Conference Agenda

RN19_08: Clinic in Change
Thursday, 22/Aug/2019:
6:00pm - 7:30pm

Session Chair: Teresa Carvalho, University of Aveiro
Location: BS.3.28
Manchester Metropolitan University Building: Business School, Third Floor, North Atrium Oxford Road


Prudential Professionalism and Social Innovations: Shifting Relationships

Florent Champy

National Centre for Scientific Research, France

In prudential activities, professionalism used to be closely related with an original form of innovation. In the singular and complex situations in which prudentiality (or practical wisdom) is needed, practice often requires deliberating not only about the means to implement but also about the prioritization of the ends of the activity itself. When the activity is routinized (which means here that it is practiced without deliberations on its ends), some members of the profession may criticize the dominant practice and propose an alternative one, based on another prioritization of its ends. Classical examples are the criticism of authoritative education on behalf of a more liberal conception (putting emphasis on the autonomy of the person), or the promotion of post-modern architecture, which prioritizes esthetics, vs. the functionalism of modern architecture. This has big theoretical consequences, as this kind of commitments and innovations sheds light on an original type of segmentation (agonistic segmentation), on the propensity for commitments, on the intraprofessional competition in markets, etc. The presentation will argue that such phenomena associated with prudentiality are becoming rare while another kind of commitments of professionals is becoming more frequent: commitments to fight the increasing obstacles to practical wisdom and restore a conception of professionalism more in line with the need of prudentiality in situations of irreducible uncertainties many professionals have to face. I will present examples of this new kind of innovations in medicine and propose a precise way to use the concept of practical wisdom to guide empirical work on them.

Professionalism as Social Closure or Self-Techniques: the Sociological Implication of CanMEDS in medical education

Po-Fang Tsai

Graduate Institute of Humanities in Medicine, TMU, Taiwan

In the past decade, competency-based or outcome-based education (CBE or OBD), in contrast to content-based or time-based education, has become the mainstream way in medical education around the western world, such as Canada (CanMEDS roles), the United States (ACGME, six core competencies), the United Kingdom (Tomorrow’s Doctor), and Scotland (the Scottish Doctor). Among these programs, the CanMEDS not only has its virtue of simplicity, in which the ‘‘medical expert’’ role is surrounded by six additional roles—communicator, collaborator, leader, health advocate, scholar, and professional, but also has been widely-adopted outside Canada. However, researchers in the sociology of professions have not yet noticed this new and contested trend. In this paper, I first examine the changing educational context of medical profession, and then focus on the sociological analysis of CBE, especially the case study of CanMEDS. The substantive analysis of CanMEDS and its CBE background demonstrate the following arguments: (1) for proving positivism in professionalism as competency, the reformers paradoxically introduce the CBE ideas from vocational education and unintendedly formulate closure in medical education; (2) the practice of CanMEDS roles echoes a foucauldian theme in professional ethics, transforming from ‘knowing oneself’ to ‘caring for oneself’ in the figure of an ideal doctor; (3) only taking into account the self-cultivated nature of professionalism can sociologist complement the neo-Weberian theory of the profession with its ethical or subjective element. In short, although neither the neo-Weberian approach nor the Foucauldian-governmentality approach scrutinizes the contested nature of CBE, the sociological implication of CanMEDS lies in the ambivalence of competency-based professionalism, which can be viewed as social closure and self-technique.

Barriers To Clinical Academic Careers For Nurses, Midwives and Allied Health Professionals In The UK

Diane Trusson1, Emma Rowley1, Louise Bramley2

1University of Nottingham, United Kingdom; 2Nottingham University Hospitals, United Kingdom

NHS healthcare professionals are encouraged to pursue careers combining clinical practice and academic research. However, data from a mixed methods study reveal that research conducted by nurses, midwives and allied health professionals (NMAHPs) is not adequately valued, leading to barriers to clinical academic career progression.

This paper reports on experiences of 67 NMAHPs in the East Midlands area of England who were pursuing a clinical academic career. Survey and interview data revealed that NMAHPs struggle to maintain their joint clinical and academic roles through lack of support at line management level and a perceived lack of value placed on their research aspirations. Participants compared their experiences with other medical colleagues (e.g. doctors and surgeons) who are supported to do research because it is typically embedded within their career development structures. In contrast, some NMAHPs reported experiencing barriers to progression such as pay cuts, reduced hours, or having no job to return to post-PhD. Despite their innovative research, potentially improving patients’ safety and satisfaction, with substantial potential cost-benefits for the NHS, some participants were considering navigating to a purely academic career path which would result in a loss of clinical expertise for the NHS.

We argue that knowledge created by clinical academic NMAHPs can be as valuable as that generated by medics. Furthermore, having research-active NMAHPs benefits the NHS by encouraging recruitment and retention of talented staff. However, management support is crucial in facilitating NMAHPs to progress in their careers and to continue to utilise their experience and expertise post-PhD.