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Nasri N, Xu W, Jamaludin KA, Mohamad Nasri N. Socio-culturally responsive medical professionalism and ethics education: A curriculum co-creation approach. Med Educ Online 2024; 29:2303209. [PMID: 38194435 PMCID: PMC10778402 DOI: 10.1080/10872981.2024.2303209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/04/2024] [Indexed: 01/11/2024]
Abstract
Medical professionalism and ethics (MPE) are critical components influencing how medical practitioners provide patients with the highest standard of care. As a result, a structured attempt has been undertaken to enhance the content and teaching delivery of the medical professionalism and ethics education (MPEE) in the undergraduate medical curriculum. Guided by Vygotsky's sociocultural learning theory, Harre and Van Langenhove's positioning theory and Taba's principles of curriculum development, a curriculum co-creation project was organized with the aim of developing a socio-culturally responsive MPEE. A total of fifteen medical students agreed to participate in the project where they co-created MPE curriculum with a medical educator over the course of three months. Upon completion of the project, a co-created, socio-culturally responsive MPE curriculum was presented. The thematic analysis revealed positive changes in the participants' attitudes, skills, and behaviors towards co-creating the MPE curriculum. They also reported feeling a sense of fulfilment after having a transformative experience as curriculum co-creators and after receiving positive feedback from the faculty, staff, and other students on the co-created MPE curriculum. The project's success demonstrates the importance of curriculum co-creation as a strategy to promote co-creation efforts among students and educators in developing a socio-culturally responsive curriculum. The project's framework and practical recommendations can be adopted by other medical educators and faculties to encourage students' participation and their role on curriculum development using the co-creation approach.
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Affiliation(s)
- Nurfarahin Nasri
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Wenwen Xu
- Faculty of Education, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
- Faculty of Aviation, Chengdu College of University of Electronic Science and Technology of China, Chengdu, China
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Zhou X, Li Q, Zhao Q, Zhang X, Xu Y, Qian P, Gao FL, Cheong IH, Guo D, Ma S, Chen H, Liu S, Wang W, Kang X, Sun M, Yang Y, Chen Q, Gao H. Toward Professionalism of Biobanking in China: A Survey on Working Status, Career Development, Challenges, and Prospects of Biobankers. Biopreserv Biobank 2024; 22:139-145. [PMID: 37582272 DOI: 10.1089/bio.2022.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Biobanking has become an increasingly important activity to provide resources for medical research support. In China, establishing and maintaining a biobank have been the latest trend in a research hospital. However, biobanking is still an emerging young field in terms of professionalization and professionalism. The development of professionalization in biobanking faces many challenges involving the development of skills, identities, norms, and values associated with becoming part of a professional group. Biobanking professionals (i.e., biobankers) are the most important factor and driving force toward professionalization in biobanking. To better understand biobankers' performance, needs, concerns, and career development, we conducted two comprehensive surveys among biobankers in China in 2019 and 2021, respectively. The questionnaires covered four major areas: (1) basic information and the status of biobankers; (2) job performance evaluation, salary, recognitions, rewards, and so on; (3) occupational training and career development; and (4) challenges and prospects and so on. The surveys revealed that most biobankers in China have positive working attitudes and a high desire for their future career development, but due to the uncertain evaluation mechanisms and promotion routes, etc., the participants were more optimistic about biobanking development compared to the biobanker's career development (77.0% and 57.4% respectively in 2021, p < 0.05). The biobankers expected more training opportunities and salary packages. Because biobankers are an integral factor and driving force to ensure the successful biobanking operation and advancement, the survey data analysis revealed interesting findings and references for the development of professionalism in biobanking. This survey will provide first-hand information to governments, biobank management teams, and the general public to further support, promote, or optimize (1) biobanking operation and sustainability, (2) biobankers' career development, (3) biobank management and quality control, and (4) strategic plans and approaches to establish a higher quality professional team of biobankers.
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Affiliation(s)
- Xuexun Zhou
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
| | - Qian Li
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Department of Biobank, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qian Zhao
- China National GeneBank, Shenzhen, China
| | - Xiaoyan Zhang
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- National Engineering Center for Biochip at Shanghai, Shanghai, China
| | - Yanping Xu
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- National Engineering Center for Biochip at Shanghai, Shanghai, China
| | - Puyi Qian
- China National GeneBank, Shenzhen, China
| | - Frank Liu Gao
- School of Public Affairs, University of Science and Technology of China, Hefei, China
| | - Io Hong Cheong
- State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dan Guo
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Clinical Biobank, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shihui Ma
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Huan Chen
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Department of Pathology Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Sijian Liu
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Department of Clinical Epidemiology and Biostatistics, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weiye Wang
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaonan Kang
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Biological Resource Center, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Menghong Sun
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Department of Pathology Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yajun Yang
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- School of Life Sciences, Fudan University, Shanghai, China
| | - Qubo Chen
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- Biological Resource Center, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China
| | - Hengjun Gao
- Biobank Branch, China Medicinal Biotech Association, Shanghai, China
- National Engineering Center for Biochip at Shanghai, Shanghai, China
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Mlambo VC, Keller E, Mussatto C, Hwang G. Development of a Medical Social Media Ethics Scale and Assessment of #IRad, #CardioTwitter, and #MedTwitter Posts: Mixed Methods Study. JMIR Infodemiology 2024; 4:e47770. [PMID: 38536206 PMCID: PMC11007602 DOI: 10.2196/47770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/25/2023] [Accepted: 09/30/2023] [Indexed: 04/13/2024]
Abstract
BACKGROUND Social media posts by clinicians are not bound by the same rules as peer-reviewed publications, raising ethical concerns that have not been extensively characterized or quantified. OBJECTIVE We aim to develop a scale to assess ethical issues on medical social media (SoMe) and use it to determine the prevalence of these issues among posts with 3 different hashtags: #MedTwitter, #IRad, and #CardioTwitter. METHODS A scale was developed based on previous descriptions of professionalism and validated via semistructured cognitive interviewing with a sample of 11 clinicians and trainees, interrater agreement, and correlation of 100 posts. The final scale assessed social media posts in 6 domains. This was used to analyze 1500 Twitter posts, 500 each from the 3 hashtags. Analysis of posts was limited to original Twitter posts in English made by health care professionals in North America. The prevalence of potential issues was determined using descriptive statistics and compared across hashtags using the Fisher exact and χ2 tests with Yates correction. RESULTS The final scale was considered reflective of potential ethical issues of SoMe by participants. There was good interrater agreement (Cohen κ=0.620, P<.01) and moderate to strong positive interrater correlation (=0.602, P<.001). The 6 scale domains showed minimal to no interrelation (Cronbach α=0.206). Ethical concerns across all hashtags had a prevalence of 1.5% or less except the conflict of interest concerns on #IRad, which had a prevalence of 3.6% (n=18). Compared to #MedTwitter, posts with specialty-specific hashtags had more patient privacy and conflict of interest concerns. CONCLUSIONS The SoMe professionalism scale we developed reliably reflects potential ethical issues. Ethical issues on SoMe are rare but important and vary in prevalence across medical communities.
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Affiliation(s)
| | - Eric Keller
- Division of Interventional Radiology, Stanford Health Care, Stanford, CA, United States
| | - Caroline Mussatto
- School of Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Gloria Hwang
- Division of Interventional Radiology, Stanford Health Care, Stanford, CA, United States
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Imran S, Yasmeen R, Mansoor M. Development and validation of self-assessment instrument to measure the digital professionalism of healthcare professionals using social media. BMC Med Educ 2024; 24:243. [PMID: 38448892 PMCID: PMC10919038 DOI: 10.1186/s12909-024-05142-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/06/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND The use of social media across the globe has risen incrementally. During the COVID-19 pandemic, these sites undeniably provided new avenues for professional networking but also led to a surge in cases of online misconduct. Professionalism instruments and scales do not assess the digital attitude and behaviour of healthcare professionals (HCPs). The purpose of this study was to identify the domains and items of digital professionalism related to social media use and to validate a self-assessment instrument to assess the digital professionalism of HCPs using social media. METHODS An instrument development multiphase mixed method study (exploratory sequential) was conducted in two phases: item development and qualitative content validation followed by validation of the instrument. Feedback was taken from 15 experts for qualitative content validation in phase 1. In phase 2, content validity was established through three rounds of modified Delphi. Validity evidence was collected for the content (content validity index), response process (cognitive interviews), internal structure (confirmatory factor analysis), and internal consistency (Cronbach's alpha). RESULTS The 48-item preliminary instrument was reduced to a 28-item instrument with eight domains: self-anonymity, privacy settings, maintenance of boundaries and confidentiality, conflict of interest, accountability, respect for colleagues, and ethics. The content validity index of the scale was 0.91. The reliability and construct validity of the instrument was established by responses from 500 healthcare professionals from multiple hospitals. Confirmatory factor analysis showed a model with a goodness-of-fit index of 0.86, root mean square error of approximation of 0.06, and observed normed χ2 of 2.7. The internal consistency through Cronbach's alpha α was 0.96. CONCLUSION The digital professionalism self-assessment instrument (DP-SAI) has an appropriate level of content and measures the construct reliably. It can be used by medical doctors, dental clinicians, nurses, physiotherapists, and clinical pharmacists to self-assess and reflect on their social media practices. This will help to address these issues to enhance the quality of online communication through various social media platforms.
