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Voorhies JL. Assessment of professionalism in a chiropractic college: A design and implementation of a rubric. THE JOURNAL OF CHIROPRACTIC EDUCATION 2023; 37:162-170. [PMID: 37721396 PMCID: PMC11095644 DOI: 10.7899/jce-22-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/05/2023] [Accepted: 07/08/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To describe the design, implementation, and revision of a rubric used in assessing professionalism that was in alignment with Council on Chiropractic Education meta-competency 5 (professional ethics and jurisprudence, curricular objective C: Expected professional conduct). METHODS The rubric was designed using a grading scale from 0 to 5 by which students needed to meet all criteria to earn full points for each defined dimension of professionalism. A comments section allowed for explanation of deductions and/or comments on exceptional behavior. Comments on professionalism were collected in a log during the trimester and used to populate the rubric. After initial use, the rubric was revised to incorporate criteria that had not initially been included and to allow for greater point deductions for multiple/repeat infractions or egregious behavior. Feedback from other faculty members was also gathered during in-service presentations of the rubric and taken into consideration. Professionalism score was 10% of the course grade. RESULTS From 2016 to 2020, the average professionalism grade changed from 95.6% to 98.9%. A review of the frequency distributions of average professionalism grades in a calendar year showed that some students were earning grades between 70% and 79%. Only achieving 70% to 75% of the professionalism grade affected the final course grade by 2.5% to 3.0%. CONCLUSION In training chiropractic students on expected behaviors related to professionalism, a rubric assessment of professionalism guided communications between the clinical educator and students to discuss professionalism and remediate unprofessional behaviors. A rubric defining expected classroom behaviors aligns with educational best practices to use assessment methods to develop professionalism in health care students.
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Taşçı Aİ, Akdeniz E, Gülpınar MA, Danacıoğlu YO, Sarı EE, Yaşar L, Karandere F, Ferahman S. Adaptation of the professionalism mini-evaluation exercise instrument into Turkish: a validity and reliability study. BMC MEDICAL EDUCATION 2023; 23:698. [PMID: 37752458 PMCID: PMC10523623 DOI: 10.1186/s12909-023-04675-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND There is an ongoing search for standardized scales appropriate for each culture to evaluate professionalism, which is one of the basic competencies of a physician. The Professionalism Mini-evaluation Exercise (P-MEX) instrument was originally developed in Canada to meet this need. In this study, it was aimed to adapt the P-MEX to Turkish and to evaluate the validity and reliability of the Turkish version. METHODS A total of 58 residents at Bakirkoy Dr. Sadi Konuk Training and Research Hospital were assessed with the Turkish version of P-MEX by 24 raters consisting of faculty members, attending physicians, peer residents, and nurses during patient room visits, outpatient clinic and group practices. For construct validity, the confirmatory factor analysis was performed. For reliability, Cronbach's alpha scores were calculated. Generalizibility and decision studies were undertaken to predict the reliability of the validated tool under different conditions. After the administration of P-MEX was completed, the participants were asked to provide feedback on the acceptability, feasibility, and educational impact of the instrument. RESULTS A total of 696 forms were obtained from the administration of P-MEX. The content validity of P-MEX was found to be appropriate by the faculty members. In the confirmatory factor analysis of the original structure of the 24-item Turkish scale, the goodness-of-fit parameters were calculated as follows: CFI = 0.675, TLI = 0.604, and RMSEA = 0.089. In the second stage, the factors on which the items loaded were changed without removing any item, and the model was modified. For the modified model, the CFI, TLI, and RMSEA values were calculated as 0.857, 0.834, and 0.057, respectively. The decision study on the results obtained from the use of P-MEX in a Turkish population revealed the necessity to perform this evaluation 18 times to correctly evaluate professionalism with this instrument. Cronbach's alpha score was 0.844. All the faculty members provided positive feedback on the acceptability, feasibility, and educational impact of the adapted P-MEX. CONCLUSION The findings of this study showed that the Turkish version of P-MEX had sufficient validity and reliability in assessing professionalism among residents. Similarly, the acceptability and feasibility of the instrument were found to be high, and it had a positive impact on education. TRIAL REGISTRATION 2020/249, Bakirkoy Dr. Sadi Konuk Training and Research Hospital.
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Affiliation(s)
- Ali İhsan Taşçı
- School of Medicine, Department of Medical Education, Marmara University, Istanbul, Turkey.
| | - Esra Akdeniz
- School of Medicine, Department of Medical Education, Marmara University, Istanbul, Turkey
| | - Mehmet Ali Gülpınar
- School of Medicine, Department of Medical Education, Marmara University, Istanbul, Turkey
| | - Yavuz Onur Danacıoğlu
- Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Emine Ergül Sarı
- Department of Pediatric Diseases, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Levent Yaşar
- Department of Gynecology and Obstetrics, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Faruk Karandere
- Department of Internal Medicine, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Sina Ferahman
- Department of General Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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AlFaris E, Irfan F, Abouammoh N, Zakaria N, Ahmed AM, Kasule O, Aldosari DM, AlSahli NA, Alshibani MG, Ponnamperuma G. Physicians' professionalism from the patients' perspective: a qualitative study at a single-family practice in Saudi Arabia. BMC Med Ethics 2023; 24:39. [PMID: 37287002 DOI: 10.1186/s12910-023-00918-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 05/23/2023] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Professionalism is a crucial component of medical practice. It is a culturally sensitive notion that generally consists of behaviors, values, communication, and relationships. This study is a qualitative study exploring physician professionalism from the patients' perspective. METHODS Focus group discussions with patients attending a family medicine center attached to a tertiary care hospital were carried out using the four gates model of Arabian medical professionalism that is appropriate to Arab culture. Discussions with patients were recorded and transcribed. Data were thematically analyzed using NVivo software. RESULTS Three main themes emerged from the data. (1) In dealing with patients, participants expected respect but understood delays in seeing physicians due to their busy schedules. In communication, participants expected to be informed about their health conditions and to have their questions answered. (2) In dealing with tasks, participants expected proper examination and transparency of diagnosis, but some expected the physician to know everything and did not appreciate them seeking outside opinions. They expected to see the same physician at every visit. (3) In physician characteristics preferences, participants preferred friendly smiling physicians. Some cared about the outer appearance of the physician whereas others did not. DISCUSSION/CONCLUSIONS The findings of the study explained only two themes of the four gates model namely dealing with patients and dealing with tasks. Cultural competence and how to benefit from patients' perceptions to be an ideal physician should be incorporated into the process of physicians' training.
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Affiliation(s)
- Eiad AlFaris
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia.
| | - Farhana Irfan
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia
| | - Noura Abouammoh
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia
| | - Nasriah Zakaria
- Ehealth Unit, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
- College of applied science, Al maarefa university Riyadh Saudi Arabia, Riyadh, Saudi Arabia
| | - Abdullah Ma Ahmed
- Department of Family and Community Medicine, College of Medicine, King Saud University Chair for Medical Education Research and Development, King Saud University, Riyadh, Saudi Arabia
| | - Omar Kasule
- Academic and Training Affairs, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Dina M Aldosari
- King Khalid Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Nora A AlSahli
- King Khalid Hospital, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Ghatar Alshibani
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Gominda Ponnamperuma
- Department of Medical Education, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Ghasemi A, Gartrell CL, Graves T. A Qualitative Study of How On-Campus Faculty and Off-Campus Preceptors Evaluate Veterinary Students' Professionalism. JOURNAL OF VETERINARY MEDICAL EDUCATION 2023; 50:167-171. [PMID: 35133951 DOI: 10.3138/jvme-2021-0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Professionalism is defined and described in a variety of ways that differ considerably in details and quantity. While professionalism has become increasingly important, educators' opinions regarding the types of professionalism vary. The objective of this qualitative study was to evaluate faculty and preceptors' perspectives regarding veterinary medical students' professionalism during their clinical rotations. A thematic content analysis was performed to classify 2,014 comments. Five main themes emerged: (a) work ethic and attitude; (b) effective interactions with clients and delivering patient care; (c) effective interactions with health care professionals; (d) punctuality, task completion, and organization; and (e) commitment to improving competency in self and others. The importance of professionalism was stressed by both groups of faculty and preceptors through written comments; however, the magnitude of each theme differed. The results indicate that without understanding professionalism elements, the lack of conceptual clarity and consensus related to expected behaviors and attitudes would make it challenging to assess professionalism appropriately. The themes identified can be used to begin a discussion about expected behavior among faculty, preceptors, and students, therefore prompting a reasonable assessment of professionalism, as well as avoiding unprofessional behavior.
