의학 직업전문성의 특성과 실천 원리

황은영,양은배,Hwang, Eun Young,Yang, Eunbae B. 연세대학교 의과대학 2010 의학교육논단 Vol.12 No.1

It is the most important thing at present for physicians to posses the qualification of medical professionalism. A lot of medical schools have made all-out efforts to develop leaders of medicine, who will be able to meet the needs of medical professionalism in this complex medical environment. The purpose of this study is to review the cognitive base of medical professionalism leading the curriculum development of medical professionalism. The discussion of medical professionalism started in the 20th century. During the 1960s, there were attempts to reshape the concepts and attributes of medical professionalism. The government began to intervene in the autonomy of physician and the self regulation policy of medical society in 1970s. Physician may be asked to play as a healer and professional (what?) during their medical practice. The fundamental role of healer such as care, compassion, honesty, integrity, confidentiality, ethical behaviors, and respect with patients were nothing fresh to tell even though the age was changed. The attributes of professional which are physician's autonomy, self regulation, teamwork, and responsibility to society has been changed dramatically over the past five decades. In general, medical educators agreed that professionalism is demonstrated through a foundation of clinical competence, communication skills, and ethical and legal understanding, upon which is built application of the principles of professionalism: excellence, accountability, altruism, and humanism. If physicians fail to show professionalism in society, they will confront the crisis which can be under the government control. The only way to keep their autonomy is to practice medical professionalism. So far today, medical schools have laid more stress on competence than value standards in educational systems and it was restricted for medical students to learn the value standards for medical practice. To understand and practice the medical professionalism, it is the most realistic way to solve the complicated medical problems.

우리나라 의과대학의 의학직업전문성 교육현황

정철운(Chul Woon Chung) 한국의학교육학회 2004 Korean journal of medical education Vol.16 No.3

Purpose: As the importance of teaching professionalism has become more emphasized in medical education, Korean medical educators are trying to introduce and revise new learning materials concerning professionalism. The purpose of this study is to analyze the transition of curricula subjects related to medical professionalism in Korean medical schools. Methods: A search for the learning subjects was done by reviewing the󰡐Korean Medical Education Guide󰡑from 1998 to present. Subject titles relating to medical professionalism and the time allocation of these subjects in lectures and laboratories in the 41 Korean Medical Schools were identified. The annual increasing rate of related subjects, as well as some characteristic differences between medical schools were analyzed. Results: There were 28 subjects with content on medical professionalism in 1998/99. There was a rapid increase in the introduction of professionalism to the curriculum annually. Although private medical schools outnumber the public system, there was no significant difference between them in the number of established subjects. But schools with fewer students had more programs relating to professionalism. This may be seen as a reflection of the relatively newly established schools with fewer students being more ready to adopt curriculum reform than older, larger medical schools. Conclusion: The results show that there has been a rapid growth in the number of subjects relating to medical professionalism in the curriculua at Korean medical schools. This study focused mainly on analyzing the current subject constellation in the curricula. A further study on the specifics of curriculum content and its teaching method is required.

연세대학교 의과대학 의학전문직업성 교육 경험의 반성적 고찰

안신기,부성희,An, Shinki,Bu, Sunghee 연세대학교 의과대학 2012 의학교육논단 Vol.14 No.1

For decades medical educators have continually emphasized medical professionalism, which is reflective response to the challenges of a rapidly changing medical environment. This study aimed to review the experience of implementing medical professionalism education at Yonsei University College of Medicine (YUCM). YUCM introduced a new curriculum in 2004 designed by Curriculum Development Project 2004 (CDP2004), a project that was launched in 2001. CDP2004 reorganized lectures as organ-based integrated lectures, introduced an introductory course for clinical medicine and medical humanities courses for premedical and medical students. Problem-based learning (PBL), elective courses, and self-study sessions in the afternoon were implemented in order to equip students with a self-directed learning attitude as medical professionals. Professors were asked by the CDP2004 curriculum to spend more time on student education and to adopt new teaching methods. Experiences of the CDP2004 curriculum reveals 1) difficulty of motivating professors to be PBL tutors 2) students' dissatisfaction with the medical humanities course (major critique was that the course was impractical and unrealistic), and 3) students' optimistic understanding about their future role as medical professionals in influencing and helping people in spite of their perception of the general medical environment not as promising. To foster professionalism, the following are necessary in our experiences: 1) faculty development of medical humanities and medical professionalism, 2) establishment of an environment throughout the whole institution to support medical professionalism education and to integrate the concept into praxis, 3) emphasis on the fact that medical professionalism education is not contradictory to biophysical medical education.