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Affiliation(s)
- Shazia Imran
- Department of Anatomy, NUST School of Health Sciences (NSHS), National University of Science and Technology, Islamabad, Pakistan.
| | - Rahila Yasmeen
- Dean Riphah Academy of Research & Education, Riphah International University, Islamabad, Pakistan
| | - Memoona Mansoor
- Department of Medical Education, Islamabad Medical & Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
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Dagi TF, Abode-Iyamah K, Sherman WJ, Fox WC. Commentary: A Scoping Review of Professionalism in Neurosurgery. Neurosurgery 2024; 94:e42-e43. [PMID: 37819100 DOI: 10.1227/neu.0000000000002713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 10/13/2023] Open
Affiliation(s)
- T Forcht Dagi
- Department of Neurosurgery, Mayo Alix College of Medicine and Science, Newton Centre , Massachusetts , USA
| | | | - Wendy J Sherman
- Department of Neurology, Mayo Clinic, Jacksonville , Florida , USA
| | - W Christopher Fox
- Department of Neurosurgery, The Mayo Clinic, Jacksonville , Florida , USA
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Friedlander LT, Wallace W, Broadbent JM, Hanlin SM, Lyons KM, Cannon RD, Cooper PR. Preparedness and competency of New Zealand graduates for general dental practice - perceptions from the workforce. Aust Dent J 2024; 69:29-39. [PMID: 37740647 DOI: 10.1111/adj.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Dental graduates need to demonstrate clinical competency. This mixed-methods study explored the perceptions of clinicians who employ or work with new graduates from the University of Otago, New Zealand, and identified themes reflecting graduates' preparedness for independent practice. METHODS An online survey using a semantic differential scale and open-ended questions collected opinions and experiences from the workforce. Quantitative data were analysed using SPSS software, and qualitative data were analysed thematically. RESULTS A representative sample of the workforce was obtained with a response rate of 35% (N = 83). Most clinicians engage new graduates to support the profession and/or rural communities. They perceived that graduates were well prepared in most areas, could translate theory to clinical practice and demonstrate professionalism. Graduates were reportedly stronger in basic dentistry, communication, ethics, and record keeping however were less strong in complex treatment planning, molar endodontics, fixed prosthodontics and exodontia. Clinical exposure during dental training was perceived as more limited, and mentoring and guidance in the transition to practice were deemed to be important. CONCLUSIONS New Zealand dental graduates appear prepared for independent practice; however, maximising clinical opportunities during training, mentoring and early professional development in advanced areas of practice is essential to enhance competency and confidence.
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Affiliation(s)
- L T Friedlander
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - Wda Wallace
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - J M Broadbent
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - S M Hanlin
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - K M Lyons
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - R D Cannon
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - P R Cooper
- Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Shields M, James D, McCormack L. Organisational challenges to wellbeing in nuclear medicine technologists: Professionalism, burnout and pragmatic growth. Radiography (Lond) 2024; 30:622-627. [PMID: 38330894 DOI: 10.1016/j.radi.2024.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/21/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Occupational risk for burnout in nuclear medicine technologists globally, and particularly during disaster demands on the profession, is poorly researched. This idiographic study explored the lived experience of nuclear medicine technologists during COVID-19 in a regional city in Australia. METHODS Data was collected from five participants using semi-structured interviews and transcribed and analysed according to the protocols of Interpretative Phenomenological Analysis (IPA). RESULTS Four group experiential themes were identified: Systemic Contraindications, Professional Strengths and Limitations, Pragmatic Growth, and Covid Rollercoaster. For these participants a dichotomous health care system, impacted by COVID-19, risked career longevity and burnout. Through empathic connection with vulnerable patients, they redefined their priorities, re-engaged in supportive connections with colleagues, and sought new pathways. CONCLUSION Multiple workplace stressors compounded by COVID-19, risked mental wellbeing, in these participants. Nevertheless, these challenges provided opportunities for reflection around career trajectory and longevity precipitating personal growth, job satisfaction and work-life balance. IMPLICATIONS FOR PRACTICE This study provided a lens on the risk factors inherent for nuclear medicine technologists in Australia, exacerbated by the COVID-19 pandemic. Current, and disaster protective practices, to ensure wellbeing and prevent burnout risk are recommended for future research.
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Affiliation(s)
- M Shields
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
| | - D James
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
| | - L McCormack
- The University of Newcastle, University Dr, Callaghan, NSW, 2308, Australia.
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Mangham W, Parikh KA, Motiwala M, Gienapp AJ, Roach J, Barats M, Lillard J, Khan N, Arthur A, Michael LM. A Scoping Review of Professionalism in Neurosurgery. Neurosurgery 2024; 94:435-443. [PMID: 37819083 DOI: 10.1227/neu.0000000000002711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/10/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The Accreditation Council for Graduate Medical Education's Milestones provides a foundation for professionalism in residency training. Specific professionalism concepts from neurosurgery could augment and expand milestones for the specialty. We reviewed the current literature and identified professionalism concepts within the context of neurosurgical practice and training. METHODS We used a scoping review methodology to search PubMed/MEDLINE and Scopus and identify English-language articles with the search terms "professionalism" and "neurosurgery." We excluded articles that were not in English, not relevant to professionalism within neurosurgery, or could not be accessed. Non-peer-reviewed and qualitative publications, such as commentaries, were included in the review. RESULTS A total of 193 articles were included in the review. We identified 6 professionalism themes among these results: professional identity (n = 53), burnout and wellness (n = 51), professional development (n = 34), ethics and conflicts of interest (n = 27), diversity and gender (n = 19), and misconduct (n = 9). CONCLUSION These 6 concepts illustrate concerns that neurosurgeons have concerning professionalism. Diversity and gender, professional identity, and misconduct are not specifically addressed in the Accreditation Council for Graduate Medical Education's Milestones. This review could be used to aid the development of organizational policy statements on professionalism.
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Affiliation(s)
- William Mangham
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Kara A Parikh
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Mustafa Motiwala
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Andrew J Gienapp
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis , Tennessee , USA
| | - Jordan Roach
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Michael Barats
- College of Medicine, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Jock Lillard
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
| | - Nickalus Khan
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - Adam Arthur
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
| | - L Madison Michael
- Department of Neurosurgery, The University of Tennessee Health Science Center, Memphis , Tennessee , USA
- Semmes Murphey, Memphis , Tennessee , USA
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Kang YJ, Lee S, Lee HJ, Kim DH. Analyzing the characteristics of mission statements in Korean medical schools based on the Korean Doctor's Role framework. Korean J Med Educ 2024; 36:99-104. [PMID: 38462245 PMCID: PMC10925805 DOI: 10.3946/kjme.2024.287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/08/2023] [Accepted: 01/03/2024] [Indexed: 03/12/2024]
Abstract
PURPOSE This study assessed the alignment between Korean medical schools' mission statements (MSs) and Korean Doctor's Role (KDR) domains, considering school characteristics. METHODS We analyzed the South Korean medical school's MS characteristics using a mixed-methods approach. Quantitative analysis preprocessed MS text data to identify concept words, while qualitative content analysis categorized information into predefined KDR domains and extracted themes from other parts. RESULTS At the KDR domain level, "social accountability" was the most frequent, followed by "education and research" and "patient care," while "professionalism" had the least frequency. At the competency level, the most frequent domains were "involvement in public and global health initiatives," while "self-regulation based on professional leadership" and "professionalism and self-management" were not present. CONCLUSION The study found that the majority of MSs had a homogeneous pattern and included traditional themes. Medical schools should evaluate and incorporate missing elements in their MSs to reflect the institution's own purpose and current societal needs.
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Affiliation(s)
- Ye Ji Kang
- Department of Medical Education, Hanyang University College of Medicine, Seoul, Korea
| | - Soomin Lee
- Hanyang University College of Medicine, Seoul, Korea
| | - Hyo Jeong Lee
- Department of Medical Education, Hanyang University College of Medicine, Seoul, Korea
| | - Do-Hwan Kim
- Department of Medical Education, Hanyang University College of Medicine, Seoul, Korea
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Chandy RJ, Rivis CC, Dao DPD, Huang WWT. Diversity, Equity, and Inclusion as Part of Professionalism and Ethics in Dermatology. South Med J 2024; 117:139-140. [PMID: 38428934 DOI: 10.14423/smj.0000000000001656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- Rithi J Chandy
- From the Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Cristian C Rivis
- From the Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Diem-Phuong D Dao
- From the Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - William Wei-Ting Huang
- From the Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Loh KM, Kong CKY, Ganapathy S. COVID-19 and its impact on healthcare professionalism: a qualitative study of behaviour among paediatric emergency physicians. Singapore Med J 2024; 65:S30-S34. [PMID: 34717308 DOI: 10.11622/smedj.2021170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/13/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Kent Mun Loh
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Catrin Kar Yee Kong
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
| | - Sashikumar Ganapathy
- Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore
- Duke-NUS Medical School, Singapore
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AlRukban M, Alajlan F, Alnasser A, Almousa H, Alzomia S, Almushawah A. Teaching medical ethics and medical professionalism in Saudi public and private medical schools. PLoS One 2024; 19:e0298605. [PMID: 38421988 PMCID: PMC10903870 DOI: 10.1371/journal.pone.0298605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
Medical ethics and professionalism are two essential parts of building up the identity of a competent physician. This study was conducted to determine the nature, content, and methods of medical ethics and professionalism education in Saudi public and private medical schools. It also sought to identify the challenges and obstacles in teaching and assessing medical ethics and professionalism and suggest appropriate changes. A cross-sectional study was carried out in Saudi private and public medical schools. To achieve the study's aim, an assessment tool in the form of a novel self-administered questionnaire was developed, piloted, and then used. A representative from each of the 28 Saudi medical schools participated in the study. Twenty-four (82.1%) responding medical schools have no medical ethics department. Most of the medical schools (64.2%) have 25% or less of their faculty staff who teach ethics holding a qualification in medical ethics. Most schools have a specific course for medical ethics and professionalism (85.7% and 57.1%, respectively). Multiple-choice questioning is the most popular assessment method in medical ethics and professionalism courses (89.3% and 60.7%, respectively). The need for more qualified staff and clear guidelines/resources is a significant drawback to the teaching of medical ethics. Therefore, the study recommends developing national guidelines dedicated to the undergraduate teaching curriculum from which courses would be designed to enhance medical ethics and medical professionalism.
