Power, Competence, and Professionalism in Medical Education (Published 2015)
Apr 06, 2016
Meza J and Provenzano A
This paper explores how competence in medical learners is socially created within the power structures embedded in medical education.
Introduction: This paper explores how competence of medical learners is socially constructed within power structures embedded in medical education. This social dynamic is contrasted with professionalism and its context dependent definition in medical education compared to more common conceptualizations for the medical profession in general.
Methods: Anthropological, ethnographic methods were used to collect data, primarily participant observation and ethnographic interviewing. The fieldwork site was a teaching hospital where the same “team” of attending physicians and residents were observed on both inpatient and outpatient settings. The theoretical frameworks included Paolo Friere, Pierre Bourdieu / Jean-Claude Passeron.
1. Competence is a result of acquiring a diagnostic “gaze” and once achieved, results in autonomy and authority within the medical hierarchy.
2. Professionalism in the context of medical education modulates the entire hierarchical structure and protects vulnerable individuals from harm due to potential misuse of power.
Discussion: The relationship between power, competence, and professionalism needs to be considered by educators because learners will hide important information unless their need for safety is addressed.
While not a conventional scientific paper some readers active in this field or more interested in the humanities may find this review of general interest.
This paper explores the relationship between power, competence and professionalism in a medical education setting. The definitions of these terms are self evident and well presented. However I personally found the paper difficult to follow and could not understand the anthropological and ethnographic methods. Nor did I find Figure 1 and Table 1 helpful. I don't think Table 1 contributes anything and could be summarized which would reduce the confusion. The authors do however make an important point of the fact that learners are vulnerable and will hide important information unless their need for safety is addressed.
The topic of professionalism is frequently expanding as we look how it is affected by varying, including culture, religion and personality. Hence I though that this paper was very relevant to todays educational environment. However, and I apologise to the authors about this, I found this paper very difficult to read and understand. There seems to be a lot of information, some of it I think relatively new, but it was arranged in a rather complicated way which made understanding difficult.