의학전문직업성의 변화와 여성의사 : 역사적인 관점의 연구

김신권(Shin Kwon Kim) 한국문화융합학회 2021 문화와 융합 Vol.43 No.6

최근 의학전문직업성이 의학 교육과 임상적인 실천에 있어서 가장 중요한 요소 가운데 하나로 인식되고 있다는 사실은 분명하다. 그러나 지금까지 의학전문직업성에 대한 공적인 합의가 충분하지 않았다는 것이 현실이며 이와 더불어 여성 의사들의 역사적인 정체성과 의학전문직업성에 대한 논의가 부족했다는 것도 사실이다. 이 논문은 의학전문직업성에 대한 역사적인 논의를 통하여 근대 유럽과 미국의 남성 주도의 의학 영역에서 여성의 의사 되기와 여성들의 의학 전문직업성에 대해 살펴보는 동시에 이것이 어떻게 한국이라는 상황 속에서 새롭게 구현되었는지를 밝히는 연구이다. 본 연구의 내용은 의학전문직업성의 개념과 역사적인 이해, 의학에 있어서 여성의 역할과 여성들의 의학전문직업성, 한국적인 상황에서의 의학전문직업성을 포함한다. 여성 의사들의 의학전문직업성과 관련하여 본 연구는 의학에 대한 전인적인 접근, 예방의학의 중요성에 대한 강조, 환자-의사의 평등한 관계를 특징으로 하는 영미권의 여성 의학전문직업성에 더해서 한국 초기의 상황의 여성 의사들은 주체적인 의학 지식과 술기, 그리고 직접적인 소통을 통한 전인적인 치료를 목적으로 하였다는 특징을 발견하였다. It is evident that medical professionalism has become one of the most important elements in education and practice of medicine. However, it is also clear that the public consensus on medical professionalism and the identity of women doctors, which is related to the concept has not been fully made. Therefore, the research examines the historical development of medical professionalism and how women have challenged to the male-dominated realm of medicine to gain their own medical professionalism. In addition, it is also important to clarify how that the medical professionalism in Euro-America influenced the process of making women doctors in Korea. This paper illustrates the concepts of and historical changes in medical professionalism, the role of women in medicine and their medical professionalism, and the characteristics of women’s medical professionalism in the American and Korean contexts. In addition to the holistic approaches to medical practices, emphasis on the preventive medicine, and eqaul relationship between physician and patient, it can be considered as an important aspect of the medical professionalism among early Korean female missionary physicians that they pursued healing of body and soul as a whole on the basis of their medical knowledge, techniques, and direct communication with patients.