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Affiliation(s)
- Mohammed AlRukban
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Fahad Alajlan
- Department of Family and Community Medicine, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ali Alnasser
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
| | - Hisham Almousa
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
| | - Sulaiman Alzomia
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
| | - Abdullah Almushawah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia, Saudi Arabia
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Relić D, Marelić M, Viskić J, Machala Poplašen L, Majer M, Sedak K, Vukušić Rukavina T. Exploring changes in the perception of e- professionalism among medical and dental students: a quantitative cross-sectional study. Croat Med J 2024; 65:43-50. [PMID: 38433511 PMCID: PMC10915766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024] Open
Abstract
AIM To compare e-professionalism perceptions between medical and dental students, focusing on their awareness and understanding of guidelines for developing e-professionalism. METHODS A cross-sectional quantitative study was conducted at the University of Zagreb School of Medicine (UZSM) and School of Dental Medicine (UZSDM) in 2022/2023. Data were gathered through a questionnaire designed specifically for the survey. RESULTS Of the 646 questionnaires collected, 626 were analyzed, with a response rate of 33.95% for UZSM and 37.83% for UZSDM. Most respondents (71.4%) were female, with a median age of 21. Medical students significantly more frequently considered it unprofessional to publish posts containing photos of patients/clients (96.5% vs 75.1%), endorsements of health products without conflict-of-interest disclosures (60.6% vs 33.0%), and posts describing patient interactions without revealing identifying information (51.7% vs 27.4%). In contrast, dental medicine students more frequently considered it unprofessional to publish posts with swearing or foul language (81.2% vs 67.4%), critical comments about lecturers (68.0% vs 46.9%), and criticisms of course material or the institution (52.3% vs 36.4%). Only 23.2% of students were aware of e-professionalism guidelines, with 37.9% of those familiar with their content. CONCLUSION While medical and dental students recognize the importance of e-professionalism, their perceptions have substantial differences. The need for promoting existing guidelines and integrating e-professionalism into curricula is evident. Continuous monitoring and research in this domain are essential to ensure future health care professionals maintain high standards of online professionalism.
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Affiliation(s)
| | - Marko Marelić
- Marko Marelić, Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova 4, 10000 Zagreb, Croatia,
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Sullivan E, Thampy H, Gay S. Raising professionalism concerns as a medical student: damned if they do, damned if they don't? BMC Med Educ 2024; 24:208. [PMID: 38424552 PMCID: PMC10905891 DOI: 10.1186/s12909-024-05144-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Understanding professionalism is an essential component of becoming a doctor in order to ensure the trust of patients and wider society. Integrally linked to the concept of professionalism is the importance of identifying and raising concerns to ensure high quality, safe patient care. It is recognised that medical students are uniquely placed to identify and report concerns given their frequent rotations through multiple clinical placements and their peer relationships and, in so doing, develop and enact their own medical professionalism. Although there is existing literature exploring medical students' willingness to raise concerns about observed professionalism lapses, this has largely been in the context of clinical interactions. Medical students will however undoubtedly encounter concerning behaviours or attitudes in their fellow students, an area that has not specifically been reported upon. This study therefore set out to explore medical students' willingness to report professionalism concerns they encounter both within and away from the clinical setting, particularly focusing on peer-related concerns. METHODS 10 medical students, in later clinical years of a large UK medical school, volunteered to take part in in-depth semi-structured interviews. Interviews were recorded, transcribed and then analysed thematically to generate themes and subthemes to represent central organising concepts. RESULTS Three broad themes were generated from the data. Hidden curricular effects including role models, hierarchical structures and the operational systems in place to raise concerns subconsciously influenced students' decisions to raise concerns. Secondly, students offered a range of justifications to defend not taking action, including considering their own vulnerabilities and values alongside demonstrating empathy for perceived mitigating circumstances. The third theme highlighted the complex interplay of influencing factors that students considered when encountering professionalism issues in their peers including wider peer cohort effects and a desire to maintain individual peer-relationships. CONCLUSIONS Medical students will inevitably encounter situations where the professionalism of others is brought into question. However, despite clear curricular expectations to report such concerns, these findings demonstrate that students undergo a complex decision-making process in determining the threshold for reporting a concern through navigating a range of identified influencing factors. This study highlights the important role medical schools play in helping reduce the inner conflict experienced by medical students when raising concerns and in ensuring they provide supportive processes to empower their students to raise concerns as part their own developing professionalism.
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Affiliation(s)
| | | | - Simon Gay
- University of Leicester, Leicester, UK
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15
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Phillips N, Politis M. Professionalism in 2024: today's doctors shouldn't be held to outdated ideas. BMJ 2024; 384:q424. [PMID: 38413143 DOI: 10.1136/bmj.q424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
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16
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Gunsilius CZ, Price MM, Rogers SL, Flynn E, Jha AP. Paying attention to attention: a program evaluation of faculty-delivered mindfulness-based attention training to optimize wellness and professionalism in medical students. BMC Med Educ 2024; 24:182. [PMID: 38395856 PMCID: PMC10893728 DOI: 10.1186/s12909-024-05119-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND As physician distress rises, medical schools must provide programs to counter such distress at the earliest stages of training. Mindfulness training (MT) is one intervention that can alleviate stress during medical school. However, framing MT around wellness alone misses the opportunity to connect core cognitive and psychological capacities strengthened by MT to professional goals and skill acquisition inherent to successful medical training. Here, we highlight how the attentional components of MT align with students' goals of becoming attending physicians while promoting academic, psychological, and interpersonal flourishing. MT courses that focus on strengthening attentional capacities can intuitively link academic and professional development with wellness, appealing to a wide array of students. METHODS We iteratively recontextualized an existing short-form mindfulness training program for high-stress pre-professionals, known as Mindfulness Based Attention Training (MBAT), to the medical school context (MBAT-Rx). MBAT-Rx was offered by physician trainers to first-year medical students at Warren Alpert Medical School of Brown University as a tool for improving study habits and focus in addition to the development of both self-care and patient care strategies. MBAT-Rx consists of weekly, two-hour sessions over four weeks, with 10-15 min of daily mindfulness practice between sessions. At the end of the four weeks, students submitted voluntary program evaluation responses detailing their experience of the program. RESULTS Optional program evaluation responses (n = 67) highlight that students found the program to be useful for their academic success and ability to pay attention, their interpersonal relationships, and their psychological health. By framing MT as an opportunity to boost core attentional capacities and connecting this to professional and academic goals in addition to wellness, MBAT-Rx appealed to a wide variety of students. CONCLUSIONS Our ongoing work suggests that framing MT as both a professional development and wellness promotion tool, taught by physicians themselves, and structured around students' time demands, may be a successful model for medical schools looking to increase the impact of their mindfulness offerings. Such programs are needed to equip medical students to navigate the demands of a challenging healthcare training landscape.
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Affiliation(s)
- Chloe Zimmerman Gunsilius
- Department of Neuroscience, Brown University, 185 Meeting Street, Providence, RI, 02912, USA.
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, USA.
- Warren Alpert School of Medicine, Brown University, Providence, RI, USA.
| | - Malena M Price
- Department of Psychology, University of Miami, Florida, USA
| | - Scott L Rogers
- Mindfulness in Law Program, School of Law, University of Miami, Florida, USA
| | - Ellen Flynn
- Department of Medicine, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
- Department of Psychiatry & Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, RI, USA
| | - Amishi P Jha
- Department of Psychology, University of Miami, Florida, USA
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17
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Koop SE. What's Important: Two Chairs: A Conversation About Patient-Centered Care and Professionalism. J Bone Joint Surg Am 2024; 106:368-369. [PMID: 37769045 DOI: 10.2106/jbjs.23.00898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Affiliation(s)
- Steven E Koop
- Gillette Children's, St. Paul, Minnesota
- Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota
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18
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Godschalx-Dekker JA, Sijbom CAM, Barnhoorn PC, van Mook WNKA. Unprofessional behaviour of GP residents leading to a dismissal dispute: characteristics and outcomes of those who appeal. BMC Prim Care 2024; 25:61. [PMID: 38378463 PMCID: PMC10877848 DOI: 10.1186/s12875-024-02294-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Recognition of poor performance in General Practice trainees is important because underperformance compromises patients' health and safety. However, in General Practice, research on persistent underperformance while in training and its ultimate consequences is almost completely lacking. We aim to explore the unprofessional behaviours of residents in General Practice who were dismissed from training and who litigated against dismissal. METHODS We performed a structured analysis using open-source data from all General Practice cases before the Conciliation Board of the Royal Dutch Medical Association between 2011 and 2020. Anonymised law cases about residents from all Dutch GP training programmes were analysed in terms of the quantitative and qualitative aspects related to performance. RESULTS Between 2011 and 2020, 24 residents who were dismissed from training challenged their programme director's decision. Dismissed residents performed poorly in several competencies, including communication, medical expertise and most prominently, professionalism. Over 90% of dismissed residents failed on professionalism. Most lacked self-awareness and/or failed to profit from feedback. Approximately 80% failed on communication, and about 60% on medical expertise as well. A large majority (more than 80%) of dismissed residents had previously participated in some form of remediation. CONCLUSIONS Deficiencies in both professionalism and communication were the most prevalent findings among the dismissed General Practice residents. These two deficiencies overlapped considerably. Dismissed residents who challenged their programme director's decision were considered to lack self-awareness, which requires introspection and the appreciation of feedback from others.
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Affiliation(s)
- Judith A Godschalx-Dekker
- Department of Psychiatry and Medical Psychology Flevoziekenhuis, Almere, The Netherlands
- GGZ Central Flevoland, Almere, The Netherlands
| | | | - Pieter C Barnhoorn
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Walther N K A van Mook
- Department of Intensive Care Medicine, Maastricht UMC+, Maastricht, The Netherlands.
- Academy for Postgraduate Training, Maastricht UMC+, Maastricht, The Netherlands.
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
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19
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Butler K, Vanstone M, Yak A, Veltman A. "Will I be able to be myself? Or will I be forced to lie all the time?": How Trans and Non-Binary Students Balance Professionalism, Authenticity, and Safety in Canadian Medical Programs. Perspect Med Educ 2024; 13:119-129. [PMID: 38406648 PMCID: PMC10885831 DOI: 10.5334/pme.1199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/05/2024] [Indexed: 02/27/2024]
Abstract
Introduction Promoting the inclusion of trans and non-binary (TNB) medical trainees is a key step in building an inclusive health workforce well-positioned to provide high-quality healthcare to all patients. Existing data on the experiences of TNB physicians and trainees describe widespread challenges related to prejudice and discrimination, with most trainees concealing their gender identity for fear of discrimination. We aimed to understand how TNB medical students have experienced professionalism and professional identity formation. Methods This was a secondary analysis of data gathered in a constructivist grounded theory study. The authors conducted semi-structured qualitative interviews in 2017 with seven current or recently graduated TNB Canadian medical students. Results and Discussion From medical school application to graduation, TNB medical students reported feeling tensions between meeting expectations of professionalism, being their authentic selves, and seeking to avoid conscious and implicit biases. These tensions played out around issues of disclosure, foregrounding identity through impression management, and responding to identity exemplars. The tension between TNB trainees' desire to bring their whole selves to the practice of medicine and feeling pressured to de-emphasize their gender is ironic when considering the increased call for medical trainees from equity-seeking communities. The most commonly used behavioural frameworks of professionalism were inherited from prior generations and restrict students whose experiences and community-based knowledge are most needed. Demands of professionalism that are incompatible with authentic professional identity development place an inordinate burden on trainees whose identities have been excluded from normative concepts of the professional, including TNB trainees.
