Redefining Medical Professionalism in Taiwan: A Qualitative Study of Societal Expectations and Educational Implications

TL;DR

This study explores how medical professionalism is understood in Taiwan, highlighting cultural values like family-centered care and emotional labor.

Contribution

It introduces a culturally specific framework for professionalism education in Confucian contexts, reconciling global standards with local ethics.

Findings

Professionalism in Taiwan emphasizes relational ethics, empathy, and emotional labor.

Cultural tensions arise between public expectations and formal medical training ideals.

A contextualized framework is proposed to align medical education with societal values in Confucian-influenced regions.

Abstract

Global frameworks of medical professionalism are often grounded in Western liberal values, which may misalign with ethical expectations in non-Western contexts. In Taiwan, where Confucian traditions shape clinical interactions, professionalism is rooted in relational ethics, family-centered care, and emotional labor. This study explored how professionalism is culturally defined and negotiated among key stakeholder groups in Taiwanese healthcare.

A qualitative, constructivist-interpretivist design guided the study. Eleven focus groups were conducted with 78 participants from a major teaching hospital and surrounding community in northern Taiwan, including practicing physicians (n = 25), medical students (n = 20), and members of the public (n = 33). A constructivist-interpretivist paradigm informed data collection and thematic analysis using Braun and Clarke’s six-phase approach. Coding was conducted in Mandarin and triangulated by an interdisciplinary research team with clinical, sociological, and educational expertise.

Eleven subthemes were identified and organized into three themes: (1) humanistic and relational values (e.g., empathy, moral character, emotional labor); (2) professional expectations (e.g., communication, accountability, lifelong learning); and (3) cultural tensions (e.g., service orientation, family obligations versus patient autonomy). Stakeholders expressed divergent views of professionalism, particularly between public expectations and formal curricular ideals.

Findings underscore the need for culturally responsive professionalism education in Confucian-influenced contexts. Integrating relational ethics, emotional attunement, and family-centered values into curricula, assessment, and faculty development may better align training with societal expectations. This study offers a contextualized framework for professionalism that reconciles global standards with local moral landscapes.