Identification of professionalism behaviour blueprint assessment medical students with Eastern and Islamic culture in the profession program

INTRODUCTION

Medical institutions have a role and responsibility in training medical students to have the knowledge and skills needed to become a reliable doctor in mastering knowledge, skills in the field of medicine. One thing that is often overlooked by medical institutions is forgetting aspects of professional behavior. Professional behavior is indispensable in creating a new generation of doctors who have professionalism and character. For medical institutions that based on Islam culture as a starting point in professional behavior, it is very important to be able to formulate indicators in professional behavior for medical students with Islamic characteristics.

There are many unhappy facts in the field regarding the issue of doctor malpractice, some websites on the internet that question the quality of doctors in Indonesia, especially regarding professionalism. Some facts in the field in various institutions such as during professional education where students tend to avoid the guided practice in the hospital in various ways and issues of doctor's immorality towards patients are thought by researchers to be able to develop indicators and instruments for evaluating Islamic professional behavior in line with eastern customs especially Indonesian people who are mostly Muslims.

In 2020, Indonesia faces free trade where there are opportunities for foreign doctors to enter Indonesia. This is a challenge for medical institutions in Indonesia to prepare qualified doctors, have high professionalism, character and have high morality as a characteristic of Indonesia's eastern culture. The existence of a gap in the implementation of professionalism abroad and in Indonesia has made medical institutions in Indonesia work harder to develop and implement professionalism in medical education.

Previous research is limited to the assessment of professional behavior that is still generally conveyed and does not link Islamic aspects of the Islamic institutions based on Islam. Many of the medical institutions especially in Indonesia have not applied the professional behavior assessment to medical students. This will certainly have an impact on the results of doctor graduates in Indonesia. Therefore, a guideline for evaluation and professional behavioral indicators are needed, that should be possessed by medical students in Indonesia who have more character and apply Islamic principles.

This research was conducted with the aim of making a model of evaluating professional behavior with Islamic characteristics. The results of this study are expected that Islamic medical institutions can apply the principles of professional behavior with Islamic characteristics to be able to create a generation of new doctors who have professional behavior and Islamic characteristics.

As far as the researcher’s knowledge of professional behavior models based on Islamic values has never been done before. Assessment instruments that already exist only assess some aspects that are not suitable to be applied in Indonesia. In this concern, more research is needed that can produce behavioral models of medical professionals that put forward the image of eastern and Islamic values in it. Indonesia has a population that is predominantly Muslim. The emergence of many Islamic hospitals has made its own demands especially for medical education institutions that are based on Islam to be able to fulfill the expectations of stakeholders in providing medical graduates with Islamic characteristics and promoting eastern culture. The results of this study are expected to provide scientific repertoire in the field of medical education. The models and instruments developed are expected to be implemented in medical institutions as part of the assessment of professional behavior that prioritizes Islamic values and has eastern cultural characteristics.

This research is a qualitative research by collecting data using the semi structured interview method. Interview script data will be analyzed using the general inductive approach.

Based on the background presented above, the purpose of this study was to determine the professional behavior of Islamic characters in medical students. The indicators will then be formulated. This research was conducted with the aim of making an indicator of evaluating professional behavior with Islamic characteristics. The results of this study are expected that Islamic medical institutions can apply the principles of professional behavior with Islamic characteristics to be able to produce a generation of new doctors who have professional behavior and Islamic characteristics.

Professionalism is a very important thing to be applied and a benchmark for the quality of doctors in Indonesia. The implementation of learning and assessment of medical professionalism is a quite high challenge.¹ However, professionalism can be taught, learned and applied and related behavior can be identified. In addition, assessment of medical professionalism is the best approach to get the quality of a professional doctor.²

The application of professional behavior assessment as long as in Indonesia cannot be implemented properly so that a study is needed to be able to integrate and implement assessment items comprehensively and measurably. Without a correct and integrated assessment, our questions about the efficiency of our learning methods to provide learning about professional behavior will not be effective.³ Another study stated that assessing professionalism is difficult because of lack of clarity of items and examples of professionalism to be assessed.⁴

Another study also made an assessment of professional behavior in the education of final level teacher education students. This assessment only concerns the problem of student responsibility, cooperation between friends, and ethical behavior towards students, as well as enthusiasm.⁵

Competency assessment in medicine does not only involve the cognitive and skill domains but also must pay attention to the assessment of professionalism including interpersonal skills, lifelong learning, professionalism and the integration of medical knowledge into medical practice.⁶

The values of professionalism according to the American Physical Therapy Association divide professionalism into physiotherapy education into 7 domains, namely accountability, altruism, compassion, excellence, integrity, professional duty, and social responsibility.⁷ The implementation of learning and the assessment of medical professionalism requires several stages which consist of determining expectations and indicators, determining the items of assessment, determining inappropriate behavior, preventing inappropriate behavior, and implementation.¹

METHODS

This research will be conducted by formulating indicators of the professional behavior of Islamic and eastern-cultural medical students. The stage of formulating indicators of professional behavior of Islamic medical students is carried out by qualitative research methods by collecting data using deep interviews by knowing the opinions of lecturers about Islamic professional behavior. Respondents in this study were lecturers of the Medical Faculty of the Muhammadiyah University of Surakarta, Pabelan, Kartasura, Central Java, Indonesia.

Interviews will be conducted with semi-structured interviews that will allow both informants to develop answers. The interview data will be analyzed using a “general inductive” approach.^8,9 This research was conducted at the Medical Faculty of the Muhammadiyah University of Surakarta Pabelan, Kartasura, Central Java, Indonesia.

RESULTS

Based on the results of interviews that have been carried out on fourteen informants including lecturers/lecturers of medicine in the Faculty of Medicine, University of Muhammadiyah Surakarta, the following data have been obtained with semi structured interviews.