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Affiliation(s)
- Kat Butler
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, CA
| | | | | | - Albina Veltman
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, CA
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20
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Kang YJ, Lin Y, Rho J, Ihm J, Kim DH. The hidden hurdles of clinical clerkship: unraveling the types and distribution of professionalism dilemmas among South Korean medical students. BMC Med Educ 2024; 24:150. [PMID: 38360613 PMCID: PMC10870601 DOI: 10.1186/s12909-024-05115-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/30/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND To improve the medical professionalism of medical students, it is essential to understand the dilemmas they face in various situations. This study explored the types and distribution of dilemmas Korean medical students encounter during their clinical clerkships. It then compared these with previous dilemma frameworks and identified the types and distribution of "complexity dilemmas," wherein two dilemma themes emerge in a single clinical situation. METHODS The researchers organized and recorded a group discussion with 106 third-year medical students who had completed their clinical clerkships. These students participated in the discussion as part of an assignment, focusing on the dilemmas they encountered during their clerkships. For data analysis and visualization, the researchers employed the MAXQDA software program and utilized the template analysis method, a qualitative research methodology. RESULTS A total of seven dilemma themes and sixteen sub-themes were identified. The identity-related dilemma concerning student-doctors had the highest frequency. The themes "mismatch" and "Nun-chi" emerged as new additions not found in previous dilemma frameworks. The complexity dilemmas appeared in the sequence of "identity-dignity," "identity-abuse," and "identity-consent". CONCLUSIONS To navigate the unique dilemmas present within South Korea's clinical culture, several key issues need consideration: elevating the role of student-doctors, balancing the primary emphasis of educational hospitals on delivering medical services, and understanding interpersonal strategies, such as "Nun-chi".
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Affiliation(s)
- Ye Ji Kang
- Department of Medical Education, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, 04763, Seoul, Republic of Korea
| | - Yanyan Lin
- Department of Medical Education, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, 04763, Seoul, Republic of Korea
| | - Jaehee Rho
- Department of Education, College of Educational Sciences, Yonsei University, 50 Yonsei-ro Seodaemun-gu, 03722, Seoul, Republic of Korea
| | - Jungjoon Ihm
- Dental Research Institute, School of Dentistry, Seoul National University, 1, Gwanak- ro, Gwanak-gu, 08826, Seoul, Republic of Korea.
| | - Do-Hwan Kim
- Department of Medical Education, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, 04763, Seoul, Republic of Korea.
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21
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Buhumaid R, Otaki F, Czabanowska K, Stanley A, Ezimokhai M, Jackson L, Ho SB. Professionalism-training in undergraduate medical education in a multi-cultural, multi-ethnic setting in the Gulf Region: an exploration of reflective essays. BMC Med Educ 2024; 24:117. [PMID: 38321450 PMCID: PMC10848390 DOI: 10.1186/s12909-024-05103-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 01/27/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Despite the established need to prioritize professionalism-training in developing future physicians, very few medical programs in the Gulf Region embed in their curricula discrete contextualized courses aimed at developing the corresponding competencies, while fostering self-directed learning. This study aims at exploring the perception of undergraduate medical students in a multi-cultural, multi-ethnic setting regarding their understanding of, and personal experience with professionalism through their engagement with the content of an innovative curriculum-based professionalism course, offered at a Medical School in Dubai, United Arab Emirates. METHODS The study used a qualitative phenomenological research design. Out of 33 students, 29 students had submitted reflective essays. The content of these essays was inductively analyzed following a six-step framework for conducting thematic analysis. The framework's steps include familiarizing oneself with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report. FINDINGS The inductive qualitative analysis generated the Professionalism Learning Journey model. This conceptual model includes four interconnected themes: Awareness, Acknowledgement, Realization, and Application. The generated model depicts the trajectory that the learners appear to experience while they are engaging with the content of the course. CONCLUSION Integrating a professionalism-training course into an undergraduate medical curriculum is likely to be positively appraised by the learners. It raises their awareness, enables them to value the subject matter and the sophistication of its application, and empowers them to put into practice the taught principles, on an individual basis and collectively. This is especially true when the course is entrenched in constructivism experiential learning theory and designed to foster self-directed learning. The introduced conceptual model, in conjunction with the innovative professionalism-training course curriculum, can serve as a template for other competencies and other schools.
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Affiliation(s)
- Rasha Buhumaid
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates.
| | - Farah Otaki
- Strategy and Institutional Excellence, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
| | - Katarzyna Czabanowska
- Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine, and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands
- Department of Health Policy Management, Faculty of Health Care, Institute of Public Health, Jagiellonian University, Kraków, Poland
| | - Adrian Stanley
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
| | - Mutairu Ezimokhai
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
| | - Lisa Jackson
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
| | - Samuel B Ho
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
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Sartirana M, Giacomelli G. Hybridity enabled: A research synthesis of the enabling conditions for hybrid professionalism in healthcare. Health Serv Manage Res 2024; 37:2-15. [PMID: 36651108 DOI: 10.1177/09514848231151829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Hybrid professionals in healthcare organizations play a critical role, the characteristics, processes and implications of which have been thoroughly studied by scholars in the field. However, not as much attention has been paid to the conditions under which such roles might be taken by professionals entering the ground of management. This gap results into a lack of conceptual clarity and eventually ends being an obstacle in framing and ameliorating the tools needed to act such a role in its different phases. This is a research area worthy of a finer-grained understanding: the ability of organizations to effectively support role hybridization, in fact, is a requisite for professionals-managers' willingness to stay in the role and cope with the complexity that such a two-fold position entails, no matter what. Based on the results of a scoping literature review, this paper presents the enabling conditions for hybrid professionalism in healthcare, and proposes a classification of them into categories corresponding to different facets of hybrid role-taking: opportunities for interaction with management, tools supporting sense-making, and provision of delegation and autonomy. For each of these categories, organizational and management tools discussed in the literature are presented. The results of the study provide a road-map of the enabling conditions for hybrid professionalism that aims to be of practical convenience for managers and policy-makers in health care. Eventually, suggestions for organizational design and personnel management, as well as directions for further research, are highlighted.
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Affiliation(s)
- Marco Sartirana
- CERGAS (Centre for Research on Healthcare Management), SDA Bocconi School of Management, Milan, Italy
| | - Giorgio Giacomelli
- GHNP Government, Health & Not for Profit, SDA Bocconi School of Management, Milan, Italy
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23
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Montgomery MW, Petersen EM, Weinstein AR, Curren C, Hufmeyer K, Kisielewski M, Krupat E, Osman NY. Moving Beyond the Dichotomous Assessment of Professionalism in the Internal Medicine Clerkship: Results of a National Survey of Clerkship Directors. Acad Med 2024; 99:208-214. [PMID: 37369066 DOI: 10.1097/acm.0000000000005308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
PURPOSE This study examines how internal medicine clerkship faculty and leadership conceptualize professionalism and professional behaviors and attitudes, identifies whether and how faculty use metrics to assess professionalism and factor it into clerkship grades, and describes barriers that prevent faculty from feeling prepared to support the development of professional behaviors in students. METHOD The Clerkship Directors in Internal Medicine opened a call for thematic survey section proposals to its physician-faculty members, blind-reviewed all submissions, and selected 4 based on internal medicine clinical clerkship training experience relevance. The survey launched on October 5 and closed on December 7, 2021. Data were analyzed using descriptive statistics. RESULTS Of 137 core clerkship directors (CDs) at Liaison Committee on Medical Education-accredited medical schools, 103 (75.2%) responded to the survey. Of 102 respondents (1 nonrespondent), 84 (82.4%) identified professional behavior lapses in involvement and 60 (58.8%) identified introspection lapses. Of 103 respondents, 97 (94.2%) reported that their clerkships ask clinical faculty and residents to formally evaluate professionalism, and 64 (62.1%) reported that they factor professionalism assessments into final clerkship grades. CDs reported multiple barriers to addressing professionalism directly with students, including logistical barriers, professionalism assessment subjectivity concerns, and the possible adverse effect of an unprofessional label for students. CONCLUSIONS Professionalism assessment and remediation in medical education currently center on a deficit model that seeks to identify and remediate professionalism lapses, rather than a developmental model that seeks to nurture growth. This dichotomous characterization of behaviors as professional or unprofessional limits assessment and can adversely affect the learning environment. The authors propose a shift to a developmental model that considers professionalism as a continuous process parallel to the acquisition of clinical skills and medical knowledge.
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Im DS, Tamarelli CM, Shen MR. Experiences of Physicians Investigated for Professionalism Concerns: a Narrative Review. J Gen Intern Med 2024; 39:283-300. [PMID: 38051480 PMCID: PMC10853115 DOI: 10.1007/s11606-023-08550-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/17/2023] [Indexed: 12/07/2023]
Abstract
Growing attention is being paid to physician health and behavior, including the occurrence of mental health issues and burnout in medical providers, physician impairment, and alleged disruptive behavior in physicians. In any of these areas, a physician may become the subject of an investigation. Studying the experience of investigated physicians is important to identify and mitigate any potential adverse personal and practice impacts, which in turn can hinder patient care. The purpose of this review is to (1) summarize the published scientific literature to date regarding the experiences of physicians who have been investigated, and (2) based on these findings consider strategies to mitigate any adverse effects of the investigatory process for physicians. A search of the databases PubMed and Ovid MEDLINE was conducted in June 2023 using relevant search terms. After reviewing titles, abstracts, full-length articles, and reference lists, 16 articles were identified and reviewed. Physicians in multiple countries who had been investigated commonly described short-term (feelings of anger, depression, anxiety, shame, powerlessness, isolation, being betrayed, less confidence in clinical decision-making) and long-term (increase in defensive practice, retiring early) impacts of the investigatory process. Physicians found the most difficult aspects of the investigation process to be the length of time involved, lack of transparency/communication regarding the process, feelings of isolation, and dealing with vexatious complaints. While complaints about physicians have the potential to portend constructive individual practice and systemic changes, research suggests that the investigatory process for physicians is associated with negative short- and long-term emotional and practice impacts. Strategies to mitigate the unintended adverse effects of investigatory processes are proposed. Further research is warranted to clarify the investigation experience for physicians, including physicians underrepresented in medicine, and to systematically assess the effectiveness of strategies to mitigate unhealthy or disruptive components of the investigatory process.
