Discourses of professionalism: Metaphors, theory and practice

Abstract

Professionalism is a contested concept and different discourses have differed by scope and epistemology. The theory of communicative action integrates epistemology (knowledge interests) with that of scope (lifeworld).

Aim: To pragmatically inform learning of professionalism.

Methods: apply the theory of communicative action to professionalism discourses.

Results: Previous professionalism discourses translated into four frames: technical; communicative; improvement, and critical. These can be viewed as four metaphors the scale; conversation; consensus conference, and protest. The theory of communicative action demonstrated that a critical frame was often lacking from discussions of professionalism and emphasized critiquing the assumptions made, the way power was utilized, and the ends to which actions were directed. Using these frameworks connected discourses on professionalism to other key medical discourses particularly quality improvement, patient centeredness, social justice, and the professional well-being.

Conclusion: The theory of communicative action adds value by introducing criteria for the evaluation of individual truth claims that expands the discussion beyond accuracy to include sincerity, ethics and coherence; and it emphasizes promoting free speech and the inclusion of diverse views and stakeholders. The theory of communicative action provides a coherent and useful framework for viewing professionalism that integrates with broader discussions about philosophy, truth claims, and post-modern society.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Critical Theory: Is descriptive and a normative basis for social inquiry aimed at decreasing domination and increasing freedom in all their forms.

Stanford Encyclopedia of Philosophy(SEP).

Communicative action: Is a theory of human behavior proposed by Jurgen Habermas where the speakers coordinate their action and pursuit of individual (or joint) goals on the basis of a shared understanding that the goals are inherently reasonable or merit-worthy.

Stanford Encyclopedia of Philosophy(SEP).

Theory of knowledge-interests: Is an epistemological classification by Jurgen Habermas into: (a) the interest of control through prediction is constitutive of the natural sciences; (b) the interest of hermeneutical understanding characterizes the humanities; and (c) social sciences, follow the knowledge interest of emancipation in that they create awareness of the contingency and changeability of the social world.

International Encyclopedia of Communication (Blackwell)

Additional information

Notes on contributors

Matthew Jon Links

Matthew Jon Links, MB BS, PhD, MPhil (Higher Ed), FRACP, is Director of Clinical Training at Gold Coast Health Service.

Tim Wilkinson

Tim Wilkinson, MB ChB MD(Otago) PhD(Otago) M Clin Ed(UNSW) FRACP FRCP(London) FANZAHPE, is Director of the Education Unit, Christchurch School of Medicine & Health Sciences.

Craig Campbell

Craig Campbell, MD, FRCPC, is the Director of Professional Development, Royal College of Physicians and Surgeons of Canada.