< 의협신문 >에 나타난 의료전문주의의 담론화 방식

김주미 ( Joo Mi-kim ) 한국지역언론학회 2016 언론과학연구 Vol.16 No.3

2000년 의약분업 사태 이후 한국에서는 의료계를 둘러싼 갈등이 사회문제로 가시화되었고, 전문직으로서 의사의 사회적 위상에 위기감이 형성되었다. 이러한 위기감은 사회 전반에 부는 탈전문직화(de-professionalization) 흐름에서 기인한 것으로 볼 수 있다. 본 연구는 전문직인 의사들이 한국 의료의 탈전문직화 흐름을 어떻게 받아들이고 있는지에 대한 질문에서 시작하였다. 본 연구는 의사가 직접 서사행위를 통한 담론화 과정에 참여하는 < 의협신문 >을 분석하여, 의사 개인 또는 집단이 어떤 시각에서 의료 영역에 찾아온 전문주의 위기 경험을 받아들이고 지금의 현실을 바라보고 있는지, 어떤 맥락 안에 스스로를 위치 짓는지 등을 이해하고자 하였다. 분석 결과, < 의협신문 >의 전문주의 담론은, 한국 의사의 탈전문직화 현상을 견제하고 대응하기 위한 방향으로 변화해 왔음을 확인하였다. < 의협신문 > 속에서 의사들은 직업적 전문성을 당연시하며 사회의 엘리트로 안주하였던 과거를 성찰하였고, 스스로 집단화·정치화하여 자신들의 문제를 해결해야 한다는 실천 의지를 다졌으며, 나아가 무너진 의료전문주의를 다시 세워나가는 ``신(新)전문직화``의 주체가 되어야 함을 호소하고 있는 것이다. 이로써 < 의협신문 >은 현대사회에서 전문직이 여전히 높은 자율성을 유지해야 한다는 전문직 지배 논리의 당위성을 강조하는 것으로 볼 수 있다. Since the separation of dispensing and prescribing of drugs in 2000, Korea has seen increasing conflict in medical industry into a serious social issue along with a sense of crisis developed for social status of medical doctors as professionals. This sense of crisis can be considered being attributed to the trend of de-professionalization prevalent throughout our society. Against this backdrop, this study has begun with a question of how professional medical doctors take the de-professionalization trend in our society. This study has sought to identify how medical doctors, individuals or group, take the experience of de-professionalization that has turned into reality in medical sector, how they view this reality and in what context they position themselves based on the analysis of the < Newspaper of the Korean Medical Association > that participates in the process of discussion through narrative activities directly conducted by doctors. The analysis results have indicated that the professionalism discussion of the < Newspaper of the Korean Medical Association > has changed toward a direction that checks and responds to the de-professionalization phenomenon among Korean medical doctors. They have taken some time to reflect on the past when they were complacent about being social elites while taking occupational professionalism for granted, determined to resolve their own issues and problems by consolidating and politicizing themselves, and further appealed to be the major players of ``neo-professionalism`` intended to rebuild the collapsed medical professionalism. All of these seem to indicate that the < Newspaper of the Korean Medical Association > has put an emphasis on the justifiability of dominant logic among professionals with a claim that professionals in modern society should still be given a relatively higher extent of autonomy.

의학교육에서 덕윤리적 전문직업성 적용과 그 함의

김정아,이화영,김수정 한국의료윤리학회 2019 한국의료윤리학회지 Vol.22 No.2

The value and importance of medical professionalism has been recognized for medical educators in Korea for several decades. However, the lack of a shared understanding of medical professionalism hinders its adoption and application in educational settings. This article introduces three mainstream understandings of medical professionalism, integrates a virtue-based and identity formation understanding into one virtue ethics understanding, and analyzes the concept of medical professionalism in the learning outcomes of the basic medical education of the Korea Association of Medical Colleges (KAMC). In particular, we borrow the notion of “practice” and the three necessary virtues for all practices from MacIntyre’s virtue theory and then apply those concepts to the medical professionalism in the learning outcomes of the basic medical education of KAMC. We find that KAMC documents adopt an outcome-based approach that needs more elaboration in terms of virtue ethics in order to present a comprehensive understanding of medical professionalism. In conclusion, we propose three necessary virtues for medical professionalism and argue for their utilization in medical education as an effective means to bridge the learning outcomes and objectives of the medical professionalism in KAMC documents. 의학 전문직업성에 대한 논의와 의학교육에의 적용이 활성화되고 있으나 해당 개념이 갖는 모호성과 분파성 때문에 실제 의학 전문직업성 교육에서 걸림돌로 작용하고 있다. 이에 저자들은 의학 전문직업성에 대한 세 갈래의 담론을 분석하고, 이 중 덕 기반 전문직업성과 전문직업적 정체성 형성을 통합하여 덕윤리적 전문직업성의 개념과 이론을 제시한다. 한편, 현재 한국의과대학 · 의학전문대학원협회(Korean Association of Medical Colleges, KAMC)「기본의학교육 학습성과-사람과 사회」 중 8. 전문직업성 영역이 존재한다는 점은 의학교육에서 중요한 함의를 갖는다. 저자들은 이 문헌이 의학교육 및 의료윤리교육에 갖는 영향력에 주목하여 명료하면서도 포괄적인 의학 전문직업성 교육을 위한 한 방편으로서 해당 의학교육표준을 활용하고자 하였다. 이에 먼저 KAMC 8. 전문직업성 영역이 행동 기반 전문직업성 접근에 치중한 한계를 드러내고, 덕윤리적 전문직업성에 비추어 보완될 수 있는 방법을 모색해보았다. 보완의 구체적 방법으로는 최종학습목표에 도달하기 위하여 실행학습목표에 덧붙여 교육될수 있는 덕목을 구체화하고자 하였다. 특히 매킨타이어가 모든 실무에 반드시 필요하다고 제시한 세 가지 덕목, 즉, 정의, 용기, 정직을 예시로 들어 KAMC 각각의 실행학습목표와 어떻게 조응하는지 제시한다. 실제 교육방법의 적용으로는 지금까지 강조되어온 숨은 교육과정만이 아니라 교실에서의 명시적교육과정에서 덕목을 구체화하고 이야기를 통해 제시하는 것이 어떤 효과를 가질 수 있는지 분석한다.