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Affiliation(s)
- David S Im
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - Carrie M Tamarelli
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mary R Shen
- Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, USA
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25
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Gunderman RB. Educational Lessons from Vince Lombardi. Acad Radiol 2024; 31:745-746. [PMID: 38008644 DOI: 10.1016/j.acra.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023]
Affiliation(s)
- Richard B Gunderman
- Department of Radiology, Indiana University School of Medicine, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202.
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Tuuminen R. Why should we publish? Acta Ophthalmol 2024; 102:7. [PMID: 37725489 DOI: 10.1111/aos.15771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Raimo Tuuminen
- Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland
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Del Barrio LG, Rodríguez-Díez C, Gea A, Arbea L, Pereira J, Díez N. Impact of a longitudinal course on medical professionalism on the empathy of medical students. Patient Educ Couns 2024; 119:108042. [PMID: 37978022 DOI: 10.1016/j.pec.2023.108042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/08/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Medical education should enhance empathy. We examined, using self-assessment instruments and standardized patients (SPs), the impact on empathy, of a multi-year intervention (years 4-6 of medical training) that uses reflective learning approaches. METHODS 241 final-year medical students participated; 110 from the 2018 graduation class (non-intervention group) and 131 from the 2019 graduation class (intervention group). Participants completed two self-reported empathy questionnaires - the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) - and a personality questionnaire, the NEO Five-Factor Inventory. Additionally, SPs in a simulated station assessed participants' empathy with two patient-reported instruments: the Consultation and Relational Empathy (CARE) scale and the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE). RESULTS Empathy scores were significantly higher in the intervention group compared to the non-intervention group when assessed by the SP (p < 0.001). No differences were found in self-reported questionnaires between the two groups. CONCLUSION A longitudinal, multi-year reflection-based intervention enhanced empathy amongst medical students as assessed by SPs, but not when assessed by student self-reported measures. PRACTICE IMPLICATIONS Multi-year reflective learning interventions during clinical training nurture empathy in medical students. Assessments completed by SPs or patients may enhance the evaluation of empathy.
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Affiliation(s)
- Loreto García Del Barrio
- Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain; Department of Medical Education, Universidad de Navarra, Pamplona, Spain
| | | | - Alfredo Gea
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain
| | - Leire Arbea
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Oncology, Clínica Universidad de Navarra, Pamplona, Spain
| | - José Pereira
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Family Medicine, McMaster University, Canada
| | - Nieves Díez
- Department of Medical Education, Universidad de Navarra, Pamplona, Spain; Department of Pathology, Anatomy and Physiology, Universidad de Navarra, Pamplona, Spain.
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Rosenbaum L. On Calling - From Privileged Professionals to Cogs of Capitalism? N Engl J Med 2024; 390:471-475. [PMID: 38197811 DOI: 10.1056/nejmms2308226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Lisa Rosenbaum
- Dr. Rosenbaum is a national correspondent for the Journal
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Welch S. A systematic review and quality appraisal of interprofessional behavioral assessment instruments for nursing education. Nurse Educ Today 2024; 133:106073. [PMID: 38150778 DOI: 10.1016/j.nedt.2023.106073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/06/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
Instruments to assess interprofessional behaviors in prelicensure interprofessional education (IPE) lack validity and reliability data. No individual behavioral assessment instrument met all standards of the Quality Appraisal of Interprofessional Learning Scales (QuAILS) checklist (Oates & Davidson, 2015). The IPA and iSOFT instruments provided the most substantial validity and reliability evidence. Future validation research studies of interprofessional education (IPE) behavioral instruments that evaluate interprofessional professionalism (IPP) domains are needed in nursing education.
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Affiliation(s)
- Susan Welch
- University of Alabama, University Boulevard, Tuscaloosa, AL 35487, United States of America.
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30
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Li D, Poncelet A. Comment on "The Vital Importance of Professionalism in Medical Education". Acad Psychiatry 2024; 48:100-101. [PMID: 38158542 DOI: 10.1007/s40596-023-01928-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Affiliation(s)
- Descartes Li
- University of California, San Francisco, San Francisco, CA, USA.
| | - Ann Poncelet
- University of California, San Francisco, San Francisco, CA, USA
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31
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Mcluckie C, Kuipers Y. Discursive constructions of student midwives' professional identities: A discourse analysis. Nurse Educ Pract 2024; 74:103847. [PMID: 38007848 DOI: 10.1016/j.nepr.2023.103847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND The construction and performance of professional identity is significant to broader socio-cultural understandings of who 'professionals' are and what they do. Importantly, it is also implicated in the development and enactment of policy, regulation, education, and professional practice. Professional identity is linked to self-esteem, self-efficacy, professional value, confidence and success. The salience of this in relation to midwifery practice is highly significant; aspects of autonomy, confidence, competence, responsibility, and accountability are all implicated in the provision of safe and effective care. AIM To explore how student midwives are constructed in the discourses of policy, professionalism, and learning, to provide new perspectives to inform, policy, education, and practice. METHODS An adapted critical discourse analysis of the United Kingdom (UK) Nursing and Midwifery Council's 2009 Standards for pre-registration midwifery education, using a three-step process: exploring discourse at the level of (1) discursive practice (2) linguistic features of the text, and (3) social practice. FINDINGS/ DISCUSSION The discourses that relate to midwifery education and practice emerge within socio-political and historical contexts. Constructions of identity are articulated through a rule-bound framework which includes competence, confidence and 'good health and good character'. There is a requirement for midwives to 'be' responsible, accountable, autonomous, professional, competent, and confident. Regulatory power is reinforced through medico-legal discourses, with the status of midwifery discursively presented as inferior to medicine. CONCLUSION According to the Standards, midwives must be a lot of things in their role and function. The Standards' discourses are authoritative, legislative and controlling, creating an ideology about professional status and agency which constructs an 'imaginary autonomy'; becoming a midwife is more automatic (with the perception of control), than agentic. All of which has significance for the social practice of midwifery. TWEETABLE ABSTRACT 'How are midwives made? Discursive constructions of student midwives' professional identities: a discourse analysis.
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Affiliation(s)
- Connie Mcluckie
- School of Health and Social Care, Edinburgh Napier University, Edinburgh EH11 4BN, United Kingdom.
| | - Yvonne Kuipers
- School of Health and Social Care, Edinburgh Napier University, Edinburgh EH11 4BN, United Kingdom
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Ball CG, Inaba K, Harvey EJ. What does professionalism really mean in the contemporary surgical landscape? Can J Surg 2024; 67:E66-E67. [PMID: 38383029 PMCID: PMC10890788 DOI: 10.1503/cjs.001524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Chad G Ball
- Coeditors-in-chief, CJS (Ball, Harvey); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball); the Department of Surgery, McGill University, Montréal, Que. (Harvey); and the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba)
| | - Kenji Inaba
- Coeditors-in-chief, CJS (Ball, Harvey); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball); the Department of Surgery, McGill University, Montréal, Que. (Harvey); and the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba)
| | - Edward J Harvey
- Coeditors-in-chief, CJS (Ball, Harvey); the Department of Surgery, University of Calgary, Calgary, Alta. (Ball); the Department of Surgery, McGill University, Montréal, Que. (Harvey); and the Division of Acute Care Surgery, Department of Surgery, University of Southern California, Los Angeles, Calif. (Inaba)
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Ball CG, Inaba K, Harvey EJ. Que signifie réellement le professionnalisme dans le paysage chirurgical contemporain? Can J Surg 2024; 67:E68-E69. [PMID: 38383030 PMCID: PMC10890789 DOI: 10.1503/cjs.001824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Affiliation(s)
- Chad G Ball
- Corédacteurs en chef, CJS (Ball, Harvey); Département de chirurgie, Université de Calgary, Calgary, Alb. (Ball); Département de chirurgie, Université McGill, Montréal, Qc (Harvey); Division de chirurgie en soins aigus, Département de chirurgie, University of Southern California, Los Angeles, Calif. (Inaba)
| | - Kenji Inaba
- Corédacteurs en chef, CJS (Ball, Harvey); Département de chirurgie, Université de Calgary, Calgary, Alb. (Ball); Département de chirurgie, Université McGill, Montréal, Qc (Harvey); Division de chirurgie en soins aigus, Département de chirurgie, University of Southern California, Los Angeles, Calif. (Inaba)
| | - Edward J Harvey
- Corédacteurs en chef, CJS (Ball, Harvey); Département de chirurgie, Université de Calgary, Calgary, Alb. (Ball); Département de chirurgie, Université McGill, Montréal, Qc (Harvey); Division de chirurgie en soins aigus, Département de chirurgie, University of Southern California, Los Angeles, Calif. (Inaba)
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Alam BF, Najmi MA, Hussain T, Babar BZ, Ghani S, Khan A, Nayab T. Perception of dental students and faculty regarding the practice of professionalism in dentistry using the Professionalism Mini Evaluation Exercise (P-MEX). Work 2024; 77:211-218. [PMID: 37638462 DOI: 10.3233/wor-220694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Professionalism is one of the fundamental traits which includes behaviors, commitments, standards, and goals that helps define a profession. OBJECTIVE This study aimed to assess the attitude of dental students and graduates regarding the practice of professionalism in dentistry using the Professionalism Mini Evaluation Exercise (P-MEX) questionnaire. METHOD This cross-sectional study was conducted amongst the dental undergraduates, lecturers and postgraduate faculty. Views regarding professionalism were assessed using the P-MEX. The 24-questions based survey form is comprised of questions related to doctor and patient relationship skills, reflective abilities, time management, and lastly, interprofessional relationship expertise. Data was analyzed using SPSS version 23. Descriptive statistics were done using mean and SD, whilst associations between responses were assessed using Mann-Whitney U and Kruskal-Wallis tests. P value less than 0.05 was considered significant. RESULTS From a total of 201 participants, 95 (47.3%) were males and 106 (52.7%) were females. Statistically significant association was seen between time management, reflective skills, and interpersonal skills with gender, as well as the domains of P-MEX and years of education. CONCLUSION The use of P-MEX provides a valid confirmation for the assessment and awareness of professionalism amongst the dental faculty and students. Females demonstrated higher traits of professionalism as compared to males. The findings from the current study identify that students and faculty members had sufficient awareness regarding professionalism and the practice of professionalism was routinely followed.
