Defining professionalism in medical education: A systematic review

Birden, Hudson; Glass, Narelle; Wilson, Ian G; Harrison, Michelle; Usherwood, Tim; Nass, Duncan

doi:10.3109/0142159x.2014.850154

Cited by 195 publications

(186 citation statements)

References 92 publications

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“…This reinforces the observation made by many of our residents during initial development of this curriculum: ''I don't know what professionalism is; I only know when it's not there.'' Defining professionalism for residents remains a challenge 8 and continues to complicate efforts to teach it.…”

Section: Discussionmentioning

confidence: 99%

A Military Transitional Year Professionalism Curriculum

Edwards¹,

Sterbis²,

Olson³

2014

Journal of Graduate Medical Education

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Transitional year residencies must provide a general enough clinical experience to prepare residents for a wide variety of specialty training programs. In the military, they must also provide an experience intense enough to give a background for independent practice as a general medical officer. The end result should be a clinician professionally mature enough to take on the roles of a specialty trainee, clinic supervisor, and/or command advisor.In our training program, it was made clear in 2008 during the annual internal review that faculty had serious concerns about resident performance regarding professionalism. These concerns were partially based on recent events resulting in dismissal of 1 resident from the program for repeated lapses in professionalism and program-level remediation for several others. Several faculty members called for a transitional year program professionalism curriculum.Although professionalism curricula have been developed and published for many other specialties, such as pediatrics, surgery, anesthesiology, and internal medicine, 1-6 published guidelines on professionalism training for transitional year residencies is lacking. The program sought to create a novel approach to professionalism training based on how it obtained feedback on resident performance in this core competency. Methods Settings and ParticipantsTripler Army Medical Center has a small military transitional year residency program with 10 to 14 residents per year and 14 designated core clinical faculty. Approximately one-half of the residents select the program after failing to match in their specialty of choice. These residents will either match for an alternate program in their intern year or become general medical officers at the completion of their transitional year residency. The remaining residents are preselected for residencies in ophthalmology, radiology, dermatology, or anesthesiology.

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Section: Discussionmentioning

confidence: 99%

A Military Transitional Year Professionalism Curriculum

Edwards¹,

Sterbis²,

Olson³

2014

Journal of Graduate Medical Education

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“…Appreciation for the importance of professionalism in the practice of medicine is ubiquitous [1,2]. Medical school faculty face the challenge of defining the behaviors through which student professionalism is judged and the standards of performance to which learners are held.…”

Section: Introductionmentioning

confidence: 99%

Student response to reports of unprofessional behavior: assessing risk of subsequent professional problems in medical school

Ainsworth

Szauter

2018

Medical Education Online

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Background: An early concern note (ECN) program is used by some medical schools to identify, counsel, and intervene when students exhibit unprofessional behavior. Student maturity, insight, propensity for reflection, and receptiveness to feedback have been suggested as predictors of future behavior. Objective: We hypothesized that (a) classifying students with a first ECN based on their response to the report would identify students at risk of repeat ECNs better than the action that prompted it and (b) receipt of multiple ECNs would identify students at risk of adverse academic events.Design: For this study, 459 ECNs were classified based on students’ (1) recognition that their behavior was inappropriate and (2) acceptance of responsibility for the behavior. Student academic progress and receipt of subsequent ECNs were tracked.Results: Students who recognized their behavior was inappropriate and accepted responsibility after an initial ECN received subsequent ECNs at lower rates (14–19%) than students who disagreed with the significance of their behavior or were resistant to accepting responsibility (36–59%). Students with limited insight and adaptability appeared to be at highest risk. Seventy-one percent of students with three or more ECNs encountered adverse academic events during enrollment.Conclusion: Student reactions to reports of unprofessional behavior may be useful as a tool to help assess risk of recurrent lapses. Students with diminished capacity to recognize behaviors as unprofessional or accept responsibility for them appear to be at highest risk for additional adverse academic and professionalism events while in medical school.

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“…In the last issue of this journal, Birden and colleagues wrote a systematic review of the literature to identify how professionalism is defined in the medical education literature (Birden et al 2014). They begin their review with a quote by Erde: ''I do not strive for a clear and unambiguous definition of 'professionalism' because I do not believe one is possible'' (Erde 2008).…”

Section: Dear Sirmentioning

confidence: 99%