definición conceptual y los atributos del profesionalismo, validados por un participante de cada categoría. Resultados: Los atributos identificados fueron: la entrega de un cuidado humanizado, basado en sólidos conocimientos científicos, con liderazgo, responsabilidad y respeto a personas, familias y comunidades. Conclusiones: Se definió profesionalismo con cinco atributos del ser profesional que coinciden con la literatura internacional. Es relevante que académicos, tutores clínicos y preceptores hagan propios estos atributos, porque a través del modelaje de estos, contribuyen a formar a los futuros profesionales.

Objective: To construct a consensual definition of professionalism that includes the essential attributes of being a professional in a school of nursing. Materials and Methods: Qualitative descriptive design using content analysis in three consecutive phases: 1) Integrative review between 2009 and 2019 in the databases Pubmed, CINAHL, Nursing (Proquest), in the references of the selected studies and in the pages of international scientific societies, without language limitations. From the 33 full texts selected, definitions of professionalism and its attributes were identified through the five stages proposed by Whittemore and Knafl; 2) Exploration with a qualitative approach, whose intentional sample included key informants from the nursing study program, such as final year students, instructors, graduates and employers; 3) Integration of the information collected through a group construction, generating records of definitions and common attributes, which were related under a system of categories until saturation was reached. Finally, a proposal was made for a conceptual definition and attributes of professionalism, validated by a participant in each category. Results: The attributes identified were the provision of humanized care based on sound scientific knowledge, with leadership, responsibility and respect for individuals, families and communities. Conclusions: Professionalism was defined using five attributes that are consistent with the international literature. It is relevant that instructors, clinical tutors and preceptors embrace these attributes, because they ultimately contribute to the training of future professionals.

Objetivo: Construir uma definição consensual de profissionalismo que contenha os atributos essenciais para um profissional em uma escola de enfermagem. Material e Método: Estudo descritivo qualitativo que utilizou a análise de conteúdo em três fases sequenciais: 1) Revisão integrativa entre 2009 e 2019 nos bancos de dados Pubmed, CINAHL, Nursing (Proquest), nas referências dos estudos selecionados e nas páginas de sociedades científicas internacionais, sem limitações de idioma. A partir dos 33 textos completos selecionados, foram identificadas as definições de profissionalismo e seus atributos por meio das cinco etapas propostas por Whittemore e Knafl; 2) Exploração de abordagem qualitativa com amostra intencional que incluiu informantes-chave do programa de estudos de enfermagem, como alunos do último ano, docentes, graduados e empregadores; 3) Integração das informações coletadas por meio de uma construção em grupo, gerando registros de definições e atributos comuns que foram relacionados sob um sistema de categorias até atingir a saturação. Finalmente, foi feita uma proposta de definição conceitual e de atributos de profissionalismo, validada por um participante de cada categoria. Resultados: Os atributos identificados foram a prestação de cuidados humanizados, com base em conhecimento científico sólido, com liderança, responsabilidade e respeito pelos indivíduos, famílias e comunidades. Conclusão: O profissionalismo foi definido por meio de cinco atributos que são consistentes com a literatura internacional. É importante que os docentes, tutores clínicos e preceptores adotem esses atributos, já que eles contribuem para a formação dos futuros profissionais.

O médico que eu quero ser: autoimagem profissional no Brasil e em Portugal / El médico que quiero ser: autoimagen profesional en Brasil y en Portugal / The doctor I want to be: professional self-image in Brazil and Portugal

Este estudo qualitativo avaliou a percepção de acadêmicos sobre sua autoimagem como futuros médicos e os fatores que influenciaram a construção da sua identidade profissional. Foram entrevistados 32 estudantes do sexto ano de Medicina no Brasil e em Portugal. Utilizou-se a análise de conteúdo na modalidade temática e a dramaturgia de Goffman para análise e interpretação dos dados. A autoimagem idealizada revelou-se em duas temáticas: o médico centrado em si e aquele que valoriza a relação interpessoal. Uma terceira temática mostrou a influência da universidade e de elementos trazidos a priori na identidade do médico. Os resultados indicam a influência do currículo oculto na construção da identidade profissional e reforçam a importância dos aspectos sociais e humanísticos na formação médica.(AU)