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Affiliation(s)
- Abolfazl Ghasemi
- Department of Small Animal Specialty Medicine, College of Veterinary Medicine, Midwestern University, 19555 N. 59th Ave., Glendale, AZ 85308 USA
| | - Carla L Gartrell
- Department of Small Animal Specialty Medicine, College of Veterinary Medicine, Midwestern University, 19555 N. 59th Ave., Glendale, AZ 85308 USA
| | - Thomas Graves
- College of Veterinary Medicine, Midwestern University, 19555 N. 59th Ave., Glendale, AZ 85308 USA
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Cao H, Song Y, Wu Y, Du Y, He X, Chen Y, Wang Q, Yang H. What is nursing professionalism? a concept analysis. BMC Nurs 2023; 22:34. [PMID: 36747180 PMCID: PMC9902819 DOI: 10.1186/s12912-022-01161-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 12/23/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Nursing professionalism plays an important role in clinical nursing. However, a clear conceptual understanding of nursing professionalism is lacking. METHOD Walker and Avant's strategy was used to analyse the concept of nursing professionalism. We searched electronic databases, including PubMed, Scopus, and CINAHL, for studies published from 1965 to 2021. Quantitative or qualitative studies published in English that focused on nursing professionalism were included in the study. RESULTS The three attributes of nursing professionalism are multidimensional, dynamic, and culture oriented. Based on the analysis, nursing professionalism is defined as providing individuals care based on the principles of professionalism, caring, and altruism. CONCLUSIONS This study offers a theoretical definition and conceptual model of nursing professionalism that may be applied to develop standardized assessment tools or nursing professionalism training programs.
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Affiliation(s)
- Huili Cao
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China ,grid.263452.40000 0004 1798 4018Linfen Hospital Affiliated to Shanxi Medical University (Linfen People’s Hospital), Linfen, 041000 Shanxi People’s Republic of China
| | - Yejun Song
- The Third Peoples Hospital of Taiyuan, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Yanming Wu
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Yifei Du
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Xingyue He
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Yangjie Chen
- grid.452461.00000 0004 1762 8478The First Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Qiaohong Wang
- grid.263452.40000 0004 1798 4018Nursing College of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China ,grid.452461.00000 0004 1762 8478The First Hospital of Shanxi Medical University, Taiyuan, 030001 Shanxi People’s Republic of China
| | - Hui Yang
- Nursing College of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China. .,The First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China.
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Grundnig JS, Steiner-Hofbauer V, Katz H, Holzinger A. 'Good' and 'bad' doctors - a qualitative study of the Austrian public on the elements of professional medical identity. MEDICAL EDUCATION ONLINE 2022; 27:2114133. [PMID: 36004404 PMCID: PMC9423859 DOI: 10.1080/10872981.2022.2114133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Professional identity formation has become a key focus for medical education, but there is still much to learn about how to help students develop their professional identity. At a time when influential concepts such as public- and patient-centered care have become common values, there is little research on the conceptions of the public that trainees might adopt during their training. Defining characteristics of 'good' and 'bad' physicians can be a starting point when considering how to incorporate aspects of professional behavior into medical curricula. Therefore, this study examined the essential elements of physician identity from the public's perspective. This study aimed to describe the Austrian public's viewpoint about the characteristics of 'good' and 'bad' doctors. Using a qualitative research design, interviews were conducted with the Austrian public (n = 1000, mean age 46.4 ± 15.8 years). Interviews were transcribed verbatim and analyzed via qualitative content analysis. The respondents stated 2078 answers for 'good' and 1728 for 'bad' doctors. The content analysis produced seven categories: 'social skills' (36.3%), 'professional competence' (30.2%), 'personality' (10.8%), 'communication' (6.3%), 'practice organization' (5.9%), 'ethical and moral behavior' (5.7%), and 'I do not know, or I have no idea' (4.9%). The public can help medical students to construct their professional identity by supporting the exploration of and commitment to professional values that society expects of physicians. Ideally, fusing medical expertise with social skills will fulfill the ideal of what the public considers a 'good' doctor. This shared definition of a 'good physician' has several implications for medical education. Future physicians can benefit from education about the general population's medical needs as well as personal needs, fears, and concerns.
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Affiliation(s)
| | | | - Henri Katz
- Teaching Center, Medical University Vienna, Vienna, Austria
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Grundnig JS, Steiner-Hofbauer V, Drexler V, Holzinger A. You are exactly my type! The traits of a good doctor: a factor analysis study on public's perspectives. BMC Health Serv Res 2022; 22:886. [PMID: 35804373 PMCID: PMC9270819 DOI: 10.1186/s12913-022-08273-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A multiplicity of qualities and behaviours are considered essential in a good doctor and are identified in various medical profession frameworks. However, there is no consensus as to their meaning or even agreement on fundamental qualities. The authors wanted to examine the importance placed by the Austrian public on the professional and personal traits of ideal physicians. Competencies were used to create different types of 'good doctor' and then examined to discover how these can be integrated into existing medical professionalism frameworks. METHODS A 69-item Likert scale-based questionnaire was developed and administered via telephone interview to 1,000 subjects. Computer-assisted telephone interviews (CATI) were carried out by the Austrian GALLUP-Institute. An explorative factor analysis with promax rotation was undertaken to summarise the interrelationships among variables. RESULTS Factor analysis identified six interpretable factors which we define as six different types of doctors: the dutiful doctor, the online health-celebrity, the medical expert, the service physician, the medical altruist, and the ethical agent. The items perceived as most important were 'takes time', 'listens', and 'makes correct diagnoses'. Outcome measures of internal consistency and reliability estimates (Cronbach´s alpha, 0.69-0.86) for each element. CONCLUSIONS The six types of physicians may be a step toward recognizing the professional behaviour of all physicians, their actions as healers, and their commitment to moral concepts, values, and needs of their patients, and society. According to our results, the public has expectations of good doctors that go beyond the scope within the medical professionalism frameworks. Therefore, these guidelines should be adapted in light of the changing expectations and needs of the general population.
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Affiliation(s)
- Julia S Grundnig
- Teaching Center, Medical University of Vienna, Spitalgasse 23, BT 87, Vienna, Austria.
| | | | - Viktoria Drexler
- Teaching Center, Medical University of Vienna, Spitalgasse 23, BT 87, Vienna, Austria
| | - Anita Holzinger
- Teaching Center, Medical University of Vienna, Spitalgasse 23, BT 87, Vienna, Austria
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Dart J, McCall L, Ash S, Rees C. Conceptualising professionalism in dietetics: an Australasian qualitative study. J Acad Nutr Diet 2022; 122:2087-2096.e7. [PMID: 35202846 DOI: 10.1016/j.jand.2022.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 02/08/2022] [Accepted: 02/16/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Professionalism is a vital aspect of healthcare and multidisciplinary teamwork. While there is substantive professionalism literature in medicine and an expanding healthcare professions literature, there is a significant gap in understanding professionalism in dietetics. There are very few research papers in the dietetics literature on this issue compared with other health professions. Given the multidisciplinary nature of healthcare, it is important to understand what professionalism means within each profession to develop shared understandings across healthcare teams. OBJECTIVE The study aim was to explore how dietetics professionalism is conceptualised by dietetic practitioners/preceptors, faculty and new graduates. DESIGN A constructionist exploratory qualitative interview study was conducted. PARTICIPANTS/SETTING One hundred participants (dietetic graduates, faculty and practitioners/preceptors), associated with 17 universities across Australia and New Zealand and from diverse geographical and work settings, participated in 27 group and 24 individual interviews from March 2018 to June 2019. ANALYSIS PERFORMED Thematic framework analysis was used to examine participants' understandings of professionalism. RESULTS Twenty-three dimensions of dietetics professionalism were identified, with the most common being communication and including four novel dimensions of professionalism (generational, emotion management, cultural capability and advocacy) not previously described in other professions. Professionalism as emotion management and generational adds new insights to the professionalism literature, expanding understandings of this vital aspect of healthcare. While high levels of consistency in professionalism understandings existed across the three stakeholder groups, some interesting differences were found. The profession of dietetics shares similarities with other professions in the ways professionalism is conceptualised. CONCLUSIONS Using these dimensions of professionalism as a framework for teaching and learning about professionalism will help in clarifying expectations and expand shared understandings about professionalism for dietitians, other health professions and across multidisciplinary teams.
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Affiliation(s)
- Janeane Dart
- Advanced Accredited Practicing Dietitian (AdvAPD), Dietitians Australia, Senior Lecturer / Doctoral Candidate, Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, AUSTRALIA.
| | - Louise McCall
- Adjunct Professor, Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, AUSTRALIA
| | - Susan Ash
- Master Health Planning, Postgrad Dip Nut & Diet., BSc, Fellow, Dietitians Australia, Adjunct Professor, Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing & Health Sciences, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, AUSTRALIA
| | - Charlotte Rees
- Professor, Head of School, School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW, 2308, AUSTRALIA, Adjunct Professor, Monash Centre for Scholarship in Health Education (MCSHE), 27 Rainforest Walk, Faculty of Medicine, Nursing & Health Sciences, Monash University, Clayton, VIC, 3800, AUSTRALIA
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Hoobehfekr S, Asghari F, Sayarifard A, Kadivar M, Kashefinejad S. Medical students' perception of professionalism climate in clinical settings. J Med Ethics Hist Med 2022; 14:10. [PMID: 35035798 PMCID: PMC8696550 DOI: 10.18502/jmehm.v14i10.7238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/10/2021] [Indexed: 11/30/2022] Open
Abstract
Medical professionalism has a crucial role in educating medical students. The role of professionalism in the clinical environment is therefore an important factor in medical education. This study attempts to evaluate the opinions of medical students in the teaching hospitals of Tehran University of Medical Sciences (TUMS) about the professionalism environment in this university. A sample of 165 students filled out the Persian translation of UMKC-SOM (Climate of Professionalism Survey) questionnaire. This instrument evaluates students’ perspectives on the degree of adherence to professionalism by faculty, residents and other students. The results of the study revealed that the total score of professionalism climate was 53.9 for faculty, 42.09 for residents, and 50.76 for students and the difference between these three groups was statistically significant (p-value < 0.01). Results of further analysis through post-hoc tests for multiple comparisons among the groups revealed that the students found their fellow students and faculty more professional than residents. The study also showed that the medical ethics course had no impact on perceptions observations (p-values > 0.05). The study results also revealed that the students found their fellow students and faculty more professional than residents. This finding demonstrates the importance of teaching professionalism to residents since they serve as role models for students. Further multicenter studies are needed to improve the professionalism climate in the medical teaching environment.