의학 전문직업성의 기초자질 함양을 위한 교육과정 평가 및 구성

방재범,이광윤,이충기,이동협,이영환,김재룡,강복수 한국의학교육학회 2008 Korean journal of medical education Vol.20 No.2

Purpose: Today, the social requirement of medicine emphasizes the importance of medical professionalism. This forces medical educators to introduce new contents and methods into the curriculum. This study aims to offer ideas for developing the curriculum through clarifying priorities on the basic qualities of medical professionalism and evaluating the current curriculums in medical schools in South Korea. Methods: In April 2005, 46 respondents majoring in basic medical sciences, clinical medicine, and medical humanities/social sciences completed a structured questionnaire. The questionnaire consisted of 3 categories related to: 1) the basic qualities of medical professionalism/general education courses, 2) the process of developing the qualities of humanities and social sciences in medical education, and 3) the appropriate allocation of credits for each subject to premedical and medical courses. The analysis consisted of frequency, chi-square, and multiple responses using Korean Ed, SPSS 14.0 for Windows. Results: The most important basic quality is basic medical knowledge. The credits for the general education are sufficient but it's contribution is lacking(44.44%). The most lacking element in the general education courses is socio-cultural comprehension(45.65%). The knowledge of humanities and social sciences is very important in developing the basic qualities(56.52%). The important learning experiences related to these is the introspection into human beings(32.16%). Credits for medical humanities classes in premedical and medical course are noticeably insufficient(45.65, 54.35%, respectively). The appropriate program of informal curriculum for fostering the qualities is meeting with various medical specialists(44.44%, 47.83%, respectively). There is almost no difference among the major groups under(p<.05.) Conclusion: To assist medical students to be equipped with the basic qualities of medical professionalism, the realm of medical humanities should be made mandatory; and the general education courses need to be reformed, especially in the premedical curriculum. In particular, continuous cooperation between faculties in medicine, liberal arts, and/or social sciences need to exist with the conglomeration of these into fewer medical humanities majors in Korea.

What Qualities Do Medical School Applicants Need to Have? - Secondary Publication