Este estudio cualitativo evaluó la percepción de académicos sobre su autoimagen como futuros médicos y los factores que influyeron en la construcción de su identidad profesional. Se entrevistaron 32 estudiantes del sexto año de medicina en Brasil y en Portugal. Se utilizó el análisis de contenido en la modalidad temática y la dramaturgia de Goffman para análisis e interpretación de los datos. La autoimagen idealizada se reveló en dos temáticas: el médico centrado en sí mismo y aquel que valora la relación interpersonal. Una tercera temática mostró la influencia de la Universidad y de elementos traídos a priori en la identidad del médico. Los resultados indican la influencia del currículo oculto en la construcción de la identidad profesional y refuerzan la importancia de los aspectos sociales y humanísticos en la formación médica.(AU)

This qualitative study evaluated the perception of academics about their self-image as future doctors and the factors that influenced the construction of their professional identity. Thirty-two sixth-year medical students in Brazil and Portugal were interviewed. Content analysis in the thematic modality and Goffman's dramaturgy were used for data analysis and interpretation. The idealized self-image was revealed in two themes: the doctor centered on himself and the one who values the interpersonal relationship. A third theme showed the influence of the University and of elements brought a priori in the doctor's identity. The results indicate the influence of the hidden curriculum in the construction of professional identity and reinforce the importance of social and humanistic aspects in medical education.(AU)

Tradução, adaptação transcultural e validação de escala que avalia o profissionalismo interprofissional / Translation, cross-cultural adaptation and scale validation to assess interprofessional professionalism

Resumo: Introdução: Nas últimas décadas, a educação interprofissional vem ganhando cada vez mais visibilidade na área da saúde, a partir do reconhecimento de que essa abordagem é capaz de melhorar a qualidade da assistência à saúde e contribuir para a qualificação dos profissionais de saúde e a formação dos estudantes de diversas graduações. No entanto, no Brasil, ainda são escassas as experiências, bem como as publicações relativas ao tema. Objetivo: Este estudo teve como objetivo apresentar os procedimentos e a análise estatística relacionados às etapas de tradução e adaptação transcultural da Interprofessional Professionalism Assessment (IPA), ferramenta observacional, publicada em 2018, elaborada na língua inglesa, capaz de mensurar o profissionalismo interprofissional entre estudantes e profissionais da saúde, no contexto do cuidado centrado no paciente. Método: O estudo transcorreu na Faculdade Pernambucana de Saúde,,no período de julho de 2020 a outubro de 2021. A amostra foi composta por três tradutores, cinco especialistas e 201 estudantes do curso de Medicina, que foram submetidos ao questionário com a finalidade de testar a confiabilidade e validade da versão final em português. Considerou-se aceitável o alfa de Cronbach igual ou superior a 0,70. Resultado: O estudo cumpriu rigorosamente as exigências metodológicas recomendadas internacionalmente para as etapas de tradução, retrotradução, painel de especialistas, teste, reteste e teste final. Gerou-se a versão traduzida para o português e adaptada para a cultura brasileira. Após o teste da versão final, realizado com estudantes do internato do curso médico, obteve-se coeficiente alfa de Cronbach igual a 0,94. Conclusão: A confiabilidade obtida foi considerada elevada, refletindo a boa consistência interna do instrumento produzido.

Abstract: Introduction: In recent decades, interprofessional education has been gaining increasing visibility in the health area, based on the recognition that this approach is capable of improving the quality of health care and contributing to the qualification of health professionals and the training of students of various degrees. However, in Brazil, there are still few experiences and publications related to this theme. Objectives: To translate into Brazilian Portuguese and carry out a cross-cultural adaptation of the "Interprofessional professionalism assessment" scale, an instrument originally published in 2018 and designed to measure interprofessional professionalism among students and health professionals, in the context of patient-centered care. Methods: The study took place at the Faculdade Pernambucana de Saúde, from July 2020 to October 2021. The sample consisted of three translators, five specialists and two hundred and one medical course students, who were submitted to the questionnaire in order to test the reliability and validity of the final version in Portuguese. Cronbach's Alpha equal to or greater than 0.70 was considered acceptable. Results: The study strictly complied with the methodological requirements recommended internationally for the stages of translation, back-translation, expert panel, test, retest and final test, the version translated to the Portuguese and adapted to the Brazilian culture was generated. After the test of the final version, performed with students from the medical course boarding school, Cronbach's Alpha coefficient equal to 0.94 was obtained. Conclusion: The reliability obtained was considered high, reflecting the good internal consistency of the instrument produced.

