Discourses of professionalism: Metaphors, theory and practice

Area of Science:

• Medical Education
• Professionalism Studies
• Social Sciences

Background:

• Professionalism is a complex concept with varying definitions and epistemological approaches.
• Existing professionalism discourses often lack a critical perspective, focusing narrowly on technical or communicative aspects.
• The theory of communicative action provides a framework to integrate knowledge interests with the scope of the lifeworld.

Purpose of the Study:

• To pragmatically inform the learning of professionalism.
• To apply the theory of communicative action to analyze professionalism discourses.
• To identify gaps and enhance the critical evaluation of professionalism in medical contexts.

Main Methods:

• Application of the theory of communicative action to analyze existing professionalism discourses.
• Identification of four distinct frames: technical, communicative, improvement, and critical.
• Utilizing metaphors such as scale, conversation, consensus conference, and protest to represent these frames.

Main Results:

• The theory of communicative action revealed a frequent absence of a critical frame in professionalism discussions.
• It emphasized critiquing underlying assumptions, power dynamics, and the ultimate goals of professional actions.
• This framework connected professionalism discourses to quality improvement, patient-centeredness, social justice, and professional well-being.

Conclusions:

• The theory of communicative action enhances professionalism discourse by introducing criteria for truth claims (sincerity, ethics, coherence).
• It promotes free speech and the inclusion of diverse stakeholder views.
• Provides a coherent framework integrating professionalism with philosophy, truth claims, and postmodern societal discussions.