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Promoting professionalism

Professionalism: a mixed-methods research study was commissioned by the GDC to provide a comprehensive study of professionalism in healthcare and dentistry.

Video:  We asked professionals about what professionalism meant to them, find out what they said as well as the key findings from our research.

 

The research found that professionalism was multifaceted and context-dependent. Some notable contextual factors reported were environmental (such as treatment setting), cultural, religious, the perceptions of others and patterns of behaviour. Some aspects of professionalism appeared to be well defined and clear-cut, such as not discriminating against patients and the importance of informed consent. Other aspects were less clear, such as personal appearance or where professional life and personal life began and ended.

There were notable differences in views of professionalism between members of the public and dental professionals. While there was agreement that clinical competence was a prerequisite for professionalism, members of the public were more focused on these factors than dental professionals.

Clinical safety and competence or, what happens in a dental appointment, was of primary concern to members of the public, particularly for parents taking children to the dentist. They were less concerned about what a professional did in their personal time, whereas dental professionals found it easier to frame professionalism in negative terms (i.e. what not to do) and were less tolerant of unprofessional behaviours in personal time than the public.

The most marked differences were in the financial and contractual areas of dental practice. Researchers found that finance and the exchange of money for dental services added a unique dimension to professionalism in dentistry. They also reported that patients expected to have their interests put first, to be involved in decision-making about their treatment and care, and to be treated with dignity, respect and compassion. Researchers found that the costs associated with dentistry influence how professionalism was viewed, and that this could explain why patients expressed their views of dentistry in similar terms to those of other consumer services. Financial and other pressures on decisions were identified as a concern for patients, and a source of stress and challenge for dentists. Dental professionals highlighted financial and systemic pressures on dental practices.

These disparities in expectations now need to be considered carefully in the context of potential drivers of complaints and concerns being raised about dental professionals. They point to the need to work with patients and professionals to arrive at a shared understanding of professionalism in dentistry.

Coming to a shared view of the principles of professionalism feel particularly important when reflecting on findings on how professional behaviours are taught, and some of the generational training differences in the areas like communications and the use of social media. Researchers reported that positive concepts of professionalism were rarely covered at undergraduate level, that professionalism was difficult to assess and was largely developed through observation and reflection. Some dental professionals thought that communication skills were innate, while others discussed the value of education and training.

Researchers found that good communication was key, as it could lessen patient anxiety and enhance a patient’s assessment of the quality of care provided. Researchers highlighted the involvement of patients in decision-making as a foundation for trust, the need for clear explanations of treatment options, and that empathy, compassion, politeness and friendliness and making conversation were seen as instrumental in putting patients at ease and feeling respected. However, researchers also found that the quality of communication could be limited by time-constraints and patient requirements.

Next steps

The ADEE’s evidence review and research findings on professionalism will now be considered and used to inform the development of the Principles of Professionalism and the review of the Standards for the Dental Team.

We will be engaging with all stakeholders as the new principles are developed. We are aiming to consult on these new principles in the summer of 2021.