Tradução e adaptação transcultural de instrumento para avaliação do profissionalismo entre médicos / Translation and transcultural adaptation of instrument for professionalism assessment among physicians

Resumo: Introdução: A discussão sobre profissionalismo médico é relativamente recente e o tema tem se tornado cada vez mais frequente em publicações sobre educação médica. Trata-se de conceito complexo, pois, como uma competência, envolve um conjunto de atributos, conhecimentos, habilidades e comportamentos que são influenciados pelos contextos político e sociocultural. Várias estratégias foram propostas para sua avaliação, mas não se identificou na literatura nenhum instrumento específico validado para o Brasil. Objetivo: Este estudo teve como objetivo realizar a tradução e adaptação transcultural de um questionário para avaliação de profissionalismo médico. Método: Realizaram-se a tradução e a adaptação transcultural do The Penn State College of Medicine Professionalism Questionnaire. A confiabilidade e a consistência interna foram avaliadas pelo alfa de Cronbach. Resultado: A tradução e a adaptação transcultural resultaram em questionário com 37 itens com boa validade semântica, idiomática, experiencial e conceitual. O alfa de Cronbach (0,886) mostrou alta confiabilidade. Conclusão: A versão final do instrumento mostrou boa validade, consistência interna e confiabilidade. Ele pode ser utilizado tanto na educação continuada de profissionais já formados como na educação médica, como ferramenta de reflexão e avaliação.

Abstract: Introduction: The discussion about medical professionalism is relatively recent and the topic has become increasingly frequent in publications on medical education. It is a complex concept, since it is a competence that involves a set of attributes, knowledge, skills, and behaviors that are influenced by the political and socio-cultural context. Several strategies have been proposed for its assessment, but no specific instrument validated for Brazilian Portuguese was identified in the literature. Objective: To translate and do the transcultural adaptation of a questionnaire for assessing medical professionalism. Methods: The Penn State College of Medicine Professionalism Questionnaire was translated and cross-culturally adapted according to recommendations found in the literature. Reliability and internal consistency were assessed by Cronbach's alpha. Results: The translation and cultural adaptation resulted in a questionnaire with 37 items with good semantic, idiomatic, experiential, and conceptual validity. Cronbach's alpha (0.886) showed good reliability. Conclusions: The final instrument showed good validity, internal consistency, and reliability. It can be used both in the continuing education of physicians and in medical education, as a tool for reflection and assessment.

Validação de escala de avaliação de profissionalismo traduzida e adaptada em cenário de simulação / Validation of a translated and adapted professionalism assessment scale in a virtual simulation scenario

Resumo: Introdução: O Professionalism Mini-Evaluation Exercise (P-MEX) é instrumento que avalia 21 habilidades de profissionalismo, distribuídas em quatro domínios. Objetivo: Este estudo teve como objetivos traduzir, adaptar e validar um instrumento de avaliação de profissionalismo médico. Método: Após a autorização do autor do P-MEX, realizaram-se a tradução do instrumento para a língua portuguesa, a análise de equivalência linguística e validade de conteúdo por especialistas em educação, e o exame de validade operacional em OSCE virtual entre estudantes do internato médico. Resultado: Houve elevada equivalência dos itens da versão em português do Brasil por especialistas em educação. O índice de validade de conteúdo da escala foi de 0,96. Seis professores validaram o P-MEX em ambiente de simulação para 27 estudantes do internato médico. Conclusão: A versão brasileira do P-MEX demonstrou ser adequada para avaliar o profissionalismo médico no contexto brasileiro, com boa validade operacional em cenário de simulação virtual.

Abstract: Introduction: "Professionalism Mini-Evaluation Exercise" (P-MEX) is an instrument that assesses 21 professionalism skills, distributed in four domains. Objective: To translate, adapt and analyze the validity of the medical professionalism evaluation exercise. Methods: After authorization from the author, the following tasks were performed: translation into Portuguese; linguistic equivalence and content validity analysis by education experts; operational validity analysis in virtual OSCE among medical clerkship students. Results: There was high equivalence of the items in the Brazilian Portuguese version by education specialists. The Scale Content Validity Index was 0.96. Six teachers validated the P-MEX in a simulation environment to 27 medical clerkship students. Conclusion: The Brazilian version of the P-MEX proved to be adequate to assess medical professionalism in the Brazilian context, and showed good operational validity in a virtual simulation scenario.

