Where we're headed: a new wave of scholarship on educating medical professionalism

Characteristics and patients’ portrayals of Norwegian social media memes. A mixed methods analysis

Background

Despite reports on troublesome contents created and shared online by healthcare professionals, a systematic inquiry of this potential problem has been missing. Our objective was to characterize the content of healthcare-associated social media memes in terms of common themes and how patients were portrayed.

Materials and methods

This study applied a mixed methods approach to characterize the contents of Instagram memes from popular medicine- or nursing-associated accounts in Norway. In total, 2,269 posts from 18 Instagram accounts were included and coded for thematic contents. In addition, we conducted a comprehensive thematic analysis of 30 selected posts directly related to patients.

Results

A fifth of all posts (21%) were related to patients, including 139 posts (6%) related to vulnerable patients. Work was, however, the most common theme overall (59%). Nursing-associated accounts posted more patient-related contents than medicine-associated accounts (p < 0.01), but the difference may be partly explained by the former focusing on work life rather than student life. