ORIGINAL ARTICLE ABSTRACT Objective: The objective of the study was to determine that how Physical therapy teachers perceive 'Professionalism' in Pakistani Context? Study Design: This was a qualitative case study. Place and Duration of Study: The study was conducted in five different universities from five different cities of th th Pakistan from 10 of January to 25 June 2013 at different time. Materials and Methods: Semi structured Interviews were conducted with 15 Physical Therapy teachers of 05 different universities from 05 different cities of Pakistan. The Physical therapy teachers with at least 5 years teaching experience in a university were included for data collection. The interviews were audio recorded; data verbatim transcribed and analyzed manually by open coding and in-Vivo coding. Thematic analysis was done in order to identify different elements of 'Professionalism' in Physical Therapy teachers through finding the patterns in the data. Member checking was done by three researchers in the study in order to validate the data. Results: After thematic analysis based on emerging patterns from transcribed data, following important elements about 'professionalism' in the order of priority were identified; expert in subject with knowledge and skill, behavior and attitude towards the students, patients and staff, Autonomy, serving and benefits to the community and accountability in health services, compassion, moral reasoning, reflective thinker, acquainted with professional ethics, trustworthiness, honest and team based approach. In response to the question about the professionalism in 'Pakistani culture, the faculty responses in the order of priority were as follows; lack of resources, proper jobs, moral support, poor salary packages and financial support and religion boundaries, requirements of the community and cultural hurdle and poor context in the society, lack of governing body, council, responsibility and accountability. Conclusion: It is concluded that for professionalism expertise in subject's domain & skills is the most important element. Besides that behavior and attitude towards students and patients are the key components of professionalism. It is concluded that in Pakistani culture, there is lack of professional behavior in physical therapy teachers/faculty. Majority of the institutes don't concentrate on professionalism. Key Words: Culture, Context, Faculty, Professionalism. because PT teachers educate physical therapists. Also PT has a close andprolongs interaction with patients during rehabilitation. It has been observed t h a t t h e r e i s i n c r e a s e d e v i d e n c e a b o u t 1 professionalism in medical litetrature. In North America and Europe the International experts have been instrumental in defining professionalism. The professionalism is also d e s c r i b e d by t h e G e n e ra l M e d i ca l C o u n c i l ' s publication as the duties of a doctors, who providesgood health care, based on an updated continuous professional education, clinical teaching and bed side training, relationships with patients, 2 and colleagues. In Pakistancurrently 60 academic institutions are offering 5 years entry level Doctor of PT Program (DPT). Fifty seven institutions have been developed in past 15 years. There were only three academic Introduction Physical therapy is an emerging field of health sciences in Pakistan. Twenty two universities offer undergraduate and graduate programs in this discipline. To understand the 'Professionalism' as core competency and phenomenon in real life practice of PT's teaching is very important. It is How do Physical Therapy Teachers Perceive 'Professionalism' in Pakistani Context? 1 2 3 Syed Shakil Ur Rehman , Shakeel Ahmad , Raheela Yasmeen JIIMC 2016 Vol. 11, No.3 Correspondence: Dr. Syed Shakil-ur-Rehman Principal/Associate Professor Riphah College of Rehabilitation Sciences (RCRS) Riphah International University, Islamabad E-mail: shakil.urrehman@riphah.edu.pk 1,2 Riphah College of Rehabilitation Sciences Riphah International University, Islamabad 3 Department of Riphah Academy of Research and Education Riphah International University, Islamabad Funding Source: NIL ; Conflict of Interest: NIL Received: Mar 27, 2016; Revised: Jun 06, 2016 Accepted: Aug 17, 2016 126 Perception about Professionalism among Physical Therapy Teachers 3 institutions till 2000. Therefore need and demand of knowledgeable, skilled and professional PT Teaching staff has been increased in last 15 years. Currently there are more than 1000 qualified Physical therapy professionals in both academic and clinical 4 institutions. Professionalism is one of the three key areas of interest and importance for a PT teacher, along with knowledge and skill. It is the behaviors and attitudes of Physical therapist teachers which isimportant and role models for their students during teaching and training sessions. In medical and health sciences, professionalism is of global interest and the reason for this is the failure of traditional method of teaching due to non-professional behaviors and attitudes of teachers. The global awareness is continuously increasing about the teaching of professionalism to