Personality and Medec 2006 (Power Point Prof SW)

11 Desember 2000 Prof dr Sasanto Wibisono, SpKJ 1

ATTITUDE AND PERSONALITY ASPECTS IN MEDICAL EDUCATION

Sasanto Wibisono

Department of PsychiatryFaculty of Medicine - University of Indonesia

11 Desember 2000 Prof dr Sasanto Wibisono, SpKJ 2

Introduction (1)

• If you have ever been a patient, than you know what to expect of the doctor’s attitude and behavior.

• That is how you should envision yourself of being a doctor!

• Patients/people will expect you to conduct your professional duty compassionately.

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Introduction (2)

• That implies aspects of ‘attitude’: i.e. sincere, with honesty, empathetic, professional, etc.

• Confidentiality, trust, ethics and legal aspects, became so important in medical practice because we are dealing with personal privacy.

• Doctor-patient’s relationship become the central issue in medical practice.

• During the past, medical profession used to be very respected and adored in a sacred sense.

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Introduction (3)

• More than just having the skill in diagnosing and treating diseases, medical doctors should have the ability for considerate interpersonal communication.

• It should took into account, the sacred mission in it’s objectives.

• It differs from other professions in the fact that in many ways it deals with the very delicate private/personal matters.

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Attitude, behavior & personalty (1)

• Attitude – manner of carrying oneself; disposition (stood in a graceful attitude); a state of mind or feeling (hostile attitude) => a functional expression of behavior.

• Behavior – the specified way to conduct oneself, to perform – the actions or reactions of a person in response to external or internal stimuli.

• ‘Behavior’ is a more general term – ‘conduct’ applies to actions considered from the standpoint of morality and ethics.

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Attitude, behavior & personalty (2)

• Behavior is a functional manifestation of personality - a reflection of personality.

• Personality – the totality of qualities and traits, collective character, behavioral, emotional, and mental traits, distinctive to a person. Developed throughout life, and more or less took it’s stable form during adolescence.

• Talking about ‘attitude formation’ is in essence talking about the whole process of personality development.

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Doctor-Patients’ Relationship (1)

• Keywords: Acceptance - Empathy - Rapport• Acceptance: unpretentious acceptance.• Empathy: the ability to comprehend and feel

(empathize), not just cognitive understanding, but inclusive the affective quality as part of the interpersonal relation/communication.

• Rapport: an established empathic interpersonal relationship, with the sense of trust and understanding. An established meaningful humane quality of communication.

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Doctor-Patients’ Relationship (2)

• How could we attained such qualification?• In fact, not all MDs could perform such

qualification in interpersonal/doctor-patient relationship. It is is not just a matter of intellectual / academic performance.

• It depends much on the basic personality, developmental and cultural background.

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Human Behavior• To understand attitude and personality, we should

understand the essential part of human behavior.• Unlike the more primitive species, human behavior is

a learned behavior (not much of an instinctual behavior).

• Human instinct - as the basic driving power• Biological constitution, psycho-educational process

and socio-environmental experiences (bio-psycho-social) constitute the basis for personality development.

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Attitude/Behavior and Personality Change (1)

• Personality is a unique individual traits which reaches it’s stable form after adolescence.

• Attitude/behavior is the reflection of personality.

• Some of the personality traits were very rigid and difficult to change or modified. Such as: the obsessive-compulsive personality, antisocial personality, schizoid personality, etc.

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Attitude/Behavior and Personality Change (2)

• Every profession with high responsibility required to be supported by those with conducive aspects of personality pattern.

• The same principle applied to Medical profession. Not all personality pattern is suitable for medical profession.

• Personality is the basic ground for behavioral manifestations and professional conducts.

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Attitude/Behavior and Personality Change (3)

Possibility of behavioral/personality change:• If the person is well motivated & sustained

by a favorable environment (unfortunately it is not always on the positive direction).

• Backed up by a conducive personality pattern.

• Behavior and attitude are more susceptible for change.

• Long enough to sustain a meaningful lasting behavioral change

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Attitude/Behavior and Personality Change (4)

• Attitude formation is not as simple as building personal characters by giving advise or lecture – it is a complex years of delvelopmental learning process involving various factors.