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Affiliation(s)
- Saba Hoobehfekr
- Resident of Psychiatry, Department of Psychiatry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Asghari
- Associate Professor, Medical Ethic Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Sayarifard
- Community Based Participatory Research Center, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Maliheh Kadivar
- Professor, Department of Neonatology, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shayan Kashefinejad
- Resident of Psychiatry, Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
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Joa CY, Park SY. Entrepreneurial doctors and consumerist patients: #plasticsurgery on Instagram. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2021. [DOI: 10.1108/ijphm-01-2020-0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose
There is an increasing need for a better understanding of healthcare service marketing in social media. This paper aims to examine Under the framework of positioning theory, popular Instagram posts related to #plasticsurgery and their accounts were analyzed and the relationships between the posts’ attributes and the number of user comments and likes were examined.
Design/methodology/approach
A total of 272 posts associated with #plasticsurgery and their account profiles were analyzed.
Findings
Plastic surgery procedures were positioned on Instagram primarily by doctors and celebrity patients who were motivated by self-promotion. Doctors often omitted their medical credential information from their account profile and posts while featuring their vanity photos, emojis and consultation solicitations. They showed patients as the objects of surgery. On the other hand, patients positioned themselves as individuals with the agency by showing their faces rather than focusing on their body parts. Instagram users responded better to the doctors who positioned themselves more as business owners than medical professionals by soliciting consultations, offering discounts, displaying surgery photos and using emojis. In responding to patient posts, Instagram users liked under-dressed images more than fully clothed images and commented more on before-and-after photos than others.
Social implications
In Instagram, doctors positioned themselves as self-interested providers of plastic surgery services, whereas patients positioned themselves as active consumers. Medical professionals’ social media activities should be more closely monitored to protect patient safety and the trust between patients and doctors.
Originality/value
This study shed light on how doctors and patients position themselves on social media and how they are received by social media users in the context of #plasticsurgery on Instagram.
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Pilot study to identify attributes of professionalism in sonography. Radiography (Lond) 2021; 27:1135-1141. [PMID: 34183245 DOI: 10.1016/j.radi.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/25/2021] [Accepted: 06/09/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION While a list of competency standards exists for sonographers, the profession does not have a specific statement concerning professionalism. What constitutes professionalism within sonography is important and needs to be considered from the perspective of all stakeholders. This paper reports the results of the first two exploratory phases of a larger study investigating professionalism in sonography. METHODS Phase 1 involved interviews with experienced and early-career sonographers to identify attributes of professionalism within the context of sonography. Attributes identified in phase 1 were used to frame survey questions for phase 2. In phase 2, sonography patients were asked to rate the attributes using Likert-type responses, and to provide additional comments at the end of each category. Patients had the opportunity to add attributes not mentioned in the survey. RESULTS Content analysis of Phase 1 interview data identified 27 professional attributes organised into seven categories. Phase 2 results indicated that only a few attributes were rated as not important or not applicable by patients. Highest-rating attributes by patients included verbal communication, patient privacy, trust, behaviour, empathy, and respect. Attributes that were not rated as highly included rapport, physical presentation, dedication to learning and improving oneself, personality, and role model. CONCLUSION Due to the complexities around a clear definition of professionalism within the context of sonography, this study has highlighted the need for a comprehensive list of attributes to identify what professionalism in sonography means. IMPLICATIONS FOR PRACTICE Having a clear understanding of the concept of professionalism within the context of sonography will provide a guide for sonographers and sonography students, and enable academic and on-site clinical trainers to explicitly teach what professionalism looks like and feels like in sonography practice.
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Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM. Scoping Review of frequently highlighted attributes of Medical Professionalism in an Undergraduate Medical Education Context. Pak J Med Sci 2021; 37:1221-1229. [PMID: 34290812 PMCID: PMC8281152 DOI: 10.12669/pjms.37.4.4004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 12/15/2020] [Accepted: 02/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background and Objectives: Medical Professionalism (MP) establishes the trust between society and doctors. We aimed at finding frequently highlighted qualities of MP in the literature. Methods: We searched PubMed and Scopus for attributes of MP, using terms, “Professionalism,” “Medical Students,” and “Undergraduate Medical Education”. We included English language, original research articles with MP attributes from the perspective of undergraduate medical education, any nationality, race, gender, and age range, as the central topic of the article. Papers published from January 1st 1986 to 29th February 2020 were included. Results: From 1349 identified articles, finally, 18 were included, authored in 10 countries, collectively contributing to answering the scoping review question. Two themes were identified: (1)Nurturing of MP, 11 (61.11%) out of 18 included articles, highlighted “respect” as the most dominant attribute as it appeared in 6 (54.55%) out of 11 reviews, “communication” 5 (45.45 %) studies and “honesty” and “integrity” 4 (36.36%). (2)Assessment of MP, 7 (38.89%) studies, and majority, 4 (57.14 %) assessed MP using American Board of Internal Medicine’s elements of MP, viz, “altruism, accountability, excellence, duty, honor and integrity, respect for others.” Conclusions: Themes exemplified MP’s most discoursed issues. The attributes are frequently used worldwide. MP deliberates as a commitment toward the individual patient, society, and necessitates transforming from its present generic form to more explicit details.
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Affiliation(s)
- Kamran Sattar
- Kamran Sattar, MBBS AcadMEd AoME (UK), MMedEd UoD (UK), PhD Scholar. Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Muhamad Saiful Bahri Yusoff
- Muhamad Saiful Bahri Yusoff, MD, MSc, PhD. Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Wan Nor Arifin
- Wan Nor Arifin: MBBS, MSc. Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Mohd Azhar Mohd Yasin: MD, MMed (Psy). Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
| | - Mohd Zarawi Mat Nor
- Mohd Zarawi Mat Nor: PhD. Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
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Armstrong AD, Agel J, Beal MD, Bednar MS, Caird MS, Carpenter JE, Guthrie ST, Juliano P, Karam M, LaPorte D, Marsh JL, Patt JC, Peabody TD, Wu K, Martin DF, Harrast JJ, Van Heest AE. Use of the Behavior Assessment Tool in 18 Pilot Residency Programs. JB JS Open Access 2020; 5:JBJSOA-D-20-00103. [PMID: 33244509 PMCID: PMC7682982 DOI: 10.2106/jbjs.oa.20.00103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The purpose of this study was to determine the feasibility and evaluate the effectiveness of the American Board of Orthopaedic Surgery Behavior Tool (ABOSBT) for measuring professionalism. Methods Through collaboration between the American Board of Orthopaedic Surgery and American Orthopaedic Association's Council of Residency Directors, 18 residency programs piloted the use of the ABOSBT. Residents requested assessments from faculty at the end of their clinical rotations, and a 360° request was performed near the end of the academic year. Program Directors (PDs) rated individual resident professionalism (based on historical observation) at the outset of the study, for comparison to the ABOSBT results. Results Nine thousand eight hundred ninety-two evaluations were completed using the ABOSBT for 449 different residents by 1,012 evaluators. 97.6% of all evaluations were scored level 4 or 5 (high levels of professional behavior) across all of the 5 domains. In total, 2.4% of all evaluations scored level 3 or below reflecting poorer performance. Of 431 residents, the ABOSBT identified 26 of 32 residents who were low performers (2 or more < level 3 scores in a domain) and who also scored "below expectations" by the PD at the start of the pilot project (81% sensitivity and 57% specificity), including 13 of these residents scoring poorly in all 5 domains. Evaluators found the ABOSBT was easy to use (96%) and that it was an effective tool to assess resident professional behavior (81%). Conclusions The ABOSBT was able to identify 2.4% low score evaluations (<level 3) for all residents. The tool was concordant with the PD for 81% of the residents considered low performers or "outliers" for professional behavior. The 5-domain construct makes it an effective actionable tool that can be used to help develop performance improvement plans for residents. Level of Evidence Level II.
