Historical analysis of professionalism in western societies: Implications for interprofessional education and collaborative practice

摘要

Health care systems around the world are under tremendous pressure to change their models of health care delivery-from the current multiprofessional health care delivery into interprofessional collaborative care models with the ultimate goal of improving patient/client outcomes. The growing diversity of the population, the increasing number of vulnerable persons (elderly, homeless, those living with chronic health conditions), the complexity of health problems, and the shortage of health care providers have forced health policymakers to call for sweeping revisions to how health care is provided, impacting how health care program students are educated. However, in professional training emphasis is placed on uniprofessional education. Learners are socialized in isolation from those in other related professions to ensure the development of a shared professional identity. Consequently, by program completion each student will not only master the knowledge, skills and norms of his/her own profession, but will also develop a silo identity, called "uniprofessional identity". This isolationist identity creates a lack of understanding of others. In limiting their exposure to learning about the roles and value of other health care professionals, persistent negative stereotypical attitudes towards other professionals are reinforced. In this paper, we present the historical evolution(s) of the discourse of professionalism to assist us to develop a deeper understanding of socio-historical context within which interprofessional education (IPE) is embedded within, and collaborative person-centered practice (CPCP). With greater insight, we can (re)conceptualize the possibilities, and advance research on, interprofessional education and practice in the present.