# Understanding Surgeon Professionalism in Indonesia: A Qualitative Study in a Multicultural and Resource-Limited Context

## TL;DR

This study explores how surgeon professionalism is perceived in Indonesia, highlighting cultural and systemic influences on non-technical aspects of professionalism.

## Contribution

The first national-level qualitative study on surgeon professionalism in Indonesia, emphasizing cultural and systemic influences.

## Key findings

- Four non-technical themes of surgeon professionalism were identified: fulfilling roles, integrity, communication, and collaboration.
- Cultural values and systemic challenges, such as resource disparities, influence perceptions of professionalism.
- The findings suggest the need for culturally sensitive interventions to improve surgical care quality and patient safety.

## Abstract

Surgeons’ professionalism is vital for ensuring safe surgical care, particularly in Indonesia, where cultural and systemic factors present unique challenges to healthcare delivery. Professionalism affects surgical outcomes, patient safety, and interprofessional collaboration directly. This study represents the first national-level exploration of surgical professionalism, involving culturally diverse participants from various regions. To explore how healthcare professionals and patients perceive surgeon professionalism in Indonesia, emphasizing cultural and systemic influences.

This qualitative study employed a phenomenological approach to capture the lived experiences and perspectives of informants regarding surgeons’ professionalism. This study was conducted at public, private, and military healthcare institutions in Indonesia, including type B, C, and D hospitals, as well as specialty hospitals. A total of 27 participants, including surgeons, anesthesiologists, pediatricians, internists, operating room nurses, ward nurses, hospital management, and patient representatives, were recruited through snowball sampling to ensure diverse perspectives. In-depth interviews were conducted to elicit the participants’ perceptions of surgeons’ professionalism in their healthcare context. Reflexivity and triangulation methods were applied to ensure validity and minimize bias. The study identified key themes and sub-themes of professionalism as perceived by participants, highlighting non-technical aspects of surgeon professionalism in Indonesia.

Four non-technical themes of surgeon professionalism were identified: fulfilling roles and responsibilities, upholding integrity, having good communication skills, and engaging in multidisciplinary collaboration. These aspects were influenced by cultural values and systemic challenges, including disparities in healthcare resources.

Surgeons' professionalism in Indonesia is shaped by cultural and structural factors distinct from global standards. The findings provide insights for culturally sensitive interventions that enhance professionalism and surgical care quality in Indonesia. Addressing these unique dynamics is essential for improving patient safety, healthcare outcomes, and professional relationships.