BackgroundDeveloping professionalism is a core task in medical education. Unfortunately, it has remained difficult for educators to identify medical students’ unprofessionalism, because, among other reasons, there are no commonly adopted descriptors that can be used to document students’ unprofessional behaviour. This study aimed to generate an overview of descriptors for unprofessional behaviour based on research evidence of real-life unprofessional behaviours of medical students.MethodsA systematic review was conducted searching PubMed, Ebsco/ERIC, Ebsco/PsycINFO and Embase.com from inception to 2016. Articles were reviewed for admitted or witnessed unprofessional behaviours of undergraduate medical students.ResultsThe search yielded 11,963 different studies, 46 met all inclusion criteria. We found 205 different descriptions of unprofessional behaviours, which were coded into 30 different descriptors, and subsequently classified in four behavioural themes: failure to engage, dishonest behaviour, disrespectful behaviour, and poor self-awareness.ConclusionsThis overview provides a common language to describe medical students’ unprofessional behaviour. The framework of descriptors is proposed as a tool for educators to denominate students’ unprofessional behaviours. The found behaviours can have various causes, which should be explored in a discussion with the student about personal, interpersonal and/or institutional circumstances in which the behaviour occurred. Explicitly denominating unprofessional behaviour serves two goals: [i] creating a culture in which unprofessional behaviour is acknowledged, [ii] targeting students who need extra guidance. Both are important to avoid unprofessional behaviour among future doctors.Electronic supplementary materialThe online version of this article (10.1186/s12909-017-0997-x) contains supplementary material, which is available to authorized users.

This AMEE guide provides a research overview of the identification of, and responding to unprofessional behaviour in medical students. It is directed towards medical educators in preclinical and clinical undergraduate medical education. It aims to describe, clarify and categorize different types of unprofessional behaviours, highlighting students' unprofessional behaviour profiles and what they mean for further guidance. This facilitates identification, addressing, reporting and remediation of different types of unprofessional behaviour in different types of students in undergraduate medical education. Professionalism, professional behaviour and professional identity formation are three different viewpoints in medical education and research. Teaching and assessing professionalism, promoting professional identity formation, is the positive approach. An inevitable consequence is that teachers sometimes are confronted with unprofessional behaviour. When this happens, a complementary approach is needed. How to effectively respond to unprofessional behaviour deserves our attention, owing to the amount of time, effort and resources spent by teachers in managing unprofessional behaviour of medical students. Clinical and medical educators find it hard to address unprofessional behaviour and turn toward refraining from handling it, thus leading to the 'failure to fail' phenomenon. Finding the ways to describe and categorize observed unprofessional behaviour of students encourages teachers to take the appropriate actions. . She received her MD in 1986, and completed residency training in general practice at the University of Amsterdam in 1990. Marianne worked in general practice for 15 years, combining this work with teaching clerks in the workplace, and from 2001 with other educational activities at the Faculty of Medicine at the VU University. From 2010 onwards, she has been coordinating the educational theme 'Professional behaviour' at the school. Recently, Marianne received her PhD with distinction. Her research explores how educators and peer students perceive and respond to unprofessional behaviours of medical students.Arianne Teherani PhD, is a Professor of role in which she leads design, development, and policy for evaluation of the school's curriculum and programs. Arianne's main research interests are in the areas of professionalism, professional identity formation, and equity in medical education. She has led studies aimed at identification and remediation of unprofessional behaviours, the role of clinical education in shaping the professional identity of learners and teachers, and the role of assessment and learning environment practices in perpetuating educational disparities and interventions aimed at creating equity during medical school. . His current medical education research focuses on generic aspects of (post)graduate training, and on intensive care medicine specifically, including the supervision of national and international PhD students. In addition he performs research in the fields of organ donatio...

Introduction Using a self-determination theory framework, we investigated burnout and engagement among PhD students in medicine, and their association with motivation, work-life balance and satisfaction or frustration of their basic psychological needs. Method This cross-sectional study was conducted among PhD students at a university medical centre (n = 990) using an electronic survey on background characteristics and validated burnout, engagement, motivation and basic psychological needs questionnaires. Cluster analysis was performed on the burnout subscale scores to find subgroups within the sample which had similar profiles on burnout. Structural equation modelling was conducted on a hypothesized model of frustration of basic psychological needs and burnout. Results The response rate was 47% (n = 464). We found three clusters/subgroups which were composed of PhD students with similar burnout profiles within the cluster and different profiles between the clusters. Cluster 1 (n = 199, 47%) had low scores on burnout. Clusters 2 (n = 168, 40%) and 3 (n = 55, 13%) had moderate and high burnout scores, respectively, and were associated with low engagement scores. Cluster 3, with the highest burnout scores, was associated with the lowest motivational, engagement, needs satisfaction and work-life balance scores. We found a good fit for the “basic psychological needs frustration associated with burnout” model. Discussion The most important variables for burnout among PhD students in medicine were lack of sleep and frustration of the basic psychological needs of autonomy, competence and relatedness. These add to the factors found in the literature.

Health professions education (HPE) research is dominated by variable-centred analysis, which enables the exploration of relationships between different independent and dependent variables in a study. Although the results of such analysis are interesting, an effort to conduct a more person-centred analysis in HPE research can help us in generating a more nuanced interpretation of the data on the variables involved in teaching and learning. The added value of using person-centred analysis, next to variable-centred analysis, lies in what it can bring to the applications of the research findings in educational practice. Research findings of person-centred analysis can facilitate the development of more personalized learning or remediation pathways and customization of teaching and supervision efforts. Making the research findings more recognizable in practice can make it easier for teachers and supervisors to understand and deal with students. The aim of this article is to compare and contrast different methods that can be used for person-centred analysis and show the incremental value of such analysis in HPE research. We describe three methods for conducting person-centred analysis: cluster, latent class and Q‑sort analyses, along with their advantages and disadvantage with three concrete examples for each method from HPE research studies.