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


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.


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.


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.


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.


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.


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.


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.


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.


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.



• 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.



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



• 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.


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.


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.


ATTITUDE (3)

Various behavioral aspects relevant to medical profession:

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


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.


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


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.


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.


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


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.


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.


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.


Organo-Biologic Psycho-educative

Social environment,& culture (including

beliefs, religion)

Nature &environment

SupernaturalReligiousness/Spiritualism

Scientific BaseBIO-PSYCHO-SOCIAL

Sasanto Wibisono, 1992


That’s all

Thank you

Documents

Personality and Medec 2006 (Power Point Prof SW)