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Affiliation(s)
- April D Armstrong
- Department of Orthopaedics and Rehabilitation, Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Julie Agel
- Department Orthopaedics and Sports Medicine, Harborview Medical Center, Seattle, Washington
| | - Matthew D Beal
- Department of Orthopaedic Surgery, North Western University, Chicago, Illinois
| | - Michael S Bednar
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Chicago, Illinois
| | - Michelle S Caird
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - James E Carpenter
- Department of Orthopaedic Surgery, Sports Medicine, Med Sport, Ann Arbor, Michigan
| | | | - Paul Juliano
- Department of Orthopaedics and Rehabilitation, Bone and Joint Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Matthew Karam
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa
| | - Dawn LaPorte
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, Maryland
| | - J Lawrence Marsh
- Department of Orthopaedics and Rehabilitation, University of Iowa, Iowa City, Iowa
| | - Joshua C Patt
- CMC Orthopaedic Surgery, University of North Carolina School of Medicine, Charlotte, North Carolina
| | - Terrance D Peabody
- Department of Orthopaedic Surgery, North Western University, Chicago, Illinois
| | - Karen Wu
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Chicago, Illinois
| | - David F Martin
- Department of Orthopaedic Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina
| | | | - Ann E Van Heest
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
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Kwan YH, Chooi S, Yoon S, Ang XL, Phang JK, Koh HL, Thumboo J, Ng SC, Fong W. Professionalism in traditional Chinese medicine (TCM) practitioners: a qualitative study. BMC Complement Med Ther 2020; 20:335. [PMID: 33167947 PMCID: PMC7653838 DOI: 10.1186/s12906-020-03127-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 10/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Medical professionalism is important for establishing public trust in doctors. Its definition is culture-sensitive. However, no research has explored medical professionalism in Traditional Chinese Medicine (TCM) practitioners. This study aims to (a) establish the domains of professionalism in TCM practitioners in Singapore, and to (b) compare the domains of professionalism of practitioners trained in TCM and practitioners trained in conventional medicine. METHODS Data for this qualitative study was collected through in-depth interviews (IDIs) with TCM practitioners. IDIs were audio-recorded and transcribed verbatim. Thematic analysis was conducted by two independent coders using the Professionalism Mini-Evaluation Exercise (P-MEX) as a framework. The domains of professionalism in TCM and conventional medicine were then compared, using data from a similar study on professionalism in practitioners trained in conventional medicine. RESULTS A total of 27 TCM practitioners (40.7% male) participated in this study. The four domains of professionalism in the P-MEX, namely doctor-patient relationship skills, reflective skills, time management and inter-professional relationship skills, and two new sub-domains, "communicated effectively with patient" and "demonstrated understanding and integrated with conventional medicine", were relevant to TCM practitioners. This is largely similar to that of practitioners trained in conventional medicine, with a few differences, including "ensured continuity of care" and "used health resources appropriately". CONCLUSION The domains of professionalism in TCM practitioners were established and they are similar to that of practitioners trained in conventional medicine. This study is the first to define medical professionalism in TCM practitioners. Findings will provide guidance on the education of professionalism in TCM practitioners.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Sarah Chooi
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Sungwon Yoon
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Xiang Ling Ang
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Hwee Ling Koh
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Swee Cheng Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore. .,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Duke-NUS Medical School, Singapore, Singapore.
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Chan KD, Humphreys L, Mey A, Holland C, Wu C, Rogers GD. Beyond communication training: The MaRIS model for developing medical students' human capabilities and personal resilience. MEDICAL TEACHER 2020; 42:187-195. [PMID: 31608726 DOI: 10.1080/0142159x.2019.1670340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: Human capabilities in medicine, including communication skills, are increasingly important within the complex, challenging and dynamic landscape of healthcare. Supporting medical students to manage unavoidable role-related stressors adaptively may help mitigate the anguish that is too commonly reported among the profession. We developed a model, "MaRIS", underpinned by contemplative pedagogy, to support medical students to enhance their human capabilities, across all three domains of Bloom's taxonomy, and their personal resilience. It is the first to integrate Mindfulness, affective Reflection, Impactive experiences and a Supportive environment into medical curriculum design. Here, we describe the theoretical basis underpinning MaRIS and present a preliminary study to evaluate its impact on students' subjectively-rated capabilities.Materials and Methods: A questionnaire capturing self-ratings of competence, empathy and resilience, as well as impressions of their experiences, was administered to foundation year medical students before (T0), during (T1) and after delivery (T2).Results: Fifty-five students completed the survey at all time points. Mean scores for all domains increased significantly from T0 to T1 and from T0 to T2. Free-text comments suggest learning impact across the cognitive, psychomotor and affective domains.Conclusions: MaRIS appears to facilitate medical students' establishment of the foundations for building the human capabilities and personal resilience required for professional practice.
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Affiliation(s)
- Kwong D Chan
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Linda Humphreys
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Amary Mey
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
| | - Carissa Holland
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Cathy Wu
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Gary D Rogers
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
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Fong W, Kwan YH, Yoon S, Phang JK, Thumboo J, Leung YY, Ng SC. Assessment of medical professionalism: preliminary results of a qualitative study. BMC MEDICAL EDUCATION 2020; 20:27. [PMID: 32000755 PMCID: PMC6993492 DOI: 10.1186/s12909-020-1943-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 01/22/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The importance of medical professionalism has been well documented in the literature. Cultural background affects the constituents of professionalism. However, few studies have explored the domains of medical professionalism in an Asian context. We aim to describe the views and experiences of both patients and faculty on medical professionalism in an urban Asian city state. METHODS Data for this qualitative study were collected through focus group discussions (FGDs) with patients and in-depth interviews (IDIs) with faculty members. The IDIs and FGDs were audio-recorded and transcribed verbatim. Thematic analysis was conducted by two independent coders using a priori framework derived from Professionalism Mini Evaluation Exercise (P-MEX). Sociodemographic data of faculty members and patients were obtained through brief questionnaires. RESULTS A total of 31 patients (58.1% male, all had visited healthcare facilities within the past year) and 26 faculty members (42.3% male, 38.5% from medical disciplines, median years as faculty is 11) participated in this study. The results supported the four domains of medical professionalism - Doctor-patient relationship skills, Reflective skills, Time management and Inter-professional relationship skills. Two new sub-domains which emerged from data were (1) communicated effectively with patient and (2) demonstrated collegiality. CONCLUSIONS The domains of professionalism in Singapore were similar to previous studies. This study allows a better understanding of medical professionalism to enhance the assessment and ultimately, the teaching of medical professionalism in an urban multi-ethnic Asian city.
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Affiliation(s)
- Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- SingHealth Rheumatology Senior Residency Programme, 20 College Road, Singapore, 169856, Singapore.
| | - Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Sungwon Yoon
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Julian Thumboo
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Swee Cheng Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Stubbing EA, Helmich E, Cleland J. Medical student views of and responses to expectations of professionalism. MEDICAL EDUCATION 2019; 53:1025-1036. [PMID: 31509286 DOI: 10.1111/medu.13933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/12/2019] [Accepted: 06/06/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT To earn society's trust, medical students must develop professional values and behaviours via a transformative process, from lay person to doctor. Yet students are expected to epitomise the values and behaviours of a doctor from the outset of medical school, leading them to feel 'judged all the time' (in terms of their professionalism). Our aim, therefore, is to extend knowledge exploring the expectations communicated to and perceived by medical students and to provide a conceptually framed understanding of students' associated emotional tensions. METHODS We used a qualitative exploratory case study methodology within a constructivist paradigm to explore the messages communicated about professionalism and students' perceived expectations of professionalism in one medical school. Data were collected in the form of: (i) regulatory and medical school documents, and (ii) focus groups with 23 participants in their first 2 years at medical school. We used thematic analysis for data interpretation and two theoretical lenses, Amalberti et al.'s framework of system migration for health care and Sinclair's adaptation of Goffman's dramaturgical theory, to critically analyse the results. RESULTS We found messages and perceived expectations of knowledge and competence, and the need to ensure trust. We also identified that the expectations of patients, doctors, society, family and friends are just as, if not more, influential than policy and regulatory expectations for early years' medical students. Moreover, we found tensions, with students feeling that the expectations of them from others were unrealistic for their level of training. With this came a sense of pressure to meet expectations that participants responded to by acting as if already competent. CONCLUSIONS Our findings suggest that external forces (expectations) drive early years' students to act as if competent. Although this is part of student identity formation it could also have implications for patient safety and therefore necessitates recognition and support from educators.
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Affiliation(s)
- Evangeline A Stubbing
- Centre for Healthcare Education Research and Innovation, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Esther Helmich
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jennifer Cleland
- Centre for Healthcare Education Research and Innovation, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
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Kumar Ghosh S, Kumar A. Building Professionalism in Human Dissection Room as a Component of Hidden Curriculum Delivery: A Systematic Review of Good Practices. ANATOMICAL SCIENCES EDUCATION 2019; 12:210-221. [PMID: 30376608 DOI: 10.1002/ase.1836] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 09/12/2018] [Accepted: 09/12/2018] [Indexed: 05/05/2023]
Abstract
The core values in medical practice which are essential for the humane outlook of a physician are clubbed within the domain of medical professionalism. Professionalism along with other discipline-independent skills (human skills) is propagated implicitly in medical schools as components of a "hidden curriculum." Evidence suggests a strong association between "hidden curriculum" delivery and development of professionalism in the human dissection room. In this review article, the authors have tried to highlight a few exclusive practices adopted by medical schools which enhance the implementation of the "hidden curriculum" within the practice of human dissection and successfully inculcate the key components of professionalism such as integrity, respect, and compassion among students. These distinctive concepts are aimed at humanizing the experience of anatomical dissection by revealing the identity of the donors along with their personal details either through display of video clips of donor interviews, interactions with the family members of the donor over a meal or recognition of the donor as a mentor and organizing memorial services in honor of donors after conclusion of the dissection in the presence of their family members. The resounding success of these good practices in building professionalism among medical students from the onset of the academic curriculum has signaled a new chapter in anatomical sciences education. It has become imperative to recognize the visionary efforts of a select few medical educators and begin incorporating these recent trends into the delivery of the "hidden curriculum" within the evolving gross anatomy education model.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
| | - Ashutosh Kumar
- Department of Anatomy, All India Institute of Medical Sciences, Patna, India
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Abstract
BACKGROUND Professionalism was recognized as a fundamental competency of medical/dental practice at the beginning of the twenty-first century. Organizations and experts published several definitions of professionalism, but research on patients' perception of professionalism has been limited. To address this gap in literature, this study explored dental patients' perception of dental professionalism, and then compared their perception with that of dental professionals. METHODS Of the 800 questionnaires that were distributed to dental patients in public and private clinics and hospitals, 504 were returned and were used in the analysis. A factor analysis was used to generate themes and sub-themes. Independent sample t-tests were performed to compare two independent groups and the ANOVA tests to compare means in more than two independent groups. RESULTS A factor analysis revealed four factors: excellence and communication skills; humanism, commitment, and service mindedness; competence in practice; and dentists' duties and management skills. Adherence to sterilization and infection control rules and procedures; personal hygiene and clean professional attire; good communication skills; diagnostic and clinical judgment and provision of the most efficient dental treatment; and ethical decisions and ethical care were ranked as the first five most important elements of dental professionalism from patients' perspective. Several demographic factors showed significant differences in perception. CONCLUSION Patients' and dentists' perception of dental professionalism and professional behavior vary in certain aspects. These differences must be addressed to ensure excellence of dental service. Dental professionals must also be aware of the personal factors that affect a patient's perception of professionalism.