Based on the Table 1 shows, it is clearly identified that there were eleven respondents, 54.55% of which were men, meanwhile, 45.45% were woman. In addition, 72.73% of the respondents worked in hospitals based whilst 27.27% from those respondents were occupied in the faculty based. Based on the above data, general induction can be done as a big theme, namely professionalism in terms of cognitive, skills, and attitudes as follows.

Based on this study, it was found that students were said to have professionalism of medical students in the medical profession program who have cognitive competence include knowledge/knowledge integration, lifelong learning, critical appraisal. This is in accordance with the expectations of the lecturers that “Medical students in the professional program are expected to have professionalism in terms of cognitive or good knowledge.”

Based on this study, it was found that students were said to have professionalism of medical students in the medical profession program who have cognitive competence include knowledge/knowledge integration, lifelong learning, critical appraisal.

This is in accordance with the expectations of the lecturers that “Medical students in the professional program are expected to have professionalism in terms of cognitive or good knowledge.” According to the respondents, professionals have competence in terms of teamwork or cooperating in teams well, having character/behavior that is Islamic, active, has social responsibility, which is professional, behaves politely, has high motivation, communicates politely, behave in a polite manner every day.

As stated by some respondents who said that Professional is part of Islamic behavior, professional is to achieve collegial competency standards Indonesian Doctors competency standards include cognitive, attitude, skill.

One example of medical students according to respondents is the examples of the behavior of professional and professional medical students or medical students in accordance with Islamic culture are examples of examination ethics, starting from introducing themselves first, saying hello before examining patients, informing patients, when examining patients, must apply politeness.

Medical students/Coass who are professional in Islamic behavior and have eastern culture are students who have good manners, are able to be kind to fellow medical staff and also to patients.

Other behaviors that must be possessed by professional medical students or Coass who are highly dedicated, work hard. In addition, the expected behavior is that medical students can work with midwives, nurses, doctors and also the clining service.

A professional stage medical student has professionalism in terms of attitude or attitude which includes being on time, looking neat, communicating, having daily behavior that is polite, honest, respecting others, having self-regulation and self-assessment, discipline, and choosing Islamic environments that support the learning process, as well as sincere/selfless in carrying out their duties as students. Other behaviors that must be possessed by professional medical students or Medical students are those who are able to admit mistakes and always want to keep trying to practice and learn in all conditions.

Islamic with the obligation to pray on time. Medical students who are professionals are expected to keep trying time discipline and practice being patient with patients and doctor advisers / lecturers.

Based on the formulation of Islamic and culturally eastern professionalism above, an instrument for evaluating professional behavior of Islamic and cultured eastern medical students was used, using the Likert scale with a very disagree value of 0 to very agree 4. The total value of cognitive professionalism is a maximum of 12, total value the skill professionalism is 28 and the attitude total professionalism value is 32 with the assessment items as follows.

Charging instructions

Please provide the response closest to the statement given. Fill in the appropriate column by giving a sign (√).

Information

• • SD: Strongly Disagree
• • D: Disagree
• • N: Neutral
• • A: Agree
• • SA: Strongly Agree.

DISCUSSION

Based on the results of the study, the data obtained from semi-structured interviews with eleven informants from lecturers in the Faculty of Medicine, University of Muhammadiyah Surakarta, can be taken three major themes related to the professional behavior of Islamic and eastern-culture students.

Medical students who are prospective doctors are expected to have all three of these factors. The three factors include cognitive factors, skills or behaviors and attitudes that are Islamic and culturally eastern.

Cognitive factors in this study are described in two sub-themes namely knowledge or integration of knowledge, lifelong learning and critical appraisal.

Own knowledge according to the lecturers includes knowledge about medical material and also about Islam itself which when described in the material in the Qur'an and Hadith includes things about medical science. Therefore, mastering the knowledge of religion can support the mastery of medical science and vice versa.

The second theme is about Islamic skills or behavior. This theme then includes seven sub-themes namely teamwork, Islamic character/behavior, being active, social skills, professionalism, polite behavior towards patients, high motivation. The third theme is about attitude. Attitude factors in this study include timely, neat appearance, communication, daily behavior, honesty, respect for others, self-regulation and self-assessment, discipline, an Islamic environment, sincerity.

This study formulates examples of professionalism in Islamic and eastern civilized medical students, although some studies suggest that research on professional behavior is a difficult study.⁴ The results of this study also support the results of research where lecturers give their perceptions of the professionalism of medical students who not only respond to cognitive and skill but also include attitude and professionalism in it.⁶

Although some sources stated that professionalism is a difficult thing to learn, but the examples of Islamic and cultured eastern professionalism that are conveyed in this study are things that can be learned and implemented.^1,2

This research adds the values of professionalism formulated by the American Physical Therapy Association which only divides professionalism values into seven domains, namely accountability, altruism, compassion, excellence, integrity, professional duty, and social responsibility and other research which only pay attention to issues of student responsibility, cooperation between friends, and ethical behavior towards students, and enthusiasm.^5,7

CONCLUSION

Based on the research data that has been obtained, it can be concluded that the indicator of professional behavior of Islamic and eastern cultured medical students includes three major themes of professional behavior that should be possessed by Islamic medical students consisting of excellent cognitive abilities which include three sub-themes namely knowledge integration, lifelong learning and critical appraisal. Excellent skills include seven sub-themes namely teamwork, good Islamic behavior, activeness (energic), social skills, professionalism, behavior towards patients, motivation. Excellent attitude consists of eight sub-themes including appropriate time, appearance, communication, daily behavior, honesty, respect for others, self-regulation and self-assessment, discipline, the environment condition, sincerity.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

REFERENCES

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