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ISLAMIC MEDICAL EDUCATION RESOURCES 04

0304-ETIQUETTE IN THE HEALTH CARE TEAM

Elementary Clinic Lecture for 3rd year medical students at the faculty of Medicine National University of Malaysia Friday 10th April 2003 by Prof Dr Omar Hasan Kasule Sr. MB ChB (MUK), MPH & DrPH (Harvard) Deputy Dean Kulliyah of Medicine, International Islamic University, Kuantan. E-MAIL omarkasule@yahoo.com . WEBSITE: http://doctor-omar.net/

1.0 COMPOSITION OF THE HEALTH CARE TEAM:

The health care team in a teaching hospital is very complex. It is multi-disciplinary and its members play complementary and inter-dependent roles. It consists of both university and hospital personnel all engaged in the care of patients. The academic personnel are the medical faculty as well as the students (under-graduate and post-graduate). The hospital staff is the consultants, nurses, nursing aides, auxiliary medical personnel.

 

2.0 DUAL FUNCTIONS OF TEACHING AND DELIVERING CARE

All members of the team have the dual function of both teaching and delivering health care. The teaching process is complex. There is programmed and structured teaching. However most of the teaching is passive; there is a lot of learning of attitudes, skills, and facts by being present and watching what is being done to the patient. There is also continuous learning from one another. Students learn from consultants but consultants may also get new insights from students.

 

3.0 THE TEACHER'S ETIQUETTE:

Teachers should take their task very seriously. The education process, involving giving and receiving knowledge is noble[i]. Teachers should have the humility to know that their knowledge is limited and that they can always learn more. Arrogance because of knowledge is condemned[ii]. Teachers must make the learning process interesting and avoid boredom[iii]. They should make the atmosphere and circumstances of learning easy for the students[iv]. Teachers must be careful in their actions, attitudes, and words at all times because being models and leaders they are seen and are emulated. They must be aware that sometimes they can teach using body language without saying anything[v]; they have to be careful about their public dispositions They should be ready to carry out their function at all times and at any opportunity[vi]. They should have an appropriate emotional expression. They can raise the voice to emphasize an important point[vii]. They can show anger or displeasure when a mistake is committed[viii]. Asking students questions to ascertain their level of knowledge is part of the teaching process and is not in any way a humiliation for them[ix]. Teachers should make sure that the students understand by constant repetition[x]. Teachers should strive to pass on to the students as much knowledge as they can. Hiding knowledge is a cause of punishment[xi].

 

4.0 THE STUDENT'S ETIQUETTE:

The Islamic etiquette of the relation between the student and the teacher should be followed. In general the student should respect the teacher. This is respect to knowledge and not the individual. The prophet taught admiration and emulation of the knowledgeable[xii]. Students should be quiet and respectfully listen to the teacher all the time[xiii]. Students should cooperage such that one who attends a teaching session will inform the others of what was learned[xiv]. Students can learn a lot from one another. The student who hears a fact from a colleague who attended the lecture may even understand and benefit more[xv]. Students should ask questions to clarify points that they did not understand or which seem to contradict previous knowledge and experience[xvi]. Taking notes helps understanding and retention of facts[xvii]. Study of medicine is a full-time occupation; students should endeavor to stay around the hospital and their teachers all the time so that they may learn more and all the time. They should avoid being involved in many other activities outside their studies[xviii].

 

5.0 ETIQUETTE OF INTERACTION BETWEEN GENDERS

Both the caregiver and patient must cover awrat as much as possible. However, the rules of covering are relaxed because of the necessity, dharurat, of medical examination and treatment. The benefit, maslahat, of medical care takes precedence over preventing the harm inherent in uncovering awrat. When it is necessary to uncover awrat, no more than what is absolutely necessary should be uncovered. To avoid any doubts, patients of the opposite gender should be examined and treated in the presence of others of the same gender. The caregivers should be sensitive to the psychological stress of patients, including children, when their awrat is uncovered. They should seek permission from the patient before they uncover their awrat. Caregivers who have never been patients may not realize the depth of the embarrassment of being naked in front of others. Medical co-education involves intense interaction between genders: Teacher-student, student-student, and teacher-teacher. Interacting with colleagues of the opposite gender raises special problems. Norms of dress, speaking, and general conduct; class-room etiquette; social interaction; laboratory experiments on fellow students; Clinical skills laboratory: learning clinical skills by examining other students; Operation theatre. Medical personnel of opposite genders should wear gender-specific garments during surgical operations because Islam frowns on any attempt to look like the opposite gender. Shari’at guidelines on interaction with patients of the opposite gender should be followed. Taking history, physical examination, diagnostic procedures, and operations should preferably be by a physician of the same gender. In conditions of necessity a physician of the opposite gender can be used and may have to look at the ‘awrat or touch a patient. The conditions that are accepted as constituting dharuurat are: skills and availability. The preference between a Muslim of opposite gender vs non-Muslim of same gender depends on the local situation.


[i] (MB70 Bukhari 1:79)

[ii]  (MB102 Bukhari 1:124)

[iii]  (MB62 Bukhatri 1:68)

[iv] (MB63 Bukhari 1:69)

[v] (MB75 Bukhari 1:85 and MB76 Bukhari 1:86)

[vi] (MB74 Bukhari 1:83)

[vii] (MB55 Bukhari 1:57)

[viii] (MB79 Bukhari Bukhari 1:90, MB80 Bukhari 1:91, and MB81 Bukhari 1:92)

[ix] (MB56 Bukhari 1:59)

[x] (MB82 Bukhari 1:95)

[xi]  (KS390 Abudaud K24 B9, Tirmidhi K39 B3, Ibn Majah Intr B24, Ibn Sa’ad J4 Q2 p56, Ahmad 2:263, Ahmad 2:296, Ahmad 2:305, Ahmad 2:344, Ahmad 2:352, Ahmad 2:495, Ahmad 2:499, Ahmad 2:508, Tayalisi H2534)

[xii] (MB66 Bukhari 1:73)

[xiii] (MB101 Bukhari 1:122)

[xiv] (MB78 Bukhari 1:89)

[xv] (MB61 Bukhari 1:67)

[xvi] (MB88 Bukhari 1:103)

[xvii] (MB93 Bukhari 1:112)

[xviii] (MB98 Bukhari 1:118)

Professor Omar Hasan Kasule Sr. April 2004