students of health and medical 5 sciences disciplines. China has made great changes in their education sy s t e m s i n c e 2 0 0 8 a n d m o s t l y u p g ra d e d thestandards in health professional education, along withnew addition of integrated courses and teaching 6 methods. The present study was designed to determine the core elements that describe 'professionalism' among the PT teachersin Pakistani culture. The objective of the study was to determine h o w P h y s i c a l t h e r a p y t e a c h e r s p e r c e i v e 'Professionalism' in Pakistani Context? Materials and Methods This was Qualitative case study. The case study strategy is used to understand the social phenomenologyin order to retain the holistic and 7 meaningful characteristics of real life events. Semi structured Interviews were conducted with 15 Physical therapy teachers of 05 different universities th from 05 different cities of Pakistan, from 10 of th January to 25 June 2013 at different time. The universities included were, Riphah International University Islamabad and Lahore, Lahore University, GC University Faisalabad, University of Sargodha, and Foundation University. Consent was taken from faculty; no conflict of interest raised. The ethical approval was taken from Riphah Research Ethical Committee before the data collection. The Physical therapy teachers with at least 05 years teaching experience in a university were included for data collection.The interviews were taken in English language. The interviews were audio recorded; data verbatim transcribed and analyzed manually by open coding and in-Vivo coding. A code can be defined as, “a word or a short phrase that metaphorically assigns a salient, essence catching, and/or redolent attribute for a portion of language-based or visual data”. There are more than twenty different types of codes and with one single data set it is not necessary to use all of them. The data was analyzed two times and coding was done in two cycles. In first cycle single word to sentence in the paragraphs were interpreted as the code. Open coding and In-Vivo coding was done. In the second cycle constant comparison in data sets of different respondents, cross case results was done in order to form the categories and themes. Thematic analysis was done in order to identify the different elements of 'Professionalism' in Physical Therapy through finding the patterns in the data. This helps in answering the research question. Member checking was done by three researchers in the study in order to validate the data.Mainly data was analyzed at 'manifest level'. Results After thematic analysis which was done manually, t h e f o l l o w i n g i m p o r t a n t e l e m e n t s o f 'professionalism' in the order of priority were identified; Expert in Subject and domain in knowledge and skill, Behavior and Attitude towards the students/patients/staff, Autonomy, serving and benefits to the community and accountability health services, Compassion, moral reasoning, reflective thinker, acquaint with professional ethics, trustworthiness, honest and team based approach. The perception of professionalism in 'Pakistani context' the faculty responses in the order of priority were; lack of resources, proper jobs, moral support, poor salary packages, financial support, religion boundaries, requirements of the community, cultural hurdle, poor context in the society, lack of governing body, council, responsibility and accountability. Other responses in orders are lack of knowledge professional ethics traininghonesty and teaching skills, also lack of literature access to literature, planning and team work. Also there is curriculum fault and limited global perception. The importance of professionalism for a Physical therapy teacher, most of the participants responded; 'it is one of the most important competency to be JIIMC 2016 Vol. 11, No.3 127 Perception about Professionalism among Physical Therapy Teachers demonstratedby most ofPhysical therapy teachers'. The level of professionalism for a Physical therapy teachers in Pakistani context, maximum responded that; 'it is one of the most important competency but very fewteachers practice act of professionalism'. substandard as compare to developed countries, the reasons for this is that, there is lack of ethical practice, lack of research and evidence based practice,lackofhigh quality education and talent equal or even more in initial phase of development of good theoretical background. There is no council, infrastructure, non-satisfactory level and lack of communication. The responses to improve professionalism in PT teachers were; proper training in research and teaching and excellence and teaching skills, conferences of national as well as international level, international level exposure, professional ethics and access to latest literature, establishment of council, approved service structure and salary package, continuous professional development , uniform curriculum regular updatation, specialized practice in PT, institution to institution collaboration, society awareness programme and vision development. In response to question that how much our PT i n s t i t u t i o n s c o n c e