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Affiliation(s)
- Beenish Fatima Alam
- Department of Oral Biology, Bahria University Medical & Dental College, Karachi, Pakistan
| | - Muhammad Arqam Najmi
- Department of Science of Dental Materials, Bahria University Medical & Dental College, Karachi, Pakistan
| | - Talib Hussain
- Department of Oral Biology, Women Medical and Dental College, Abbottabad, Pakistan
| | - Bilal Zaman Babar
- Department of Dental Materials, Women Medical and Dental College, Abbottabad, Pakistan
| | - Salwan Ghani
- Department of Oral Biology, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Amna Khan
- Department of Oral Biology, Women Medical and Dental College, Abbottabad, Pakistan
| | - Talha Nayab
- Department of Dental Materials Science, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
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van Lier F, Hoeks S, Pearse RM. Prediction, prognosis, and professionalism in perioperative medicine. Br J Anaesth 2024; 132:13-14. [PMID: 37977955 DOI: 10.1016/j.bja.2023.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023] Open
Abstract
Guidelines provide a framework to take better care of our patients. They are published by different professional groups and are based on all the research done for us by hardworking colleagues. Compiling a guideline is an enormous amount of work and is generally done with the utmost care. However, recommendations often require a subjective interpretation of published research, where personal and academic interests can influence the outcome. We discuss two recently published guidelines on perioperative cardiovascular assessment that led to different conclusions on some important areas of patient care.
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Affiliation(s)
- Felix van Lier
- Department of Anesthesia, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Sanne Hoeks
- Department of Anesthesia, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Rupert M Pearse
- Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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36
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Liu HY, Larson AR, Strong SA, Parekh R, Gautam M, Flores LE, Silver JK. Workforce Diversity, Equity, and Inclusion: A Crucial Component of Professionalism in Psychiatry. Child Adolesc Psychiatr Clin N Am 2024; 33:17-32. [PMID: 37981333 DOI: 10.1016/j.chc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Documented disparities have profoundly impacted the training and careers of physicians from socially and historically marginalized groups, including women, people with disabilities, people who identify with racial and ethnic minority groups, and the lesbian, gay, bisexual, transgender, and queer or questioning+ community. Professionalism is a core component of medical training and practice, yet a focus on workforce diversity, equity, and inclusion is often absent. This report aims to encourage the adoption of workforce diversity, equity, and inclusion as a crucial component of professionalism, with an emphasis on the field of psychiatry.
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Affiliation(s)
- Howard Y Liu
- University of Nebraska Medical Center, 985578 Nebraska Medical Center, Omaha, NE 68198-5578, USA.
| | - Allison R Larson
- Georgetown University, MedStar Washington Hospital Center, 5530 Wisconsin Ave, Suite 660, Chevy Chase, MD 20815, USA
| | - Sheritta A Strong
- University of Nebraska Medical Center, 985578 Nebraska Medical Center, Omaha, NE 68198-5578, USA
| | - Ranna Parekh
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Mamta Gautam
- Psychosocial Oncology Program, The Ottawa Hospital Cancer Center, TOH General Campus, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada
| | - Laura E Flores
- College of Allied Health Professions, University of Nebraska Medical Center, 984035 Nebraska Medical Center, Omaha, NE 68198-4035, USA
| | - Julie K Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA
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Keshmiri F, Haerizadeh M, Ghelmani Y. The professionalism of clinical teachers in clinical education. Indian J Med Ethics 2024; IX:18-25. [PMID: 38375649 DOI: 10.20529/ijme.2023.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
BACKGROUND Professionalism has long been recognised as a core competency for clinical teachers as role models and educators. The present study aimed to evaluate the adherence to professionalism of clinical teachers from the perspectives of resident doctors and undergraduate medical students. METHODS This is a descriptive and cross-sectional study. All learners, including undergraduate medical students and residents who were studying in the medical school and teaching hospitals affiliated with Shahid Sadoughi University, were entered into this study as evaluators (n = 311). Of these, 151 clinical teachers were assessed by the learners. The students were asked to assess the two clinical teachers with whom they had interacted during the previous month in the clinical department. The Faculty Professionalism Evaluation Questionnaire was used in this study. RESULTS The results of the confirmatory factor analysis (CFA) confirmed the adequacy of the model. The total mean score was 1.98 (standard deviation=0.36, range = 0.96 to 2.82). In addition, the total mean score of the adherence to professionalism among clinical teachers was reported at the level of "met expectations". The results showed that the teachers' scores in the domains of "doctor-patient relationship" and "doctor-student relationship" were reported under the "met expectations" level. Their scores in the "inter-professional relationship" and "doctor-self relationship" domains were reported as "below expectations". The results showed the scores of teachers' professionalism were significantly lower from the viewpoints of residents than in the perceptions of medical students (p=0.0001). CONCLUSION The professionalism scores of clinical teachers were evaluated as "below expectations" from the learners' perspectives.
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Affiliation(s)
- Fatemeh Keshmiri
- Associate Professor, Medical Education Department, Education Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, IRAN
| | - Mehran Haerizadeh
- Medical Student, Internal Medicine Department, Faculty Of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IRAN
| | - Yaser Ghelmani
- Assistant Professor, Internal Medicine Department, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IRAN
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Durham AJ, Anderson S, Norton H, Mierau A, Melnick SJ, Vannatta RA. Professionalism and Safety of DPT Students in First, Full-Time Clinical Experiences: Accelerated Hybrid versus Traditional Programs. J Allied Health 2024; 53:e19-e25. [PMID: 38430500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/03/2023] [Indexed: 03/03/2024]
Abstract
PURPOSE Doctor of Physical Therapy (DPT) education continues to progress with contemporary content and innovative teaching methods. The purpose of this study was to examine clinical assessment data from the Physical Therapist Clinical Performance Instrument (PT-CPI) focused on professionalism and safety in an initial clinical experience between an accelerated-hybrid and traditional DPT program. METHODS A retrospective analysis was performed on mid-term and final Safety, Professional Behavior, and Communication PT-CPI scores of each program's first clinical experience. The traditional program served as a control group. A total 186 students were examined: 100 from the traditional program and 86 from the accelerated-hybrid program. RESULTS There was a significant effect of learning environment on final test scores while controlling for midterm scores in Safety (p < 0.001), Professional Behavior (p < 0.001), and Communication (p < 0.001) with students in the accelerated-hybrid program scoring higher. Each program showed improvements from midterm to final PT-CPI, outperforming the set benchmark score with the accelerated-hybrid program showing larger growth in Communication and Safety. CONCLUSION Students in both DPT programs display acceptable levels of professionalism and safety according to program benchmarks and demonstrate growth in these areas throughout the clinical experiences despite differences in program design.
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Affiliation(s)
- Allison J Durham
- Bowling Green State University, 104 Health and Human Services Bldg., Bowling Green, OH, 43403, USA. Tel 419-372-6333.
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de Klerk T, Temane A, Downing C. The Development and Implementation of a Model to Facilitate Self-Awareness of Professionalism for Enrolled Nurses. J Holist Nurs 2023; 41:377-393. [PMID: 36348634 PMCID: PMC10652659 DOI: 10.1177/08980101221134758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/07/2022] [Accepted: 10/08/2022] [Indexed: 11/16/2023]
Abstract
Within the South African context, the nursing profession comprises different nursing cadres. The enrolled nurse is considered a sub-category of nursing and therefore does not carry the title of 'professional' as in a professional nurse. The purpose of the study was to develop, describe, implement, and evaluate a model for the facilitation of self-awareness for the professionalism of enrolled nurses at a specific nursing agency in Gauteng. A theory generating, qualitative, exploratory, descriptive and contextual design was used and was conducted following Chinn and Kramer's four stages of model development. The model can benefit nursing education because it relates to an essential aspect of growth and maturity in one's career. Ultimately, the facilitation of self-awareness for professionalism can advance one's career, or the lack of self-awareness may impede one's career. Developing, describing, implementing and evaluating this model to facilitate self-awareness for the professionalism of enrolled nurses at a specific nursing agency in Gauteng provides an original contribution to the theory in nursing professionalism and ethos. This model can be utilised as a tool to facilitate self-awareness for the professionalism of enrolled nurses at a nursing agency.
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Guraya SS, Guraya SY, Doubell FR, Mathew B, Clarke E, Ryan Á, Fredericks S, Smyth M, Hand S, Al-Qallaf A, Kelly H, Harkin DW. Understanding medical professionalism using express team-based learning; a qualitative case-based study. Med Educ Online 2023; 28:2235793. [PMID: 37463323 PMCID: PMC10355686 DOI: 10.1080/10872981.2023.2235793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/02/2023] [Accepted: 07/07/2023] [Indexed: 07/20/2023]
Abstract
Medical Professionalism (MP) defined as values, behaviours and attitudes that promote professional relationships, public trust and patient safety is a vital competency in health profession education. MP has a distinctive uniqueness due to cultural, contextual, conceptual, and generational variations. There is no standard instructional strategy to probe the understanding of MP in a cohesive, structured, interactive manner. This study aimed to investigate undergraduate medical students' understanding of MP using express team-based learning (e-TBL) at both campuses of Royal College of Surgeons Ireland (RCSI). Using the key principles of a sociocultural theoretical lens in adult learning theory, we designed e-TBL as a context-learning-based educational strategy. We conducted three e-TBL sessions on cross-cultural communication and health disparities, a reflective report on clinical encounters, and professionalism in practice. We collected, collated, and analyzed the student experiences qualitatively using data gathered from team-based case discussions during e-TBL sessions. A dedicated working group developed very short-answer questions for the individual readiness assurance test (IRAT) and MP-based case scenarios for team discussions. In this adapted 4-step e-TBL session, pre-class material was administered, IRAT was undertaken, and team-based discussions were facilitated, followed by facilitator feedback. A qualitative inductive thematic analysis was performed, which generated subthemes and themes illustrated in excerpts. Our thematic analysis of data from 172 students (101 from Bahrain and 71 from Dublin) yielded four unique themes: incoming professional attitudes, transformative experiences, sociological understanding of professionalism, and new professional identity formation. This qualitative study provides a deeper understanding of medical students' perceptions of medical professionalism. The generated themes resonated with divergent and evolving elements of MP in an era of socioeconomic and cultural diversity, transformative experiences, and professional identity formation. The core elements of these themes can be integrated into the teaching of MP to prepare fit-to-practice future doctors.