• Attitude & behavior are the observable manifestations of personality aspects in social communication – in normal as well as illness.

• Some conditions might need special behavior modification techniques to change.

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ATTITUDE (1)

• Is a part of the behavioral manifestations: manner of carrying oneself in relation to others - the way to talk and express oneself, a position of the body, a state of mind or feeling, disposition.

• Attitude formation might be an artificial and temporary one, but if compatible, it may also serve the personality or behavioral disposition in a more predictable pattern. People could learn a genuine way of communication, an artificial or symbolic way.

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ATTITUDE (2)

• With regard to the objectives of medical education, assessment of the personality and behavior of medical students are more meaningful than assessment of the attitudes.

• Observation of ‘attitudes’ may serve as indicator for monitoring qualification.

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ATTITUDE (3)

Various behavioral aspects relevant to medical profession:

• Moral • Ethics • Social norms and valuesOther aspect to be considered: • Legal aspect / consequences

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Moral, Ethics, Norms & Values (1)

• Attitude/behavioral guidance towards a more organized & civilized community-life.

• Assumed to aspire good reasons for a better social-life. Unfortunately there are no infallible standard measures.

• Everything will revert to conscience - a subjective judgmental conjunction with respects to humanitarian consideration.

• Refer back to the baseline: personality, behavior and attitude.

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Moral. Ethics, Norms & Values (2)

• Moral: the quality of behavior or attitudes as seen from the judgmental presumption, based on social conformity of good & bad standards. It depends much on the individual insight.

• Ethics: the philosophical revelation of moral in terms of rules or standards governing the conduct of members of a specific group or profession.

• Ethic: a set of principles of right conduct*)

*) American Heritage College Dictionary

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Moral. Ethics, Norms & Values (3)

• Social Norms & Values: an unwritten set of standards for behavioral conduct, built up as part of social or cultural way of life => the measuring codes of conduct in a particular social environment. Developed alongside history of the society by the influence of traditional, cultural and religious values.

• Codes or aphorism? In a chaotic community, these norms & values became futile. Inconsistency, inconsequence and double standards, became the guiding principles.

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Significant Issues Relevant to Medical Education (1)

• Student’s perspectives:– personal/potential compatibility (cognitive/

affective, personality profile, etc.)– adjustment capability related to cultural and

educational background (coping mechanism)– inherent adjustment problems attributed to

philosophical/ historical background– degree of insight in personality function and

development.

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Significant Issues Relevant to Medical Education (2)

• Institutional perspectives:– Enrollment screening requirements– Clarity, efficiency, consistency and

consequence in the institutional rules– Clarity in educational objectives– Institutional environment / identification figure– Availability of guidance & counseling service

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CLOSING REMARKS (1)

Conducive personality & behavior are essential assets for medical students / medical doctors. Its significance precedes attitude formation.

Even though it’s difficult to assess (except on its extreme manifestations), it should be part of qualification assessment.

Complex developmental background (bio-psycho-social) should be considered in the assessment.

Medical students should be knowledgeable about personality and its developmental process.

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CLOSING REMARKS (2)

Attitudes could be directed to a certain pattern through learning process, exercise, experiences, and other behavioral approach.

Change in attitude does not assure a long-lasting behavioral & personality change. Subject to individual variation rooted in the basic personality.

Needs enduring insight and strong motivation for behavioral & personality change.

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CLOSING REMARKS (3)

Try to be open minded and understanding in self assessment & criticism. Be receptive for posibility of positive personality development.

Some personality traits are not amenable to behavioral change, and in fact are not conducive for medical education.

Moral, ethics, social norms & values, legal aspects, etc., are only guidelines. The more important individual controlling power is the conscience.

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Organo-Biologic Psycho-educative

Social environment,& culture (including

beliefs, religion)

Nature &environment

SupernaturalReligiousness/Spiritualism

Scientific BaseBIO-PSYCHO-SOCIAL

Sasanto Wibisono, 1992

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That’s all

Thank you