Enlightenment on the Construction of Medical Professionalism from the Perspective of Moral Injury / 中国医学伦理学

The purpose of medicine is to preserve and develop the treatment in the process of saving lives and helping injuries. Medical professionalism is a comprehensive expression of physician’s clinical abilities, relationships and values between different subjects. In practice, white robed doctors utilize high standards of professionalism to practice the medical purpose and goals of "always centering on the interests of the patient" in specific diagnosis and treatment behaviors. At the same time, fulfilling the promises and expectations of medicine to the public. For these reasons, selfless dedication, self-sacrifice, and one-way pure altruism are all internalized into the basic requirements of medical professionalism: doctors should not only have the skill to revive the dead, but also have the benevolence of evangelists; they not only need to achieve maximum efficiency in technology, but also achieve the highest truth, goodness, and beauty in virtue. When these qualities are exaggerated or unattainable due to uncontrollable reasons, there will be a rift between the entrenched value systems and practical needs. In recent years, the global epidemic has had a huge impact on the medical system and medical staff, and the moral beliefs, role expectations, and value systems of doctors have also been impacted unprecedentedly, resulting in moral injury. The international research on moral injury in medical field has also received attention. China is currently in the adjustment period of epidemic related policies, with medical personnel bearing the brunt. Therefore, referring to relevant international research on moral injury to re-examine the relationship between the medical professionalism, which emphasizes one-way pure altruism, dedication and weakening or even neglecting personal well-being, and current medical practices. And constructing a moral injury early warning-repair system that focuses on doctors, patients, medical teams, medical institutions, medical environments, health systems, and other stakeholders, and ensuring its healthy operation. Not only in extreme periods, but also in ordinary daily diagnosis and treatment, it can support doctors to actively, safely, and healthily fulfill their mission of saving lives and helping injuries.

Research on the Role of Voluntary Service in Cultivating the Medical Professionalism of Medical Freshmen: Text Analysis Based on the "Volunteer Star" Deeds of Peking University Premedical Students / 中国医学伦理学

Based on the content of medical professionalism and the theoretical model of knowledge, belief and practice, this paper used the methods of "inductive category construction" and "deductive category construction" to form the categories and analyze the text, taking the narrative materials of 112 "volunteer stars" outstanding individuals selected by the pre-medical student office of student affairs department of Peking University Health Science Center from 2019 to 2021 as the research subjects. The findings demonstrated that volunteer service had a positive effect on the cultivation of medical professionalism of medical freshmen, and played an effective role in guiding medical freshmen from the two dimensions of knowledge and belief, in which the role of medical voluntary service was more obvious. However, the breadth and depth of volunteer service in cultivating medical professionalism were limited. Based on this, this paper proposed that medical colleges and universities should emphasize voluntary service in the cultivation of medical professionalism, especially the development of medical voluntary service activities designed for medical students, and strengthen the cultivation effect by coordinating with other cultivation methods.

Effectiveness of healthcare ethics training in the undergraduate medical curriculum: A quasi-experimental study from rural India

Conventional medical education does not provide adequate training to undergraduates to resolve healthcare-related ethical dilemmas. This quasi-experimental study using a pre-post design was conducted to assess knowledge, attitudes and practices in healthcare ethics (HCE) and evaluate the effectiveness of the introduction of HCE in ethical behaviour among medical undergraduates at the Mahatma Gandhi Institute of Medical Sciences in Sevagram, India. All the participants thought that knowledge of HCE is important. There was an improvement in the knowledge of HCE after the intervention, as both weighted mean and percentage consensus improved. In Phase I, absolute learning gain, relative learning gain, and normalised gain “g” were significantly higher after the intervention. In Phase II, the intervention showed low and moderate effectiveness in improvements in the affective and psychomotor domain, and in the ability to handle ethical issues, respectively; but no significant improvement in communication skills. During the feedback session, it was seen that a majority of the participants thought that it is the need of the hour to introduce skill-based HCE into their curriculum from the first year. It can be concluded that it is possible to improve knowledge, and affective, psychomotor ability to handle ethical issues among undergraduate medical students with formal training