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Affiliation(s)
- Shaista Salman Guraya
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Salman Yousuf Guraya
- College of Medicine, Clinical Sciences Department, University of Sharjah, Sharjah, UAE
| | - Fiza-Rashid Doubell
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Bincy Mathew
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Eric Clarke
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Áine Ryan
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Salim Fredericks
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Mary Smyth
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Sinead Hand
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Amal Al-Qallaf
- School of Medicine, Royal College of Surgeons Ireland, Medical University of Bahrain, Bahrain
| | - Helen Kelly
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
| | - Denis W. Harkin
- Faculty of Medicine and Health Sciences, RCSI University of Medicine and Health Sciences Dublin, Dublin, Ireland
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Neighbour R. A duty to expose: professionalism in a time of crisis. Br J Gen Pract 2023; 73:538-539. [PMID: 38035807 PMCID: PMC10688930 DOI: 10.3399/bjgp23x735609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Affiliation(s)
- Roger Neighbour
- Past President, Royal College of General Practitioners; Professor of Medical Education, Brunel Medical School, Brunel University London, Uxbridge
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Sattar K, Yusoff MSB, Arifin WN, Mohd Yasin MA, Mat Nor MZ. A scoping review on the relationship between mental wellbeing and medical professionalism. Med Educ Online 2023; 28:2165892. [PMID: 36621960 PMCID: PMC9833410 DOI: 10.1080/10872981.2023.2165892] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/01/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education. METHODS We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants. RESULTS From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification. CONCLUSION The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.
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Affiliation(s)
- Kamran Sattar
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Muhamad Saiful Bahri Yusoff
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Wan Nor Arifin
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Azhar Mohd Yasin
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Zarawi Mat Nor
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Barry CL, Coombs J, Buchs S, Kim S, Grant T, Henry T, Parente J, Spackman J. Professionalism in Physician Assistant Education as a Predictor of Future Licensing Board Disciplinary Actions. J Physician Assist Educ 2023; 34:278-282. [PMID: 37467183 PMCID: PMC10653293 DOI: 10.1097/jpa.0000000000000515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
PURPOSE The purpose of this study was to evaluate associations between postgraduate disciplinary actions (PGDA) by state licensing boards and physician assistant (PA) school documented professionalism violations (DPV) and academic probation. METHODS This was a retrospective cohort study comprising PA graduates from 2001 to 2011 at 3 institutions (n = 1364) who were evaluated for the main outcome of PGDA and independent variable of DPV and academic probation. Random-effects multiple logistic regression and accelerated failure time parametric survival analysis were used to investigate the association of PGDA with DPV and academic probation. RESULTS Postgraduate disciplinary action was statistically significant and positively associated with DPV when unadjusted (odds ratio [OR] = 5.15; 95% CI: 1.62-16.31; P = .01) and when adjusting for age, sex, overall PA program GPA (GPA), and Physician Assistant National Certifying Exam Score (OR = 5.39; 95% CI: 1.54-18.85; P = .01) (fully adjusted). Academic probation increased odds to 8.43 times (95% CI: 2.85-24.92; P < .001) and 9.52 times (95% CI: 2.38-38.01; P < .001) when fully adjusted. CONCLUSION Students with professionalism violation or academic probation while in the PA school had significant higher odds of receiving licensing board disciplinary action compared with those who did not. Academic probation had a greater magnitude of effect and could represent an intersection of professionalism and academic performance.
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Affiliation(s)
- Carey L Barry
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
| | - Jennifer Coombs
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
| | - Shalon Buchs
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
| | - Sooji Kim
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
| | - Travis Grant
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
| | - Trenton Henry
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
| | - Jason Parente
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
| | - Jared Spackman
- Carey L. Barry, MHS, PA-C, DFAAPA, is a chair of the Department of Medical Sciences and Associate Clinical Professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jennifer Coombs, PhD, MPAS, PA-C, DFAAPA, is a director of graduate studies and is a professor, Division of Physician Assistant Studies, Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City, Utah
- Shalon Buchs, MHS, PA-C, DFAAPA, is a director of evaluation for the Office of Continuous Quality Improvement and is an associate professor, Florida State University College of Medicine, Tallahassee, Florida
- Sooji Kim, BS, is a research assistant, PA Program, Northeastern University, Boston, Massachusetts
- Travis Grant, MS, PA-C, is an assistant clinical professor, University of Florida School of Physician Assistant Studies, Gainesville, Florida
- Trenton Henry, MSPH, is a research associate at Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jason Parente, MS, PA-C, is an associate program director and is an associate clinical professor, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
- Jared Spackman, MPAS, PA-C, is a PA program director and is an associate professor at University of Utah School of Medicine, Salt Lake City, Utah
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Miller E, Tang Girdwood S, Shah A, Anyigbo C, Lanphier E. Professionalism or prejudice? Modelling roles, risking microaggressions. J Med Ethics 2023; 49:822-823. [PMID: 37460204 DOI: 10.1136/jme-2023-109295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 07/05/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Emily Miller
- Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Sonya Tang Girdwood
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Division of Clinical Pharmacology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Anita Shah
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Chidiogo Anyigbo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Elizabeth Lanphier
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Ethics Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
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de Castro Araújo Neto F, Tavares TMA, de Menezes Santos D, da Fonseca FL, de Araújo DCSA, Mesquita AR, de Lyra DP. Cross-cultural adaptation and psychometric evaluation of the "Modification of Hall's professionalism scale for use with pharmacists". BMC Med Educ 2023; 23:871. [PMID: 37974140 PMCID: PMC10655448 DOI: 10.1186/s12909-023-04815-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Professionalism is the demonstration of behaviors that guide the actions of health professionals. In Pharmacy, its implementation is possible through assessment instruments for pharmacists, such as the "Modification of Hall's Professionalism Scale for Use with Pharmacists". OBJECTIVE To translate the "Modification of Hall's Professionalism Scale for Use with Pharmacists" into a Brazilian Portuguese version and evaluate its psychometric properties for pharmacists. METHOD The methodological process of this study took place in three stages: translation and cross-cultural adaptation of the instrument original version into a Brazilian Portuguese version; validation of the scale content through consensus among geographically distinct experts and, finally; examination of the scale psychometric measurement properties through a convenience sample of 600 Brazilian pharmacists. At this stage, construct validity was verified using Exploratory Factor Analysis (EFA) and reliability was examined by calculating the composite reliability. RESULTS The adapted instrument to a Brazilian Portuguese version demonstrated content validity with coefficients considered acceptable, above 0.8. The EFA demonstrated a structure supported by six factors and 39 items. The H index suggested high stability for all factors as well as composite reliability. CONCLUSION The Brazilian Portuguese version of the instrument presented appropriate content validity coefficients and psychometric properties. This measure may be useful for future studies on professionalism regarding teaching strategies and assessment of this construct among pharmacists.
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Affiliation(s)
- Fernando de Castro Araújo Neto
- Laboratory of Teaching and Research in Social Pharmacy, Department of Pharmacy, Federal University of Sergipe - São Cristóvão Campus, São Cristóvão - Sergipe, Brazil
- Health Sciences Graduate Program, University Hospital of Sergipe - Federal University of Sergipe, Aracaju Campus, Aracaju - Sergipe, Brazil
| | - Thaís Maria Araújo Tavares
- Laboratory of Teaching and Research in Social Pharmacy, Department of Pharmacy, Federal University of Sergipe - São Cristóvão Campus, São Cristóvão - Sergipe, Brazil
| | - Douglas de Menezes Santos
- Laboratory of Teaching and Research in Social Pharmacy, Department of Pharmacy, Federal University of Sergipe - São Cristóvão Campus, São Cristóvão - Sergipe, Brazil
| | - Francielly Lima da Fonseca
- Laboratory of Teaching and Research in Social Pharmacy, Department of Pharmacy, Federal University of Sergipe - São Cristóvão Campus, São Cristóvão - Sergipe, Brazil
- Pharmaceutical Science Graduate Program, Federal University of Sergipe, São Cristóvão Campus, São Cristóvão - Sergipe, Brazil
| | - Dyego Carlos Souza Anacleto de Araújo
- Laboratory of Innovation in Pharmaceutical Care, Department of Pharmaceutical Sciences, Federal University of Espírito Santo - Maruípe Campus, Vitória - Espírito Santo, Brazil
| | - Alessandra Rezende Mesquita
- Laboratory of Teaching and Research in Social Pharmacy, Department of Pharmacy, Federal University of Sergipe - São Cristóvão Campus, São Cristóvão - Sergipe, Brazil
| | - Divaldo Pereira de Lyra
- Laboratory of Teaching and Research in Social Pharmacy, Department of Pharmacy, Federal University of Sergipe - São Cristóvão Campus, São Cristóvão - Sergipe, Brazil.
- Health Sciences Graduate Program, University Hospital of Sergipe - Federal University of Sergipe, Aracaju Campus, Aracaju - Sergipe, Brazil.
- Pharmaceutical Science Graduate Program, Federal University of Sergipe, São Cristóvão Campus, São Cristóvão - Sergipe, Brazil.
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Sternszus R, Slattery NK, Cruess RL, Cate OT, Hamstra SJ, Steinert Y. Contradictions and Opportunities: Reconciling Professional Identity Formation and Competency-Based Medical Education. Perspect Med Educ 2023; 12:507-516. [PMID: 37954041 PMCID: PMC10637293 DOI: 10.5334/pme.1027] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/24/2023] [Indexed: 11/14/2023]
Abstract
The widespread adoption of Competency-Based Medical Education (CBME) has resulted in a more explicit focus on learners' abilities to effectively demonstrate achievement of the competencies required for safe and unsupervised practice. While CBME implementation has yielded many benefits, by focusing explicitly on what learners are doing, curricula may be unintentionally overlooking who learners are becoming (i.e., the formation of their professional identities). Integrating professional identity formation (PIF) into curricula has the potential to positively influence professionalism, well-being, and inclusivity; however, issues related to the definition, assessment, and operationalization of PIF have made it difficult to embed this curricular imperative into CBME. This paper aims to outline a path towards the reconciliation of PIF and CBME to better support the development of physicians that are best suited to meet the needs of society. To begin to reconcile CBME and PIF, this paper defines three contradictions that must and can be resolved, namely: (1) CBME attends to behavioral outcomes whereas PIF attends to developmental processes; (2) CBME emphasizes standardization whereas PIF emphasizes individualization; (3) CBME organizes assessment around observed competence whereas the assessment of PIF is inherently more holistic. Subsequently, the authors identify curricular opportunities to address these contradictions, such as incorporating process-based outcomes into curricula, recognizing the individualized and contextualized nature of competence, and incorporating guided self-assessment into coaching and mentorship programs. In addition, the authors highlight future research directions related to each contradiction with the goal of reconciling 'doing' and 'being' in medical education.