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Affiliation(s)
- Salwa Mahmoud Taibah
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia,
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Rogers GD, Mey A, Chan PC. Development of a phenomenologically derived method to assess affective learning in student journals following impactive educational experiences. MEDICAL TEACHER 2017; 39:1250-1260. [PMID: 28933577 DOI: 10.1080/0142159x.2017.1372566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Assessment of affective learning (AL) is difficult but important, particularly for health professional students, where it is intimately linked to the development of professional values. This study originally aimed to determine whether an emotionally impactive, extended, multimethod, interprofessional simulation experience enhanced the AL of senior medical students, compared to conventional seminars and workshops alone. This necessitated the development of a method to assess for the presence and quality of AL. METHODS We developed a "double hermeneutic" method, derived from Smith's Interpretative Phenomenological Analysis, to identify examples of AL, according to Krathwohl's hierarchy ("receiving," "responding," "valuing," "organization," "characterization"), in the journals of students from each arm of a randomized educational trial. Three assessors rated the highest level of AL seen in each journal and then we compared ratings from the two study arms. RESULTS A total of 135 journals were available for assessment (81 Intervention, 54 Control). The method proved to be effective in identifying and characterizing examples of uniprofessional and interprofessional AL. The median level identified in Intervention journals ("valuing") was significantly higher than Control journals ("responding," p < 0.0001). CONCLUSIONS The method described provides a means to assess affective learning among health professional students. An extended, immersive simulation experience appears to enhance affective learning.
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Affiliation(s)
- Gary D Rogers
- a School of Medicine , Griffith University , Gold Coast , Australia
- b Health Institute for the Development of Education and Scholarship (Health IDEAS) , Griffith University , Gold Coast , Australia
| | - Amary Mey
- b Health Institute for the Development of Education and Scholarship (Health IDEAS) , Griffith University , Gold Coast , Australia
- c School of Pharmacy , Griffith University , Gold Coast , Australia
| | - Pit Cheng Chan
- a School of Medicine , Griffith University , Gold Coast , Australia
- b Health Institute for the Development of Education and Scholarship (Health IDEAS) , Griffith University , Gold Coast , Australia
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Challen V, Laanelaid Z, Kukkes T. A qualitative study of perceptions of professionalism amongst radiography students. Radiography (Lond) 2017; 23 Suppl 1:S23-S29. [DOI: 10.1016/j.radi.2016.10.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 11/16/2022]
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Mak-van der Vossen MC, van Mook WNKA, Kors JM, van Wieringen WN, Peerdeman SM, Croiset G, Kusurkar RA. Distinguishing Three Unprofessional Behavior Profiles of Medical Students Using Latent Class Analysis. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:1276-83. [PMID: 27119326 DOI: 10.1097/acm.0000000000001206] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE Because unprofessional behavior of physicians is associated with unprofessional behavior in medical school, identifying unprofessional behavior in medical school is critical. Research has noted the difficulty in assessing professional behavior. Instead of identifying isolated behaviors, it could be more helpful to recognize behavioral patterns to evaluate students' professional behavior. The authors aimed to identify patterns in the unprofessional behaviors of medical students and to construct descriptions based on these patterns. METHOD Content analysis of research articles yielded a template of unprofessional behaviors for coding student evaluation forms indicating unsatisfactory professional behavior, collected from 2012 to 2014 at the VUmc School of Medical Sciences, Amsterdam, the Netherlands. Latent class analysis was used to identify classes of students with a high chance of displaying comparable unprofessional behaviors. Teachers' feedback of prototype students was summarized to generate profile descriptions. RESULTS A template of 109 behaviors was used to code 232 evaluation forms of 194 students (3.9% students/year). Latent class analysis identified three hypothetical classes of students: Class 1 (43%) was labeled as "Poor reliability," class 2 (20%) was labeled as "Poor reliability and poor insight," and class 3 (37%) was labeled as "Poor reliability, poor insight, and poor adaptability." CONCLUSIONS These profiles of unprofessional behavior might help to improve the evaluation of unprofessional behavior in medical school. Further research should provide evidence for confidently accepting or rejecting the profiles as an instrument to identify which students are expected to benefit from remediation trajectories.
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Affiliation(s)
- Marianne C Mak-van der Vossen
- M.C. Mak-van der Vossen is a general practitioner, PhD student, Department of Research in Education, and coordinator of the educational theme "Professional behavior," VUmc School of Medical Sciences, Amsterdam, the Netherlands. W.N.K.A. van Mook is internist/intensivist, Department of Intensive Care Medicine, Maastricht University Medical Center, and associate professor, Medical Education, Maastricht University, Maastricht, the Netherlands. J.M. Kors is a midwife and medical educator, AVAG Midwifery Academy, Amsterdam Groningen, the Netherlands. W.N. van Wieringen is biostatistician, Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands. S.M. Peerdeman is neurosurgeon, VU University Medical Centre, and professor of professional development, VUmc School of Medical Sciences, Amsterdam, the Netherlands. G. Croiset is professor of medical education and director, VUmc School of Medical Sciences, Amsterdam, the Netherlands. R.A. Kusurkar is head, Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands
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Pearson D, Walpole S, Barna S. Challenges to professionalism: Social accountability and global environmental change. MEDICAL TEACHER 2015; 37:825-830. [PMID: 26030377 DOI: 10.3109/0142159x.2015.1044955] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This article explores the concept of professionalism as it relates to social change and social accountability, and expands on them in the light of global environmental changes. Professionalism in medicine includes concepts of altruism, service, professional knowledge, self-regulation and autonomy. Current dialogues around social accountability suggest that medical schools should re-orientate their strategy and desired education, research and service outcomes to the health needs of the communities they serve.This article addresses the following questions: • How do we reconcile ideas of medical professionalism with the demands of creating a more equal, just, sustainable and socially inclusive society? • What new challenges do or will we face in relation to environmental degradation, biodiversity loss, ecosystem health and climate change? • How can medical schools best teach social and environmental responsiveness within a framework of professionalism? • How do medical schools ensure that tomorrow's doctors possess the knowledge, skills and attitude to adapt to the challenges they will face in future roles?We offer ideas about why and how medical educators can change, recommendations to strengthen the teaching of professionalism and social accountability and suggestions about the contribution of an emerging concept, that of "environmental accountability".
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Hordichuk CJ, Robinson AJ, Sullivan TM. Conceptualising professionalism in occupational therapy through a Western lens. Aust Occup Ther J 2015; 62:150-9. [DOI: 10.1111/1440-1630.12204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2015] [Indexed: 12/01/2022]
Affiliation(s)
| | | | - Theresa M. Sullivan
- Department of Occupational Therapy; University of Manitoba; Winnipeg MB Canada
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Barr J, Bull R, Rooney K. Developing a patient focussed professional identity: an exploratory investigation of medical students' encounters with patient partnership in learning. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2015; 20:325-38. [PMID: 25008246 DOI: 10.1007/s10459-014-9530-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 06/19/2014] [Indexed: 05/23/2023]
Abstract
Patient encounters are central to the provision of learning opportunities for medical students and their development as medical professionals. The primary aim of the study reported in this paper was to discover how partnering medical students with patients with chronic illness in undergraduate learning influenced the development of a patient centred professional identity and professionalism. An exploratory interpretive research design was used to address the research aim within a patient partner program (P3). Three qualitative data collection methods were used: (1) focus groups (2) extended response questionnaire and (3) semi-structured interviews. Data were coded and analysed thematically. The professional identity of medical students is constructed along traditional lines in the preclinical years. Patient-partnership offers a disruption to this development by way of an intersection with patients with chronic illness which potentially allows meaningful construction of what a patient-centred identity should be. This point of reflection provides an opportunity to engage at a higher level in medical identity development and professionalism. The findings discussed in this paper further stimulate the patient-centred agenda by understanding the conflict associated with the student-patient nexus in medical education and its potential for building professionalism and a patient-centred professional identity. To continue the drive for a patient-centred professional identity there must be ongoing engagement with patients in medical education, preferably commencing early in a student's journey so that it becomes the expected norm. This study has highlighted that a true patient-centred emphasis is being encountered too late in their socialisation process.
