The Concept of Professionalism in the New Zealand Context
Bull, Robert, New Zealand Journal of Occupational Therapy
Founding occupational therapy services began in New Zealand with a narrow scope of clinical practice. These services were grounded in Adolf Meyer's model which took a holistic approach to help people and used activities to meet basic needs (Yerxa, 1992). Since that point of inception, the locus of occupational therapy practice has expanded into various specialities and sub-specialties. Along with increased complexity in clinical practice, the profession is developing a robust scientific base (Schwartz, 1992). This academic base is beginning to build momentum in New Zealand through the extension of post-graduate programmes and the graduation of homegrown doctoral candidates. There has been impressive growth, particularly over the past two decades. Wilson (2005) noted this development of the profession in New Zealand in a recent article, which focused on the roles, tasks, and responsibilities of occupational therapists.
Similar to the platform Maslow (1943) described in his proposed hierarchy of needs, the profession, and individual clinicians, require a solid foundation upon which to build, so that occupational therapy can grow to its full potential. If the profession is to reinforce its sound holistic base then key aspects such as knowledge, skills and attitudes need to be developed equally and concurrently. Notwithstanding past achievements, there are still considerable gains to be made towards the self-actualisation of occupational therapy as a health profession in New Zealand.
Knowledge, skills, and attitudes
Whether focusing on the development of an individual or the profession, the three concepts of knowledge, skills and attitudes can be used to identify where the emphasis of time and resources is required. In respect to the first two, knowledge and skills, there are positive examples of high achievement throughout New Zealand such as the Frances Rutherford Award. In addition, the continual growth of academic programmes within the Schools of Occupational Therapy gives evidence to the fact that a strong foundation is being developed.
Therefore is it time to consider professional attitudes and to look at ways to improve the concept of professionalism in clinical practice before the profession starts to lose ground. History has demonstrated that the role of occupational therapists changed as clinical practice developed. That may be why Wilson (2005) reminded us that if we do not keep the tasks we are doing, someone else will do them. So how can we describe or even measure professionalism? What does the word mean to individual clinicians and the profession as a whole?
This paper will specifically focus on attitudes, or to use the right term--professionalism. The implications from this discussion are potentially wide ranging and include the field of education, and the public and private sectors of practice.
Definition of professionalism
Cruess, Johnston and Cruess (2004) state there is no conclusive or inclusive definition of professionalism provided in literature. They suggest that an agreed definition could assist educators to teach about professions, professional responsibilities and professional behaviour within a health context. The definition they proposed reads:
An occupation whose core element is work based upon the mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or learning or the practice of an art founded upon it is used in the service of others. Its members are governed by codes of ethics and profess a commitment to competence, integrity and morality, altruism, and the promotion of the public good within their domain. These commitments form the basis of a social contract between a profession and society, which in return grants the profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice and the privilege of self-regulation. …