n t r a t e o n t e a c h i n g professionalism, the respondent said; “PT i n s t i t u t i o n s p a y v e r y l e s s a t t e n t i o n t o professionalism. Very few said that PT institutions concentrate on professionalism”. Globally, our Physical Therapy faculty members stand in order of priorities are below the level or The possible outcomes after achieving good level of professionalism, the following were identified; improve PT service and its quality and application of latest skills with evidence based practice, professional teacher and good researcher, benefits of students, community and patient, enhance quality of knowledge, professional ethical practice, recognition, responsibility, improve autonomous practice and international standards. Discussion I n o u r s t u d y t h e i m p o r ta n t e l e m e n t s o f 'professionalism' in the order of priority were JIIMC 2016 Vol. 11, No.3 128 Perception about Professionalism among Physical Therapy Teachers identified; Expert in subject and domain in knowledge and skill, Behavior and Attitude towards the students/patients/staff, Autonomy, serving and benefits to the community and accountability health services, Compassion, moral reasoning, reflective thinker, acquaint with professional ethics, trustworthiness, honest and team based approach. In 2012 Byszewski A et al in their study said “role modeling is single most important aspect of 8 professionalism”. A systematic review done by Passi V et al in 2012, in which they studied that there are 5 main themes for supporting the development of professionalism in medical students. These include curriculum design, student selection, and teaching and learning 9 methods, role modeling and assessment methods. In our study there are five components of professionalism which are more important for our PT teachers in Pakistan. These are accountability, ethical knowledge, Lifelong learning, honesty, autonomy and reflection. In 2012 a study conducted by Cruess SR and his colleagues on teaching professionalism and concluded that teaching professionalism requires cognitive base from each and every teaching community,which is a definition of profession, the attributes of the professional, and the relationship of medicine to the society which it serves. These should b e t a u g h t e x p l i c i t l y. T h e s u b s t a n c e o f professionalism must become part of each physician's identity and be reflected in observable behaviors. Professionalism should be taught as “an ideal to be pursued” rather than as a set of rules and 10 regulations. According to our study after achieving good level professionalism in PT Teachers in Pakistani Context; there will be improvement in teaching as well as PT services, which ultimately would have a very good impact on community. Hur Y in 2009 studied that medical professors need to encourage their students to increase their elevation. He studied on 31 core elements, significant perception gap were found in 28 elements. The 31 core elements were divided form 3 major domains – including professional knowledge, clinical skills, and professional attitude-all contained perception gaps, and professors' ratings generally were higher than 10 those of the students, a noteworthy observation. According to our study, strategies should be adopted to improve professionalism in PT teachers in Pakistani context the responses were proper training in research and teaching and training and excellence in teaching skills, conferences of national as well as international level, international level exposure, professional ethics and access to latest literature, establishment of council, approved service structure and salary package continuous professional d e v e l o p m e n t , u n i fo r m c u r r i c u l u m re g u l a r updatation, specialized practice in PT, institution to institution collaboration, society awareness programme and vision development. CahalinLPin 2012 conducted a study onLinda Crane Lecture on Professionalism as a Core Values in PT. The objective was to highlight the professionalism of Linda Crane with examples of the methods appropriate for physical therapist and to develop their own professionalism. She used a tool developed by the American PT Association (APTA), 11 named professionalism assessment tool. The study was conducted on small sample size of professionals due to lack of time with Physical Therapist. In future for generalized results large sample size with more universities are to be involved. Conclusion It is concluded that for professionalism expertise in subject's domain & skills is the most important element. Besides that behavior and attitude towards students and patients are the key components of professionalism. It is concluded that in Pakistani culture, there is lack of professional behavior in physical therapy teachers. Majority of the institutes don't concentrate on professionalism. REFERENCES 1. Cruess SR, Cruess RL. Teaching professionalism – Why, What JIIMC 2016 Vol. 11, No.3 129 Perception about Professionalism among Physical Therapy Teachers Interna�onal standard. and How. Facts, Views & Vision in ObGyn. 2012; 4:259–65. 2. 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