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Affiliation(s)
- Jennifer Barr
- Launceston Clinical School, School of Medicine, University of Tasmania, Locked Bag 1377, Launceston, TAS, 7250, Australia,
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Jawaid M, Khan MH, Bhutto SN. Social network utilization (Facebook) & e-Professionalism among medical students. Pak J Med Sci 2015; 31:209-13. [PMID: 25878645 PMCID: PMC4386188 DOI: 10.12669/pjms.311.5643] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 09/23/2014] [Accepted: 10/05/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To find out the frequency and contents of online social networking (Facebook) among medical students of Dow University of Health Sciences. METHODS The sample of the study comprised of final year students of two medical colleges of Dow University of Health Sciences - Karachi. Systematic search for the face book profiles of the students was carried out with a new Facebook account. In the initial phase of search, it was determined whether each student had a Facebook account and the status of account as ''private'' ''intermediate'' or ''public'' was also sought. In the second phase of the study, objective information including gender, education, personal views, likes, tag pictures etc. were recorded for the publicly available accounts. An in depth qualitative content analysis of the public profiles of ten medical students, selected randomly with the help of random number generator technique was conducted. RESULTS Social networking with Facebook is common among medical students with 66.9% having an account out of a total 535 students. One fifth of profiles 18.9% were publicly open, 36.6% profiles were private and 56.9% were identified to have an intermediate privacy setting, having customized settings for the profile information. In-depth analysis of some public profiles showed that potentially unprofessional material mostly related to violence and politics was posted by medical students. CONCLUSION The usage of social network (Facebook) is very common among students of the university. Some unprofessional posts were also found on students' profiles mostly related to violence and politics.
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Affiliation(s)
- Masood Jawaid
- Dr. Masood Jawaid, MCPS, MRCS, FCPS, Assistant Professor Surgery and Incharge e-Learning, Dow University Hospital & Dow International Medical College, Dow University of Health Sciences, Karachi - Pakistan
| | - Muhammad Hassaan Khan
- Muhammad Hassaan Khan, MBBS, Dow International Medical College, Dow University of Health Sciences, Karachi - Pakistan
| | - Shahzadi Nisar Bhutto
- Shahzadi Nisar Bhutto, Student Final Year MBBS, Sindh Medical College, Dow University of Health Sciences, Karachi - Pakistan
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Dehghani A, Salsali M, Cheraghi MA. Professionalism in Iranian Nursing: Concept Analysis. Int J Nurs Knowl 2015; 27:111-8. [DOI: 10.1111/2047-3095.12082] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ali Dehghani
- School of Nursing and Midwifery; Tehran University of Medical Sciences; Tehran Iran
| | - Mahvash Salsali
- School of Nursing and Midwifery; Tehran University of Medical Sciences; Tehran Iran
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Birden H, Glass N, Wilson I, Harrison M, Usherwood T, Nass D. Defining professionalism in medical education: a systematic review. MEDICAL TEACHER 2014; 36:47-61. [PMID: 24252073 DOI: 10.3109/0142159x.2014.850154] [Citation(s) in RCA: 115] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
INTRODUCTION We undertook a systematic review and narrative synthesis of the literature to identify how professionalism is defined in the medical education literature. METHODS Eligible studies included any articles published between 1999 and 2009 inclusive presenting viewpoints, opinions, or empirical research on defining medical professionalism. RESULTS We identified 195 papers on the topic of definition of professionalism in medicine. Of these, we rated 26 as high quality and included these in the narrative synthesis. CONCLUSION As yet there is no overarching conceptual context of medical professionalism that is universally agreed upon. The continually shifting nature of the organizational and social milieu in which medicine operates creates a dynamic situation where no definition has yet taken hold as definitive.
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Parsley NL, Harris IB. Podiatric medical students' perceptions of professionalism in the clinical setting: a qualitative analysis. J Am Podiatr Med Assoc 2013. [PMID: 23204194 DOI: 10.7547/1020434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The teaching and assessment of professionalism have become central areas of research and practice in medicine and in allopathic and osteopathic undergraduate and graduate medical education generally. In contrast, discussion of professionalism as it relates to podiatric medical education is nearly nonexistent in the literature. METHODS A study of podiatric medical students' perceptions of professionalism-related issues in the clinical setting was performed using a qualitative analysis. A written survey was sent to 88 students who had recently completed their clinical training experiences. The survey was completed anonymously, and all identifying information was redacted before analysis of the data, which was performed using thematic content analysis with constant comparative analysis. In addition, basic demographic information was acquired as part of the data collection process. RESULTS Sixty-six students (75%) responded and agreed to participate in the survey. Students provided written reports of lapses in professional behavior that they had witnessed, heard about, or been personally involved in performing. The study confirmed that podiatric medical students had experienced various types of professional lapses in behavior, and six predominant themes were identified. CONCLUSIONS This study, which was performed with a selected group of individuals at a single institution, serves as an initial assessment of the needs of podiatric medical students and will be useful for developing professionalism-related instructional activities that could benefit students in the future.
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Affiliation(s)
- Nancy L Parsley
- Dr. William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, Chicago, IL 60064, USA.
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Professionalism and social networking: can patients, physicians, nurses, and supervisors all be "friends?". Health Care Manag (Frederick) 2013; 31:285-94. [PMID: 23111479 DOI: 10.1097/hcm.0b013e31826fe252] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine the use of social networking (Facebook) among nurse anesthetists. We examined whether they would have concerns about their supervisor, patients, or physicians seeing their Facebook profile. We also examined their attitudes related to maintaining professional boundaries with regard to the initiation or receipt of Facebook "friend" requests from their supervisor, patients, or physicians they work with. Our respondents consisted of 103 nurses currently enrolled in a graduate-level nurse anesthetist program. All respondents had a minimum of 2 years of work experience in critical care nursing. Most respondents were found to be neutral about physicians and supervisors viewing their Facebook profiles but expressed concerns about patients seeing such information. A vast majority indicated they would accept a friend request from their supervisor and a physician but not a patient. Surprisingly, about 40% had initiated a friend request to their supervisor or physician they work with. Implications for health care managers are discussed.
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Abstract
OBJECTIVES Professionalism is an essential competence for dental professionals. Dental educators require both a clear definition and an understanding of the scope of professionalism in order to teach and assess it. The aim of this study was to identify concepts of professionalism in dentistry and the themes within this construct. METHOD Semi-structured interviews with participants purposively sampled to ensure representation of relevant viewpoints. Qualitative framework analysis was used to induct themes. RESULTS Four themes arose from the data: (i) professionalism as a second order competence, (ii) the expression of professionalism as dependent on context, (iii) reflection as a necessary component and (iv) professionalism encompasses both tacit and overt personal aspects. These results were then incorporated into a conceptual model of dental professionalism. CONCLUSIONS Analysis of the interview data reveals that participants conceptualise professionalism as the manner in which one reflects on and reconciles different aspects of professional practice, which demonstrates acceptance of professional responsibility and accountability. It is manifested in the manner in which work is carried out. The definition and model conceptualise the construct of professionalism within dentistry that can be used to derive an educational and assessment system.
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Birden H, Glass N, Wilson I, Harrison M, Usherwood T, Nass D. Teaching professionalism in medical education: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25. MEDICAL TEACHER 2013; 35:e1252-66. [PMID: 23829342 DOI: 10.3109/0142159x.2013.789132] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
INTRODUCTION We undertook a systematic review to identify the best evidence for how professionalism in medicine should be taught. METHODS Eligible studies included any articles published between 1999 and 2009 inclusive. We reviewed papers presenting viewpoints and opinions as well as empirical research. We performed a comparative and thematic synthesis on all papers meeting inclusion criteria in order to capture the best available evidence on how to teach professionalism. RESULTS We identified 217 papers on how to teach professionalism. Of these, we determined 43 to be best evidence. Few studies provided comprehensive evaluation or assessment data demonstrating success. As yet, there has not emerged a unifying theoretical or practical model to integrate the teaching of professionalism into the medical curriculum. DISCUSSION Evident themes in the literature are that role modelling and personal reflections, ideally guided by faculty, are the important elements in current teaching programmes, and are widely held to be the most effective techniques for developing professionalism. While it is generally held that professionalism should be part of the whole of a medical curriculum, the specifics of sequence, depth, detail, and the nature of how to integrate professionalism with other curriculum elements remain matters of evolving theory.
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Affiliation(s)
- Hudson Birden
- University Centre for Rural Health, Lismore, New South Wales, Australia.
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Bin Abdulrahman K, Gibbs T, Harden R. The medical education journey continues. MEDICAL TEACHER 2013; 35 Suppl 1:S5-S7. [PMID: 23464819 DOI: 10.3109/0142159x.2013.770828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Khalid Bin Abdulrahman
- Development & Academic Accreditation, Al-Imam Mohammed Bin Saud Islamic University (IMSIU), Al-Nada, Saudi Arabia.