Ethical challenges faced by community mental health workers in urban Chennai

Background: Delivery of mental health interventions to youth in schools requires a cadre of community mental health workers (CMHWs) in addition to psychiatrists. Literature is sparse in the India context on the ethical and professional challenges faced by CMHWs, especially those working with youth. Hence, the aim of the study was to understand these challenges faced by CMHWs working in schools in urban Chennai and explore ways to overcome them. Methods: A qualitative study was done with CMHWs involved in the delivery of youth mental health (YMH) interventions, including mental health literacy, screening for mental disorders and mental health support to youth in schools in urban Chennai. Focus group discussions (FGDs) were conducted with the study participants and audio recorded. Transcription of the recording was done verbatim and coded for themes using a thematic analysis approach. Results: Two FGDs were conducted with a total of eight participants. The mean (± standard deviation) age of the participants was 27 ± 3.7 years; all having a master’s degree in either psychology, social work, or public health. The major themes that emerged were the meaning of ethics and professionalism, confidentiality, dilemma in decision making, incongruence between the requirements of student and school administration, and personal and professional challenges faced by CMHWs. Recommendations to overcome these challenges were also explored. Conclusion: The results indicate CMHWs face significant ethical challenges with confidentiality, and decision making while delivering YMH interventions in schools, highlighting the need for designing and implementing a framework to address these challenges.

Pronóstico kinesiológico cardiorrespiratorio: un enfoque biopsicosocial / Cardiorespiratory Kinesiological Prognosis: a biopsychosocial approach

La kinesiología, fisioterapia o terapia física, se ha desarrollado de manera permanente a través de una perspectiva biopsicosocial, en la que identificar el contexto biomédico del usuario, junto con sus limitaciones en la actividad y restricciones en la participación es esencial para una atención individualizada del usuario en su contexto. Entidades como la Asociación Americana de Terapia Física (American Physical Therapist Association, APTA) y la Conferencia Mundial de Terapia Física (World Confederation for Physical Therapy, WCPT) o actualmente conocida como Fisioterapia Mundial (World Physiotherapy, WP), conceden como aspecto propio del kinesiólogo o fisioterapeuta la acción de diagnosticar, evaluar, tratar y pronosticar las disfunciones de usuarios con necesidades de atención en salud. Sin embargo, algunas de estas competencias profesionales no están del todo definidas para su aplicación en la práctica clínica. El presente artículo de comunicación profesional entrega las bases conceptuales en la que se sostienen los hitos necesarios para esta-blecer una propuesta metodológica de elaboración del pronóstico kinesiológico funcional basado en el área cardiorrespiratoria con un enfoque biopsicosocial según la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud (CIF). Esto, con la finalidad de que el pronóstico funcional sea incorporado como parte de la formación curricular en la profesión, así como dentro de un proceso continuo en la práctica kinesiológica

Kinesiology, Physiotherapy or Physical Therapy has been permanently developed on a biopsychosocial perspective. Identifying the user's biomedical context, along with his or her activity limitations and participation restrictions, is essential for individualized attention to the user in his or her context. Entities such as the American Physical Therapy Association and the World Confederation for Physical Therapy, or currently known as World Physiotherapy, give the kinesiologist or physical therapist the task of diagnosing, evaluating, treating, and predicting the dysfunctions of users with health care needs. However, some of these professional compe-tencies are not wholly defined for application in clinical practice, and less, in the curricular formation of the physiotherapy students. This article gives helpful concepts to elaborate a biopsychosocial cardiorespiratory functional prognosis for Kinesiology, based on the International Classification of Functioning, Disability, and Health (ICF), to incorporate as part of the curricular formation in the profession and within a continuous process in kinesiological practice

Desafíos en la formación de los valores del profesionalismo médico en tiempos del COVID-19 y de crisis social / Challenges for training medical professionalism values in times of COVID-19 and social crisis

The essence of professional education not only involves transmitting knowledge, but also values and attitudes for a practice that allows us to face changing global and national scenarios. Physicians are currently facing new challenges derived from the impacts of the pandemic as well as the social crisis. Increased workload, limited access to health systems, economic uncertainty, and increased public scrutiny hamper physicians to fulfill their responsibilities to patients and society. Likewise, digital learning and few opportunities for face-to-face practice during the pandemic abruptly altered the training process for students and residents. In this essay, teaching of medical professionalism and its values is reviewed, considering the challenges posed by new social and healthcare contexts fort the future professional behavior. This commitment, however, requires not only ethical values but also humanism and social commitment. Medical professionalism acts as a stabilizing and morally protective social force. Thus, it is critical to fathom essential values of professionalism that characterize medical practice today. Indeed, the explicit incorporation of these values in undergraduate and postgraduate programs will undoubtedly allow the training of better professionals for the practice of medicine. (Rev Med Chile 2022; 150: 1248-1255)

