Supporting the Development of Professionalism in Surgeons in Practice: A Virtues-Based Approach to Exploring a Surgeon’s Moral Agency

  • Linda de Cossart CBE
  • Della Fish
Part of the Innovation and Change in Professional Education book series (ICPE, volume 17)


The intentions of this chapter are to refresh and clarify how we might construe and facilitate the continuing development of professionalism in surgical practitioners in the twenty-first century. Firstly, we consider the current concept of professionalism in surgery and then attend to two aspects of supporting the development of professionalism in practitioners who are members of a profession that serves vulnerable fellow human beings. Secondly, we share our experience of facilitating one way of beginning those deep but very sensitive considerations about the person the professional brings to their work. We conclude that all this requires members of the profession of surgery to be willing and able to articulate what it means to them to be a member of a profession and that surgical teachers take time to become well developed educators in the moral mode of educational practice.


Professionalism Virtues Phronesis Moral education 


  1. 1.
    Fish, D., & de Cossart, L. (2007). Developing the wise doctor. London: Royal Society of Medicine Press.Google Scholar
  2. 2.
    Fish, D., & Coles, C. (Eds.). (1998). Developing professional judgement in health care: Learning through the critical appreciation of practice. Oxford: Butterworth Heinemann.Google Scholar
  3. 3.
    Carr, D. (2000). Professionalism and ethics in teaching. London: Routledge.Google Scholar
  4. 4.
    Hilborne, N. (2015) Jackson: ‘Professional negligence’ could disappear as attitudes to professionals change. Legal Futures (Online). Available at: Accessed 7 Oct 2016.
  5. 5.
    Fish, D. (2012). Refocusing postgraduate medical education: From the technical to the moral mode of practice. Cranham: Aneumi Publications.Google Scholar
  6. 6.
    Drane, J. F. (1995). Becoming a good doctor: The place of virtues and character in medical ethics (2nd ed.). Kansas: Sheed and Ward.Google Scholar
  7. 7.
    The Jubilee Centre for Character and Virtues’ statement on character, virtue and practical wisdom in the professions. Accessed 15 Oct 2015.
  8. 8.
    Blond, P., Antonacopoulou, E., & Pabst, A. (2015). In professions we trust: Fostering virtuous practitioners in teaching, law and medicine. London: ResPublica Available via: Scholar
  9. 9.
    Fish, D. (2015). Starting with myself as doctor and a supervisor. Booklet 1 of Medical Supervision Matters. Cranham: Aneumi Publications.Google Scholar
  10. 10.
    Cruess, R. L., Cruess, S. R., & Steinert, Y. (2010). Teaching medical professionalism. Cambridge: Cambridge University Press.Google Scholar
  11. 11.
    Montgomery, K. (2006). How doctors think: Clinical judgment and the practice of medicine. Oxford: Oxford University Press.Google Scholar
  12. 12.
    Gelhaus, P. (2012). The desired moral attitude of the physician: 1 empathy. Medical Healthcare and Philosophy, 15(2), 103–113. Published 14 December 2012.CrossRefGoogle Scholar
  13. 13.
    de Cossart, L., & Fish, D. (2005). Cultivating a thinking surgeon: New perspectives on clinical teaching, learning and assessment. Shrewsbury: TfN Publications.Google Scholar
  14. 14.
    Eraut, M., & du Bouley, B. (2000). Developing the attributes of medical professional judgement and competence: A review of the literature (Cognitive Sciences Research Paper 518). University of Sussex, 2000. Online version. Sections 3.1 and 3.2 reprinted on CD as part of Module 1 of the Human Face of Medicine. London: BMJ Publishing Group.Google Scholar
  15. 15.
    Canter, R. (2016, January). The new professionalism. 98(1), 10–13.Google Scholar
  16. 16.
    Non-technical skills for surgeons (NOTSS). Accessed 13 Oct 2016.
  17. 17.
    Freidson, E. (2001). Professionalism, the third logic. Chicago: University of Chicago Press.Google Scholar
  18. 18.
    Keogh, B. (2013). The Keogh review. NHS England. Accessed 15 Oct 2016.
  19. 19.
    Arthur, J., Kristjansson, K., Thimas, H., Kotzee, B., Ignatowicz, A., & Qui, T. (2015). Virtuous medical practice: Research report Birmingham University Jubilee Centre. Accessed 13 Oct 2016.
  20. 20.
    Hansen, D. (2001). Exploring the moral heart of teaching: Towards a teacher’s creed. London: Teachers College Press.Google Scholar
  21. 21.
    Fish, D., de Cossart, L., & Wright, T. (2015). Practical dilemmas about supervision and teaching. Booklet 2 of Medical Supervision Matters. Cranham: Aneumi Publications.Google Scholar
  22. 22.
    Fish, D., de Cossart, L., & Wright, T. (2015). Practical dilemmas about the learner and learning. Booklet 3 of Medical Supervision Matters. Cranham: Aneumi Publications.Google Scholar
  23. 23.
    Fish, D., de Cossart, L., & Wright, T. (2015). Practical dilemmas about assessment and evaluation. Booklet 4 of Medical Supervision Matters. Cranham: Aneumi Publications.Google Scholar
  24. 24.
    Brown, J., Leadbetter, P., & Clabburn, O. (2016). Evaluation at East Lancashire Hospitals Trust (ELHT) of the impact of the project: ‘Supervision Matters: Clinical Supervision for Quality Medical Care’.Google Scholar
  25. 25.
    Thomé, R. (2012). Educational practice development: An evaluation (An exploration of the impact on participants and their shared organisation of a postgraduate certificate in education for postgraduate medical practice 2010–2011). Cranham: Aneumi Publications.Google Scholar
  26. 26.
    Thomé, R. (2013). Educational practice development: An evaluation of the second year 2011–12 (An exploration of the impact on participants and their shared organization of year two of the postgraduate masters in education for postgraduate medical practice). Cranham: Aneumi Publications.Google Scholar
  27. 27.
    Annas, J. (2011). Intelligent virtue. Oxford: Oxford University Press.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Linda de Cossart CBE
    • 1
  • Della Fish
    • 1
  1. 1.Ed4medprac Ltd.CranhamUK

Personalised recommendations