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Affiliation(s)
- Robert Sternszus
- Department of Pediatrics & Institute of Health Sciences Education, McGill University, Montreal, Quebec, CA
| | | | - Richard L. Cruess
- Department of Orthopedic Surgery & Institute of Health Sciences Education, McGill University, Montreal, Quebec, CA
| | - Olle ten Cate
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht and Utrecht University, NL
| | - Stanley J. Hamstra
- Department of Surgery, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Holland Bone and Joint Program, Toronto, Canada
- ACGME, Chicago, IL, US
- Department of Medical Education, Northwestern University Feinberg School of Medicine, Chicago, IL, US
| | - Yvonne Steinert
- Department of Family Medicine & Institute of Health Sciences Education, McGill University, Montreal, Quebec, CA
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Almutairi M, Alharbi TAF, Timmins F. Perceptions of nursing students and faculty members towards academic integrity and professionalism in Saudi Arabia: A cross-sectional study. Nurse Educ Today 2023; 130:105942. [PMID: 37607443 DOI: 10.1016/j.nedt.2023.105942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/25/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Maintaining and nourishing academic integrity along with professionalism in nursing education is integral and imperative to the development of the nursing profession. However, evidence shows that academic dishonesty and incompetency exist and are raising problems among college students of all disciplines including nursing. To date, limited studies have been conducted in this area in Saudi Arabia. OBJECTIVES To determine the perceptions of nursing students and faculty members towards academic integrity and professionalism. DESIGN A cross-sectional design. SETTINGS AND PARTICIPANTS A convenience sample of undergraduate students enrolled in government universities in Saudi Arabia, and their faculty members. METHODS 342 Saudi nursing students and 113 nursing faculty members were surveyed with a valid and reliable questionnaire modified to the study setting. RESULTS Findings revealed that the majority of nursing students and faculty members were aware of the nature of academic dishonesty and unprofessionalism. Less 40 % of students and teachers reported academic dishonesty and unprofessionalism as frequent. The majority of respondents in both groups revealed there were no existing policies in their colleges relevant to academic integrity/dishonesty. For those who reported the presence of a policy, the highest percentage of the respondents expressed just occasional implementation. There was no significant difference between the perceptions of students and faculty in all scenarios regarding academic integrity and professionalism. Lastly, the level of education and affiliated nursing college was associated with the respondents' perceptions. CONCLUSIONS Nursing students and faculty members have considerable cognizance of the concept of academic integrity and professionalism. However, the occurrence of academic dishonesty and unprofessionalism was observed at both universities. The lack of established policies is a particular challenge for management. Hence, it is essential that educational institutions formulate clear academic policies that cultivate academic integrity, prevent academic dishonesty, and enhance the level of professionalism.
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Affiliation(s)
- Mariam Almutairi
- UCD School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, 4, Stillorgan Rd, Belfield, Dublin, Ireland; Department of Nursing, College of Applied Medical Science, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Talal Ali F Alharbi
- Department of Community, Psychiatric and Mental Health Nursing, College of Nursing, Qassim University, Saudi Arabia.
| | - Fiona Timmins
- UCD School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, 4, Stillorgan Rd, Belfield, Dublin, Ireland.
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Sebastian T, Prade A, Keis O, Schramm A, Öchsner W. Student experiences of professionalism and role models in an oral and maxillofacial surgery internship: A qualitative study. Eur J Dent Educ 2023; 27:849-858. [PMID: 36458891 DOI: 10.1111/eje.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 10/13/2022] [Accepted: 10/30/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Dental students have a clear concept of professionalism and the importance of role models. Our aim was to determine how dental students experience their first oral and maxillofacial surgery internship in terms of their concept of professionalism and their perception of role models. METHODS From June to August 2020, semi-structured telephone interviews were conducted with 22 dental students in their eighth and ninth semesters at the Medical Faculty of the University of Ulm. The interviews were transcribed and evaluated by qualitative content analysis according to Mayring. RESULTS The students' concept of dental professionalism was shaped by the elements of a good approach to patients, professional competence, and manual skills. This perception was not changed by the internship. Having a role model was seen as an important learning strategy, and role models were perceived in both positive and negative ways. Role models were perceived as positive if they corresponded to the student's concept of professionalism and as negative if they did not correspond to this concept, especially with regard to social interaction or the approach to patients. Students' reactions to discrepancies between their own moral values and the role models' behaviour were characterised by passivity and withdrawal. With regard to potential future careers, positive internship experiences supported student goals, whereas negative experiences raised doubts about them. CONCLUSION Supervising dentists may still underestimate the considerable impact of internships, and their awareness of this impact needs to be increased. Students' reactions to conflicts between reality and their own values do not appear to be constructive. One approach to solving this problem may be to include discussions of professional development in curricula.
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Affiliation(s)
- Tim Sebastian
- Medical Faculty of the University of Ulm, School of Dentistry, Ulm, Germany
| | - Amelie Prade
- Medical Faculty of the University of Ulm, Medical School, Ulm, Germany
| | - Oliver Keis
- Section on Teaching and Learning, Medical Faculty of the University of Ulm, Ulm, Germany
| | - Alexander Schramm
- Department of Oral and Maxillofacial Surgery, University of Ulm, Ulm, Germany
| | - Wolfgang Öchsner
- Department of Anesthesiology and Intensive Care Medicine, University of Ulm, Ulm, Germany
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Khan HF, Yasmeen R, Ali S. Validation Of An Assessment Tool For Professionalism In Medical Students: A Mixed Method Study. J PAK MED ASSOC 2023; 73:2177-2182. [PMID: 38013524 DOI: 10.47391/jpma.7770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Objectives To develop and validate a tool for the assessment of professionalism in medical students during clerkship. METHODS The mixed-method study was conducted from February to September 2018 at the Islamic International Medical College, Riphah University, Islamabad, Pakistan. A preliminary focus group discussion was followed by two rounds of Delphi technique to validate micro-scenarios for the relevance of each item of the instrument alongside its content validity. For content and construct validation of the tool, content validity, cognitive validity, cognitive pretesting, confirmatory factor analysis and reliability assessment was done. Piloting was done on medical students doing clerkship. Data was analysed using SPSS 21 and AMOS 21. RESULTS A 35-item preliminary tool from micro-scenarios generated after focus group discussion was developed for the first Delphi round. For the second round, a 29-item tool was resent to the experts for validation. After the second round, the content validity scale was 0.94. Removal of 1 item produced a 28-item tool. Pre-cognitive testing of the 28 items resulted in rephrasing of 4, modification of 2, and deletion of 1 and a tool with 27 items. Piloting was carried out and after CFA resulted in a reduced 21 item tool. Cronbach's alpha value was 0.96. A good to excellent model fit was produced after performing confirmatory factor analysis. CONCLUSIONS A tool comprising of 21 items scored on a 5-point Likert scale that had acceptable construct validity and good content validity was developed. It can be used to evaluate the level of professionalism of local medical students doing clerkship.
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Affiliation(s)
- Humaira Fayyaz Khan
- Department of Physiology, Riphah International University, Islamabad, Pakistan
| | | | - Shabana Ali
- Department of Anatomy, Riphah International University, Islamabad, Pakistan
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Drum B, Shi J, Peterson B, Lamb S, Hurdle JF, Gradick C. Using Natural Language Processing and Machine Learning to Identify Internal Medicine-Pediatrics Residency Values in Applications. Acad Med 2023; 98:1278-1282. [PMID: 37506388 DOI: 10.1097/acm.0000000000005352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
PROBLEM Although holistic review has been used successfully in some residency programs to decrease bias, such review is time-consuming and unsustainable for many programs without initial prescreening. The unstructured qualitative data in residency applications, including notable experiences, letters of recommendation, personal statement, and medical student performance evaluations, require extensive time, resources, and metrics to evaluate; therefore, previous applicant screening relied heavily on quantitative metrics, which can be socioeconomically and racially biased. APPROACH Using residency applications to the University of Utah internal medicine-pediatrics program from 2015 to 2019, the authors extracted relevant snippets of text from the narrative sections of applications. Expert reviewers annotated these snippets into specific values (academic strength; intellectual curiosity; compassion; communication; work ethic; teamwork; leadership; self-awareness; diversity, equity, and inclusion; professionalism; and adaptability) previously identified as associated with resident success. The authors prospectively applied a machine learning model (MLM) to snippets from applications from 2023, and output was compared with a manual holistic review performed without knowledge of MLM results. OUTCOMES Overall, the MLM had a sensitivity of 0.64, specificity of 0.97, positive predictive value of 0.62, negative predictive value of 0.97, and F1 score of 0.63. The mean (SD) total number of annotations per application was significantly correlated with invited for interview status (invited: 208.6 [59.1]; not invited: 145.2 [57.2]; P < .001). In addition, 8 of the 10 individual values were significantly predictive of an applicant's invited for interview status. NEXT STEPS The authors created an MLM that can identify several values important for resident success in internal medicine-pediatrics programs with moderate sensitivity and high specificity. The authors will continue to refine the MLM by increasing the number of annotations, exploring parameter tuning and feature engineering options, and identifying which application sections have the highest correlation with invited for interview status.
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Affiliation(s)
- Benjamin Drum
- B. Drum is assistant professor, Department of Internal Medicine, and adjunct professor, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jianlin Shi
- J. Shi is a research associate, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah
| | - Bennet Peterson
- B. Peterson is a graduate student, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah
| | - Sara Lamb
- S. Lamb is vice dean of education, University of Utah School of Medicine, Salt Lake City, Utah
| | - John F Hurdle
- J.F. Hurdle is professor, Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah
| | - Casey Gradick
- C. Gradick is assistant professor, Department of Internal Medicine, and adjunct professor, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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