Profesionalismo y medicina narrativa / Professionalism and narrative medicine

This work is a bibliographical review of the challenges of professionalism in medical training. Medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice. By virtue of the changes in the practice of medicine during the last years, professionalism values emerge as qualities that should reshape medicine. Several medical associations are redefining professionalism and insist that this issue should be included in the training curriculum. Thus, several medical education institutions are pursuing strategies to teach and assess professionalism. Modeling is still relevant as a learning strategy, but it must be tutored and directed. Also, timely and formative feedback appears as the most frequently suggested evaluative action. Both processes incorporate a personal reflective practice. Several recent studies suggest that a reflective experience is relevant for the formation of a professional identity. Narrative Medicine methodology emerges as an innovative strategy to address this issue, as it seeks to deliver valuable learning experiences to the students through reflection and the search for a new paradigm for medical practice.

Profissionalismo médico como competência formativa: evidências no currículo e nos significados atribuídos por alunos do internato em Saúde da Família / Medical professionalism as a formative competence: evidenced by curriculum and meanings assigned by Family Health internship students

Profissionalismo médico (PM) compreende o exercício da medicina considerando ciência, consciência e excelência. Objetivou-se, neste artigo, descrever como o PM se apresenta no currículo médico e reconhecer o universo semântico dos internos de medicina sobre o tema. Trata-se de pesquisa qualitativa, do tipo estudo de caso, realizada mediante aplicação de questionário a 55 alunos do internato em Saúde da Família de um curso sediado no estado do Ceará, Brasil, e análise do projeto pedagógico do curso (PPC). O PPC foi explorado quanto aos domínios do PM; as palavras expressas pelos estudantes foram processadas pelo softwareIRaMuTeQpor análise prototípica e de similitude, com discussão à luz da Matriz de Competências do Profissionalismo Médico no Brasil. Competência cultural e compromisso com a competência técnica se destacaram, enquanto que os demais domínios foram identificados como incipientes. Os estudantes atribuíram significados de PM associados à ética (f=39; OME=2,1), à empatia (f=21; OME=2,4) e à responsabilidade (f=17; OME=2,3). O Profissionalismo Médico revelou-se fragmentado no currículo e refletiu universos semânticos emelaboração, elucidando a necessidade de estimular essa competência na formação dos graduandos.

Medical Professionalism (MP) comprises the practice of medicine while considering science, conscience, and excellence. The objective was to describe how MP is presented in the medical curriculum and recognize medical interns' semantic universe on the theme. Qualitative research of the case study typewas carried out by analyzing the pedagogical project (PPC, in Portuguese) and a questionnaire applied to 55 students of the Family Health internship in the state of Ceará. The PPC was explored in terms of the Medical Professionalism subject, and the IRaMuTeQ software processed the words expressed by the students by prototypical and similarity analysis, with discussion in the light of the Matrix of Competencies of Medical Professionalism in Brazil. Cultural competence and commitment to technical competence stood out, while the other domains were identified as incipient. Students associated medical professionalism with ethics (f = 39; OME = 2.1), empathy (f = 21; OME = 2.4), and responsibility (f = 17; OME = 2.3). Medical Professionalism was revealed to be fragmented in the curriculum and it reflected semantic universes still under development, which elucidates the need to stimulate this competence in the training of undergraduates.

Medical Professionalism and Ethics

Frequent media reports of disputes between medical teachers, resident doctors, and patients have been disturbing thus indicating an increasing gap and decline in the values of the profession. The foundation of medical professionalism and ethics is trust, truth, human values, and strong societal commitment. Our professional responsibilities as medical educators have immediate and long-term impact on the quality of training, patient care, and overall image of the professional group in the society. Formal teaching and training in professionalism and medical ethics that emphasize humanistic aspects and standard of conduct, respectively, are equally essential as biomedical aspects. Interestingly, the principles of medical ethics and attributes of professionalism overlap. However, real-life experiences and complex clinical scenarios place medical educators at the crossroads that contradict their professional commitments resulting in ethical dilemmas. COVID-19 pandemic has further challenged the principles of medical professionalism, especially patient welfare, autonomy, and social justice to prioritize patient care and make tricky decisions based on insufficient resources including withholding and withdrawing potentially lifesaving treatments. Unfortunately, until now the teaching and training in medical professionalism and ethics have remained subtle and medical students learn by chance. The recent introduction of the AETCOM module and Code of Medical Ethics in the curriculum is a ray of hope to brighten the image of medical professionals.