Expectations and Obligations: Professionalism and Medicine’s Social Contract with Society

Cruess, Richard L.; Cruess, Sylvia R.

doi:10.1353/pbm.0.0045

Cited by 215 publications

(63 citation statements)

References 102 publications

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“…These early policies created by medical schools in the Web 2.0 era can provide a blueprint for other schools to adopt and adapt for use, in an effort to maintain medicine's social contract with society (18). These policies vary in the range of issues addressed and also in their general approach, from stringent prohibitions to reflective questions.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Social media policies at US medical schools

Kind

Genrich

Sodhi

et al. 2010

Medical Education Online

135

128

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Background/PurposeToday's medical students are learning in a social media era in which patient confidentiality is at risk yet schools’ social media policies have not been elucidated. The purpose of this study is to describe the presence of medical schools on top social media sites and to identify whether student policies for these schools explicitly address social media use.MethodWebsites of all 132 accredited US medical schools were independently assessed by two investigators for their presence (as of March 31, 2010) on the most common social networking and microblogging sites (Facebook and Twitter) and their publicly available policies addressing online social networking. Key features from these policies are described.Results100% (n=132) of US medical schools had websites and 95.45% (126/132) had any Facebook presence. 25.76% (34/132) had official medical school pages, 71.21% (94/132) had student groups, and 54.55% (72/132) had alumni groups on Facebook. 10.6% of medical schools (14/132) had Twitter accounts. 128 of 132 medical schools (96.97%) had student guidelines or policies publicly available online. 13 of these 128 schools (10.16%) had guidelines/policies explicitly mentioning social media. 38.46% (5/13) of these guidelines included statements that defined what is forbidden, inappropriate, or impermissible under any circumstances, or mentioned strongly discouraged online behaviors. 53.85% (7/13) encouraged thoughtful and responsible social media use.ConclusionsMedical schools and their students are using social media. Almost all US medical schools have a Facebook presence, yet most do not have policies addressing student online social networking behavior. While social media use rises, policy informing appropriate conduct in medical schools lags behind. Established policies at some medical schools can provide a blueprint for others to adopt and adapt.

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Section: Discussion/conclusionmentioning

confidence: 99%

Social media policies at US medical schools

Kind

Genrich

Sodhi

et al. 2010

Medical Education Online

135

128

View full text Add to dashboard Cite

show abstract

“…Society expects that the medical profession will uphold the highest behavioral and ethical standards, which form the so-called ‘social contract’ [3]. Our task as medical educators should therefore be not only to provide the students with access to medical information, direction on how to use this medical knowledge, and the clinical skills necessary to become competent practitioners, but guidance on how to become medical professionals.…”

Section: Introductionmentioning

confidence: 99%

Formation of medical student professional identity: categorizing lapses of professionalism, and the learning environment

Hendelman

Byszewski

2014

BMC Med Educ

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BackgroundAcquiring the values of medical professionalism has become a critical issue in medical education. The purpose of this study was to identify lapses in professionalism witnessed by medical students during their four year MD curriculum, and to categorize, from the students’ perspective, who was responsible and the settings in which these occurred.MethodsAn electronic survey, developed by faculty and medical students, was sent to all students with two email reminders. It included quantitative responses and some open-ended opportunities for comments. All analyses were performed with SAS version 9.1.ResultsThe response rate was 45.6% (255 of 559 students) for all four years of the medical school curriculum. Thirty six percent of students had witnessed or been part of an exemplary demonstration of professionalism; 64% responded that they had witnessed a lapse of professionalism. At the pre-clerkship level, the most frequent lapses involved students: arrogance (42.2%), impairment (24.2%), followed by cultural or religious insensitivity (20.5%). At the clerkship level of training, where students are exposed to real clinical situations, the lapses involved primarily faculty (including preceptor and clinician) or other staff; these included arrogance (55.3%), breach of confidentiality (28.3%), and cultural or religious insensitivity (26.6%); impairment involved mostly students (25.5%). These findings are analyzed from the perspective of role modeling by faculty and in the context of the learning environment.ConclusionsMedical students witnessed a lapse of professionalism involving both fellow students as well as faculty and administrative staff, in several domains. Results from this study emphasize the importance of role modeling and the need for faculty development, to improve the learning environment. This study adds to the limited emerging literature on the forces that influence medical student professional identity formation.

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“…[2] Both documents stress that today’s professionals need to consider not only what is right and good for individual patients, but to care for all patients and thus for society as a whole. [1], [3], [4] For this purpose, professionals are called to commit to the redefined fundamentals and principles of professionalism, entailing commitments to professional competence, to honesty with patients and to improving the quality of care. The latter needs to reflect the progress that has been made in the discipline of quality improvement [3], including the engagement of physicians and nurses in systematic (organizational) quality improvement activities [5].…”

Section: Introductionmentioning

confidence: 99%

Measuring Professionalism in Medicine and Nursing: Results of a European Survey

et al. 2014

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BackgroundLeveraging professionalism has been put forward as a strategy to drive improvement of patient care. We investigate professionalism as a factor influencing the uptake of quality improvement activities by physicians and nurses working in European hospitals.ObjectiveTo (i) investigate the reliability and validity of data yielded by using the self-developed professionalism measurement tool for physicians and nurses, (ii) describe their levels of professionalism displayed, and (iii) quantify the extent to which professional attitudes would predict professional behaviors.Methods and MaterialsWe designed and deployed survey instruments amongst 5920 physicians and nurses working in European hospitals. This was conducted under the cross-sectional multilevel study “Deepening Our Understanding of Quality Improvement in Europe” (DUQuE). We used psychometric and generalized linear mixed modelling techniques to address the aforementioned objectives.ResultsIn all, 2067 (response rate 69.8%) physicians and 2805 nurses (94.8%) representing 74 hospitals in 7 European countries participated. The professionalism instrument revealed five subscales of professional attitude and one scale for professional behaviour with moderate to high internal consistency and reliability. Physicians and nurses display equally high professional attitude sum scores (11.8 and 11.9 respectively out of 16) but seem to have different perceptions towards separate professionalism aspects. Lastly, professionals displaying higher levels of professional attitudes were more involved in quality improvement actions (physicians: b = 0.019, P<0.0001; nurses: b = 0.016, P<0.0001) and more inclined to report colleagues’ underperformance (physicians – odds ratio (OR) 1.12, 95% CI 1.01–1.24; nurses – OR 1.11, 95% CI 1.01–1.23) or medical errors (physicians – OR 1.14, 95% CI 1.01–1.23; nurses – OR 1.43, 95% CI 1.22–1.67). Involvement in QI actions was found to increase the odds of reporting incompetence or medical errors.ConclusionA tool that reliably and validly measures European physicians’ and nurses’ commitment to professionalism is now available. Collectively leveraging professionalism as a quality improvement strategy may be beneficial to patient care quality.

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Expectations and Obligations: Professionalism and Medicine’s Social Contract with Society

Cited by 215 publications

References 102 publications

Social media policies at US medical schools

Social media policies at US medical schools

Formation of medical student professional identity: categorizing lapses of professionalism, and the learning environment

Measuring Professionalism in Medicine and Nursing: Results of a European Survey

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