Pragmatic Challenges to Contemporary Vi Sions on Professionalism in Taiwan and Western Countries：Proposing and Evaluating a Situational and Relational Learning Paradigm Based upon Community Mental Health

This research project will use community mental health as a field for developing a learning paradigm that encompasses a situational and relational approach to medical professionalism, and should make a contribution to regional professional exchanges as well as protection of human rights. Major mental hospitals in Taiwan have established models for therapeutic communities that incorporate pragmatically adopted patient-centered approaches, while successfully integrating biomedical knowledge with social support networking skills. These models developed in Taiwan not only convincingly address the issue of humanizing psychiatric treatment, but also create an opportunity for Taiwan to earn a good international reputation. Taiwan’s experiences can serve as evidence for the patient-centered professional model and open new horizons by addressing gaps in contemporary theories about professionalism. Building on Taiwan’s established international collaborations with China and Southeast Asian countries, this project will adopt a participatory narrative action approach to propose a learning paradigm that is situational and relational. Using Jonsen’s four-topic approach as an orienting concept, we will design learning environments and service learning curricula in collaboration with mental health workers and appropriate patient groups. With support from leaders in the Taiwan Psychiatry Association, this project will take three years to develop a Situational Judgment Test and build learning contexts for students to research professional different models of the professional’s role in domestic and foreign institutions. In the first year, we will design courses/curricula related to early clinical exposure for premedical students through involvement with major therapeutic communities in Taiwan. International students will also be included in the interdisciplinary service learning courses to further enrich the cross-cultural competence of all participants. In the second year, we will present the first year achievements of the international community mental health workshop and offer similar courses during the winter or summer breaks, in collaboration with leading mental hospitals in Bangkok or Chiangmai, Thailand. Also, advanced participatory courses that integrate either public health or other basic sciences will be implemented using a problem-based learning design. In the third year, the learning fields will be extended to Indonesia and China. Furthermore, we will incorporate clinical ethics and psychiatry in designing new courses for clinical teaching purposes. Course design is mainly based on narrative medicine and a participatory approach, and will include developing methods for assessment. Over time this project will propose a relational and contextual model to challenge theories and methods for teaching professionalism and role modeling. The development of SJT will also significantly contribute methods for evaluating students’ medical ethics and professionalism at different learning stages. Enriching their competence in professionalism through a role model approach with cross cultural, team-based learning, this project will help students appreciate the strengths and weaknesses of the mental health system and professional training in Taiwan. At the same time, it will open new horizons for them in the form of opportunities in China or Southeast Asia.