Yera Hur,Sun Kim 연세대학교의과대학 2009 Yonsei medical journal Vol.50 No.3

Purpose: Doctors are asked to play the roles of both a healer and a professional. In dealing with this inherent demand, we should first ask ourselves if we are selecting students who show traits that would enable them to become a good doctor. The primary concern of this study was to identify the core elements of medical professionalism that will develop into professional competence that we should be sought in medical school applicants. Materials and Methods: One hundred-six responses from the Delphi survey done by medical school professors and 230 completed questionnaires from medical students were used for analysis. We also set out to analyze the level of medical professionalism in newly entering medical students using a 5-point Likert scale. Results: Of the 27 elements of medical professionalism examined, the most important core element was thought to be ‘life-long learning skills’. The level of professionalism in Korean medical students was mostly assessed to be less than the 3.0 mean score given by the professors. Medical students tended to rate themselves higher than did the professors for their level of medical professionalism. Conclusion: Medical professionalism can be categorized into three domains; professional knowledge, professional skills, and professional attitude. For the prominent differences in the recognition of the levels of professionalism elements in medical students by students and professors, further studies investigating the reasons for discrepancy are needed. Purpose: Doctors are asked to play the roles of both a healer and a professional. In dealing with this inherent demand, we should first ask ourselves if we are selecting students who show traits that would enable them to become a good doctor. The primary concern of this study was to identify the core elements of medical professionalism that will develop into professional competence that we should be sought in medical school applicants. Materials and Methods: One hundred-six responses from the Delphi survey done by medical school professors and 230 completed questionnaires from medical students were used for analysis. We also set out to analyze the level of medical professionalism in newly entering medical students using a 5-point Likert scale. Results: Of the 27 elements of medical professionalism examined, the most important core element was thought to be ‘life-long learning skills’. The level of professionalism in Korean medical students was mostly assessed to be less than the 3.0 mean score given by the professors. Medical students tended to rate themselves higher than did the professors for their level of medical professionalism. Conclusion: Medical professionalism can be categorized into three domains; professional knowledge, professional skills, and professional attitude. For the prominent differences in the recognition of the levels of professionalism elements in medical students by students and professors, further studies investigating the reasons for discrepancy are needed.

中國 社會體制 變化와 醫療專門職의 地位變動

동아인문학회 2008 동아인문학 Vol.13 No.-

<P>This paper is a positivistic case study of Chinese social system reformation and the status change of medical profession. Chinese government chose the reformation and open door policy to pursue the socialistic market economy. The change of social system effected on the status change of medical profession. In this paper, the survey has been performed to Chinese medical profession about the status change of medical profession after the reformation and open door policy. The contents of survey were the degree of development in medical areas, the status change of medical profession, the cause of the status rising of medical profession, the evaluation of the professionalization of medical profession, the development strategy of medical profession.</P><P> The results of the survey showed that medical profession evaluated that the effects of the reformation and open door policy on medical areas were generally positive. But for the effects of the reformation and open door policy on the status of medical profession, the negative answers were more than the positive answers. In Chinese society, the occupational status of Communist party executive and public officials are still higher than that of professionals like professors or medical doctors.</P><P> This research is significant that it is a positive case study of the relationship between Chinese social system reformation and the status change of medical profession. And this is a sociologically interesting study in the sense that this is a research of the status change of medical profession in the coexisting situation of socialist regime and capitalist system.</P>

덕 윤리와 의학전문직업성의 관련성

김수정 이화여자대학교 생명의료법연구소 2011 생명윤리정책연구 Vol.5 No.2

The goal of medical education depends on the end of the medicine. The end of medicine is to found in the process in which medical doctors seek for their identity. On the one hand, medical community accepts what their society asks for them and acts as one in order to protect its interest. One the other hand, it punishes those who violates moral code and insult the status of doctor in order to keep its integrity. This paper deals with the relationship between medical professionalism and virtue ethics. First, it finds moral characteristics which are expected from medical profession. Second, it discusses on the purpose of medical education based on the analysis of the relationship between medical professionalism and virtue ethics. In order to discuss on virtues of medical professionalism, it is necessary to know its nature and characteristics of primary activity. Virtues helps the medical profession to realize and accomplish its end whereas vices deter the realization of its end. The relationship between medical professionalism and virtue is defined through three characteristics. First, virtue ethics emphasizes the process in the moral agent interprets moral principles, choose the primary values, and makes good judgments. Second, deontology and utilitarianism overlooks the possibility of extraordinarily good actions. But, altruism and compassion toward the sick is somewhat built in medical profession. Virtue ethics is proper to explain moral characteristics of medical profession. Third, virtue ethics promotes moral sensitivity and helps to built moral habits among future medical professionals. Good doctors who built moral characteristics easily identify what is morally good action and what is not.