Browsing by Author "Ellawala, A.T."

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Attributes of professionalism expected of a medical doctor in Sri Lanka
(Sri Lanka Medical Association, 2016) Ellawala, A.T.; Chandratilake, M.N.; de Silva, N.R.
INTRODUCTION: Professionalism is an essential competency for a doctor. OBJECTIVES: To identify the attributes of professionalism expected of a doctor in the Sri Lankan setting. METHOD: A two-round Delphi study was conducted online with the participation of 158 representatives of various stakeholders in healthcare. In the first round, participants outlined attributes of professionalism expected of a doctor in the local context. Through conventional content analysis, a list of attributes was compiled. These were rated by participants in round II. The most important attributes were identified by calculating the Content Validity Index (CVI) of responses. Kappa value was calculated to determine the adequacy of inter-rater agreement. RESULTS: In round I, 56 attributes of professionalism were identified. These items were compiled into a questionnaire with four distractors (i.e. misperceptions of professionalism) to minimize indiscriminate rating of items. In round II, 46 items received a CVI >0.78 (cutoff value to determine essential items). ‘Possessing adequate knowledge and skills’ received the highest CVI (0.99), followed by ‘displaying a sense of responsibility’ (0.98) and ‘being compassionate and caring’ (0.97). ‘Altruism’ and ‘socio-cultural sensitivity’ were not rated as important. Interestingly, one of the 4 distractors (‘stands for professional autonomy’) also received a CVI>0.78. The K-value was 0.77, indicating adequate inter-rater agreement. CONCLUSIONS: This study enabled the development of a prioritized list of professionalism related attributes expected of a doctor in Sri Lanka. The conceptualization of professionalism in the local healthcare context appears to have both commonalities and disparities with the rest of the world.
Lapses of professionalism occurring among Sri Lankan medical students: How should they be remediated?
(Sri Lanka Medical Association., 2019) Ellawala, A.T.; Chandratilake, M.N.; de Silva, N.R.
INTRODUCTION & OBJECTIVES: Early recognition and correction of lapses of professionalism occurring during 'the undergraduate period is vital. This study aimed to explore the lapses of professionalism occurring among local medical students and identify appropriate remedial measures. METHODS: The study was conducted in two phases. In Phase I, in-depth interviews and focus group discussions were conducted with medical teachers, clinicians, deans, students, nurses and patients (n= 129) to explore lapses they had witnessed. Conversations were audio-recorded, transcribed and analysed inductively. Description by multiple groups was considered an indicator of prevalence of a behaviour. In Phase II, a consensus conference with medical teachers, clinicians, deans and students (n=3 I), was conducted to achieve consensus on remediation strategies for identified lapses occurring as a first-time offence or a repeated behaviour pattern. Degree of consensus was based on modal distribution of responses. RESULTS: In Phase I, over 100 types of misconduct were described. The most common behaviours included, 'not doing allocated ward work', 'not contributing to group work' and 'several students examining a patient at the same time'. In Phase II, it was possible to achieve an acceptable level of agreement (50% or higher consensus) regarding remediation strategies for over 70% of the items, including almost all lapses identified as most common. Strategies ranged from 'ignore' to 'expulsion' and included measures such as discussion with peers, remedial work and counselling. CONCLUSION: Sri Lankan medical students exhibit a wide range of professionalism lapses of varying severity. The value of correcting such behaviour in a standardized manner is recognised.