Academic journal article Education

Cynicism/idealism: Implications for Health Care

Academic journal article Education

Cynicism/idealism: Implications for Health Care

Article excerpt

In the socialization process of the medical profession, values, norms and roles play an important role in the motivations and aspirations of medical students.

An examination of attitudes and values indicates that values of a culture do not exist in isolation; rather they form groups of related values. Thus, in values clusters, each value is directly tied into other values. Each value becomes an integral part of a larger whole. The values of a culture identify its ideals, its ultimate aims and most general standards for assessing good and bad or desirable and undesirable.

Norms, on the contrary, are quite specific. They are rules governing behavior in a society or group such as the medical profession. Roles are a collection of norms associated with a particular position in society. That is, these norms describe how we expect someone in a particular position to act or not to act.

It is essential to document the fact that cynicism and idealism are linked to values, norms and roles in the professionalization process of medical students. Moreover, it would seem that the preclinical level at medical school is considered a training ground for "uncertainty"--a tendency toward cynicism. The medical student at this stage of his/her professionalization does not know precisely what and why he/she is supposed to learn; how much is to be mastered or how to go about the study of medicine.

It appears that the essential motivating force that keeps the student interested in the preclinical years of medicine is the eagerness to get beyond them and into the clinical years of medical school; to play the role of student-physician, and ultimately to become a physician. This evolution and achievement gives rise to idealism within the student's personality.

The interplay with one's personality of cynicism and idealism may be viewed as the struggle that occurs within individuals in determining that which is uncertain and that which is certain or ideal. The value-attitude system of student physicians may be shaped by the interplay of these personality variables. Within this mileau the effect of cynicism and idealism on a number of patient related variables will be examined. (Fredericks and Mundy, 1976 and 1980; Fredericks and Fredericks, 1997)

Among the various studies that bear upon cynicism and idealism would be those of Carl Rogers who developed the most systematic formulation of the self concept based upon fundamentals of psychotherapy (Rogers, 1951 and 1961). Sullivan, on the other hand, developed a comprehensive and systematic theory of personality that was directly linked to interpersonal behavioral patterns. He argued that the concept of personality had meaning only when defined in terms of a person's characteristic ways of relating to others (Sullivan, 1953). In conjunction with Sullivan, the principles of interpersonal behavior accommodation have been analyzed at length by others (Benjamin, 1993; Carson and Sanislow, 1993; Kiesler, 1993; Leary, 1957; and Wiggins, 1982).

Method

The sample twenty-five years ago consisted of 108 medical students. Present data were gathered from 51 of the original respondents who were sent self-administered questionnaires and attitude inventories. Seventy-nine of the original 108 subjects were sampled; the 51 physicians who voluntarily completed the instruments sent represent a 65 percent response rate. Completed questionnaires were identified by code number in order to preserve the anonymity of the respondents.

Criteria and Issues

Cynicism and idealism are discussed in relation to Professional and Economic Issues considered important by physicians in Table 1. Table 2 examines the Criteria as they relate to the Humane Treatment of Patients. Physician Attitudes Toward the Poor as influenced by the Criteria of Cynicism and Idealism are investigated in Table 3.

Table 1 Cynism/Idealism by Professional and Economic Issues Considered Important

                                       (*)Class I   (*)Class II
Professional and Economic                 Percent      Percent
Issues Considered Important               n=9          n=29

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