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Al-Eraky MM, Chandratilake M, Wajid G, Donkers J, van Merrienboer J. Medical professionalism: development and validation of the Arabian LAMPS. MEDICAL TEACHER 2013; 35 Suppl 1:S56-62. [PMID: 23581897 DOI: 10.3109/0142159x.2013.765553] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
AIM The attributes of the professional physicians varies among cultures. This study aims to develop and validate a questionnaire that measures attitudes of medical students on professionalism in the Arabian context. METHOD Thirty-two experts contributed to item generation in particular domains. The instrument was administered to Arabian medical students and interns and responses were collected using five-point Likert scales. Data were analyzed to estimate the reliability of the instrument. The inventory in its final version was labeled as the Learners' Attitude of Medical Professionalism Scale (LAMPS). RESULTS A total of 413 medical students and interns responded from two universities in Egypt and Saudi Arabia. Means of item response ranged from 2.38 to 4.72. The highest mainly deals with "Respect to others," while the lowest belong to "Honor/Integrity." The final version of the LAMPS has 28 items in five domains, with a reliability of 0.79. DISCUSSION The LAMPS has salient features compared to other similar instrument. It was designed based on a reliable framework in explicit behavioral items, not abstract attributes of professionalism. The LAMPS can help teachers to identify learning gaps regarding professionalism amongst their students and track attitude changes over time or as the result of interventions. CONCLUSION To the best of our knowledge, the LAMPS is the first context-specific inventory on medical professionalism attitudes in the Arabian context.
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Robinson AJ, Tanchuk CJ, Sullivan TM. Professionalism and occupational therapy: An exploration of faculty and students’ perspectives. The Canadian Journal of Occupational Therapy 2012; 79:275-84. [DOI: 10.2182/cjot.2012.79.5.3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background. Professionalism is a complex, multifaceted concept embedded within the curricula of occupational therapy programs and professional documents; yet there is no clear explanation in the literature. Purpose. To explore occupational therapy faculty and students’ perspectives of the meaning of professionalism. Methods This interpretivist qualitative study used convenience sampling to recruit eight second-year occupational therapy master's students and five occupational therapy faculty members to participate in two separate focus groups. Open-coding and constant comparative methods were used to identify themes. Findings. Data analysis yielded the following student focus group themes: uncertainty about professional expectations; searching for answers through concrete concepts; and the context-specific nature of professionalism. Faculty focus group themes were professional responsibility; professional awareness; and the context-specific nature of professionalism. Understanding and enacting professionalism may be a developmental process. Implications. Further exploration of the meaning of professionalism from a variety of other occupational therapy stakeholders is needed.
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Affiliation(s)
| | - Chelsea J. Tanchuk
- Student Support Services, School District No. 42, 23000 116th Ave., Maple Ridge, BC, V2X 0T8
| | - Theresa M. Sullivan
- Department of Occupational Therapy, University of Manitoba, R111-771 McDermot Ave., Winnipeg, MB, R3E 0T6
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Katz JD, Haile-Mariam TW, Roth K, Moskovitz P, Niemtzoff M, Fried A. Teaching suffering: The testimonial-commentary method. PSYCHOL HEALTH MED 2012; 17:629-35. [DOI: 10.1080/13548506.2011.652639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Byszewski A, Hendelman W, McGuinty C, Moineau G. Wanted: role models--medical students' perceptions of professionalism. BMC MEDICAL EDUCATION 2012; 12:115. [PMID: 23153359 PMCID: PMC3537482 DOI: 10.1186/1472-6920-12-115] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 11/01/2012] [Indexed: 05/22/2023]
Abstract
BACKGROUND Transformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education. METHODS Survey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA). Chi-square and Fischer's exact test (for cell count less than 5) were used to derive p-values for categorical variables by level of student learning. RESULTS The response rate was 45.6% (255 of 559 students) for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship). Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to "celebrate" professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was highlighted in the answers to the open ended questions. CONCLUSIONS Students identify the need for strong positive role models in their learning environment, and for effective evaluation of the professionalism of students and teachers. Medical school leaders must facilitate development of these components within the MD education and faculty development programs as well as in clinical milieus where student learning occurs.
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Affiliation(s)
- Anna Byszewski
- Professor of Medicine, Division of Geriatric Medicine, University of Ottawa, Ottawa, Canada
- The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Box 678, Ottawa, ON, Canada
| | | | - Caroline McGuinty
- Postgraduate Training, Internal Medicine, University of Toronto, Toronto, Canada
| | - Geneviève Moineau
- Vice President, Education, Association of Faculties of Medicine of Canada, Toronto, Canada
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Zijlstra-Shaw S, Robinson PG, Roberts T. Assessing professionalism within dental education; the need for a definition. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2012; 16:e128-e136. [PMID: 22251336 DOI: 10.1111/j.1600-0579.2011.00687.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Professionalism is a broad competency needed by dentists to act effectively and efficiently and is seen as a central part of both undergraduate and postgraduate curricula. Assessment is vital in education to assess progress and direct future learning. It is also an essential part of good professional regulation, which depends upon high quality assessment to maintain credibility. Educators must produce clear expectations that students can strive for. Thus dental educators are required to understand precisely what is meant by "professionalism" in relation to dentistry in order to both teach and assess it. The aim of this paper is to explain the importance of professionalism, explore its features and its assessment as described in the literature. The paper concludes that without a validated definition of this construct, assessment of professionalism within dental education will be compromised.
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Affiliation(s)
- S Zijlstra-Shaw
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
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Mossop LH. Is it time to define veterinary professionalism? JOURNAL OF VETERINARY MEDICAL EDUCATION 2012; 39:93-100. [PMID: 22433745 DOI: 10.3138/jvme.0411.041r1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The medical profession has spent much time and many resources engaging in a discourse of medical professionalism and debating the appropriate attitudes and behavior of physicians, but little has been published concerning the concept of veterinary professionalism. Physicians are commonly examined by social scientists and educationalists to establish definitions of medical professionalism in order to teach and assess these values within curricula. This challenging process has not been without criticism, however, with some calling the numerous definitions unhelpful, especially when these behaviors are not demonstrated in practice or the wider sociological implications of medical professionalism are ignored. Veterinary curricula often include professional skills, and there has been some discussion about their inclusion as well as the scope of veterinary surgeons and their role in society. Despite this, no true definition of veterinary professionalism exists, and the teaching of the values and behaviors expected of veterinary professionals may not be explicit. Regardless of the difficulties of engaging in such a discourse, perhaps it is time that this occurred and a realistic and usable definition of veterinary professionalism is established. This is a period of change for the veterinary profession, and a teachable and assessable definition can provide some clarity and assist educators within ever evolving veterinary curricula.
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O'Sullivan H, van Mook W, Fewtrell R, Wass V. Integrating professionalism into the curriculum: AMEE Guide No. 61. MEDICAL TEACHER 2012; 34:e64-e77. [PMID: 22289014 DOI: 10.3109/0142159x.2012.655610] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Professional values and behaviours are intrinsic to all medical practice, yet remain one of the most difficult subjects to integrate explicitly into a curriculum. Professionalism for the twenty-first century raises challenges not only to adapting the course to changing societal values but also for instilling skills of ongoing self-directed continuous development in trainees for future revalidation. This Guide is based on the contemporary available literature and focuses on instilling Professionalism positively into both undergraduate and postgraduate training deliberately avoiding the more negative aspects of Fitness to Practise. The literature on Professionalism is extensive. An evidence-based approach has been taken throughout. We have selected only some of the available publications to offer practical advice. Comprehensive reviews are available elsewhere (van Mook et al. 2009a-g). This Guide takes a structured stepwise approach and sequentially addresses: (i) agreeing an institutional definition, (ii) structuring the curriculum to integrate learning across all years, (iii) suggesting learning models, (iv) harnessing the impact of the formal, informal and hidden curricula and (v) assessing the learning. Finally, a few well-evaluated case studies for both teaching and assessment have been selected to illustrate our recommendations.
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Affiliation(s)
- Helen O'Sullivan
- Institute of Learning and Teaching, Faculty of Health and Life Sciences, The University of Liverpool, UK.
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O'sullivan H, McKimm J. Doctor as professional and doctor as leader: same attributes, attitudes and values? Br J Hosp Med (Lond) 2011; 72:463-6. [DOI: 10.12968/hmed.2011.72.8.463] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Helen O'sullivan
- Centre for Excellence in Evidence Based Learning and Teaching, Faculty of Health and Life Sciences, Director of Postgraduate Studies, School of Medicine, The University of Liverpool, Liverpool L69 3GE and
| | - Judy McKimm
- Medical Education in the College of Medicine, Swansea University, Swansea
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Monrouxe LV, Rees CE, Hu W. Differences in medical students' explicit discourses of professionalism: acting, representing, becoming. MEDICAL EDUCATION 2011; 45:585-602. [PMID: 21564198 DOI: 10.1111/j.1365-2923.2010.03878.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
CONTEXT Rather than merely acting professionally, medical students are expected to become professionals. Developing an embodied professional persona is not straightforward as there is no single perspective of what medical professionalism comprises. In the context of this confusion, medical educationalists have been charged with developing a professionalism curriculum that emphasises, supports and measures students' professionalism. This paper focuses on medical students' discourses of medical professionalism in order to understand the means through which students conceptualise professionalism. METHODS Discourse analysis was undertaken. Two hundred students from three medical schools (in England, Australia and Wales) participated in 32 group and 22 individual interviews. Students' explicit definitions of professionalism were inductively coded according to the dimensions of professionalism they identified (n=19) and the discourses of professionalism they used (individual, collective, interpersonal, complexity). Connections were explored between pre-clinical and clinical students' understandings of professionalism across the schools and the respective policies, documents and teaching opportunities available to them. RESULTS Understandings of professionalism differed between pre-clinical and clinical students and between schools with different approaches to professionalism education. Students who experienced early patient interaction and opportunities to engage in conversations about professionalism within clinician-led small groups demonstrated complex, embodied understandings of professionalism, drawing on all four discourses. Students who learned predominately through lectures used a restricted range of discourses and focused on dressing or acting like a professional. CONCLUSIONS Providing students with opportunities to engage in active sense-making activities within the formal professional curriculum can encourage an embodied and sophisticated understanding of professionalism.
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Affiliation(s)
- Lynn V Monrouxe
- Division of Medical Education, School of Medicine, Cardiff University, Cardiff, UK.
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Wright CA, Jolly B, Schneider-Kolsky ME, Baird MA. Defining fitness to practise in Australian radiation therapy: A focus group study. Radiography (Lond) 2011. [DOI: 10.1016/j.radi.2010.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Hodges BD, Ginsburg S, Cruess R, Cruess S, Delport R, Hafferty F, Ho MJ, Holmboe E, Holtman M, Ohbu S, Rees C, Ten Cate O, Tsugawa Y, Van Mook W, Wass V, Wilkinson T, Wade W. Assessment of professionalism: recommendations from the Ottawa 2010 Conference. MEDICAL TEACHER 2011; 33:354-63. [PMID: 21517683 DOI: 10.3109/0142159x.2011.577300] [Citation(s) in RCA: 186] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Over the past 25 years, professionalism has emerged as a substantive and sustained theme, the operationalization and measurement of which has become a major concern for those involved in medical education. However, how to go about establishing the elements that constitute appropriate professionalism in order to assess them is difficult. Using a discourse analysis approach, the International Ottawa Conference Working Group on Professionalism studied some of the dominant notions of professionalism, and in particular the implications for its assessment. The results presented here reveal different ways of thinking about professionalism that can lead towards a multi-dimensional, multi-paradigmatic approach to assessing professionalism at different levels: individual, inter-personal, societal-institutional. Recommendations for research about professionalism assessment are also presented.
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MacDonald J, Sohn S, Ellis P. Privacy, professionalism and Facebook: a dilemma for young doctors. MEDICAL EDUCATION 2010; 44:805-13. [PMID: 20633220 DOI: 10.1111/j.1365-2923.2010.03720.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES This study aimed to examine the nature and extent of use of the social networking service Facebook by young medical graduates, and their utilisation of privacy options. METHODS We carried out a cross-sectional survey of the use of Facebook by recent medical graduates, accessing material potentially available to a wider public. Data were then categorised and analysed. Survey subjects were 338 doctors who had graduated from the University of Otago in 2006 and 2007 and were registered with the Medical Council of New Zealand. Main outcome measures were Facebook membership, utilisation of privacy options, and the nature and extent of the material revealed. RESULTS A total of 220 (65%) graduates had Facebook accounts; 138 (63%) of these had activated their privacy options, restricting their information to 'Friends'. Of the remaining 82 accounts that were more publicly available, 30 (37%) revealed users' sexual orientation, 13 (16%) revealed their religious views, 35 (43%) indicated their relationship status, 38 (46%) showed photographs of the users drinking alcohol, eight (10%) showed images of the users intoxicated and 37 (45%) showed photographs of the users engaged in healthy behaviours. A total of 54 (66%) members had used their accounts within the last week, indicating active use. CONCLUSIONS Young doctors are active members of Facebook. A quarter of the doctors in our survey sample did not use the privacy options, rendering the information they revealed readily available to a wider public. This information, although it included some healthy behaviours, also revealed personal information that might cause distress to patients or alter the professional boundary between patient and practitioner, as well as information that could bring the profession into disrepute (e.g. belonging to groups like 'Perverts united'). Educators and regulators need to consider how best to advise students and doctors on societal changes in the concepts of what is public and what is private.
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Affiliation(s)
- Joanna MacDonald
- Department of Psychological Medicine, University of Otago, Wellington School of Medicine and Health Sciences, Wellington 6242, New Zealand.
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Egnew TR, Wilson HJ. Faculty and medical students' perceptions of teaching and learning about the doctor-patient relationship. PATIENT EDUCATION AND COUNSELING 2010; 79:199-206. [PMID: 19748201 DOI: 10.1016/j.pec.2009.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Revised: 07/27/2009] [Accepted: 08/12/2009] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To explore student and faculty perceptions of how students are learning doctor-patient relationship skills in their clinical medical education. METHODS Exploratory qualitative study involving data from interviews and focus groups with students and interviews with teaching faculty. RESULTS Respondents reported that pre-clinical relationship skills curricula were not well-coordinated with clinical curricula. Within the clinical curriculum, respondents perceived a disparity between general practice and hospital-based attachments. Teaching of relationship skills on the wards was highly variable, rarely explicit, and primarily dependent on role-modelling. In contrast, general practice runs included explicit teaching with feedback that reinforced skills taught in the pre-clinical curriculum. Respondents recommended increased focus on and assessment of students' interpersonal skills within clinical settings. CONCLUSION Pre-clinical and clinical relationship skills curricula were not coordinated. The tension between service commitments and student teaching in hospital-based attachments contributed to an insufficient focus on communication and relationship skills acquisition and did not reinforce teaching in pre-clinical and ambulatory clinical settings. PRACTICE IMPLICATIONS The teaching of doctor-patient relationship skills can be augmented by coordinating pre-clinical and clinical curricula and by requiring observation and structured feedback related to explicit criteria of student skills acquisition across all clinical learning experiences.
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Miles S, Leinster SJ. Identifying professional characteristics of the ideal medical doctor: the laddering technique. MEDICAL TEACHER 2010; 32:136-140. [PMID: 20163229 DOI: 10.3109/01421590903196987] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE The aim was to examine the utility of the laddering interview technique to investigate complex issues in medical education, such as professionalism. METHOD The laddering technique was used to identify examples of professional behaviour associated with the ideal medical doctor, and to explain why participants thought these behaviours were important. Three groups were interviewed: doctors (n = 30), first-year medical students (n = 31) and patients (n = 33). RESULTS All groups identified characteristics associated with a 'communication and interpersonal skills' theme. Data suggested the essence of the doctor-patient interaction was shared by the groups, with varying later emphases due to their different perspectives. Additionally, Doctors and Students generated characteristics associated with 'team-working' and 'competence' themes; Doctors' conceptualization of each theme was more detailed. Positive and negative impacts of Doctor's professional behaviour on the patient, doctor and the wider medical arena were also identified. CONCLUSION Use of laddering resulted in data-rich results for each of the three stakeholder groups, illustrating shared and divergent preferences as to the preferred characteristics of a medical doctor and effects of successful and less-successful doctor-patient interactions. The identified characteristics are relevant to the area under investigation and salient to these key stakeholders.
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Affiliation(s)
- Susan Miles
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK.
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Lown N, Davies I, Cordingley L, Bundy C, Braidman I. Development of a method to investigate medical students' perceptions of their personal and professional development. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2009; 14:475-486. [PMID: 18633725 DOI: 10.1007/s10459-008-9130-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 06/13/2008] [Indexed: 05/26/2023]
Abstract
Personal and Professional Development (PPD) is now key to the undergraduate medical curriculum and requires provision of appropriate learning experiences. In order to achieve this, it is essential that we ascertain students' perceptions of what is important in their PPD. We required a methodological approach suitable for a large medical school, which defines constructs used by the students to describe their PPD, and is not constrained by a researcher's predetermined line of questioning. It should also quantify the saliencies of these constructs in the student population and indicate how they gauge their own PPD. The instrument should also be suitable for administration at key stages of the students' learning experience. Here we describe the first stages in developing a novel method, which fulfils these requirements. It is based on a modified self repertory grid, the "Ideal Self" Inventory. All first year students (N = 379), provided five descriptors of a "good medical student" and of a not very good medical student, which generated 1,531 'ideal' qualities. To define underlying themed constructs, 49 randomly selected descriptors, were grouped together by self selected students (n = 55), using commonly held assumptions. Frequency of item co-occurrence was tabulated by multidimensional scaling. Themed clusters of 'ideal' qualities, defined by hierarchical cluster analysis, were overlaid onto the multidimensional scaling to generate a concept map. This revealed seven themed constructs; Personal Welfare, Time and Self Management Committed Work Ethic, Learning Skills, Personal Development/Reflection, Personal and Professional Conduct and Teamwork. We then analysed the 1,531 'ideal' qualities, by determining the frequency with which students used each construct and the proportion of students who used a construct at least once. Personal and Professional Conduct, Committed Work Ethic and Time and Self Management were the most frequently used, implying that they were the most salient for the first year students.
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Affiliation(s)
- Nick Lown
- University of Manchester Medical School, Stopford Building, Oxford Road, Manchester M13 9PT, UK
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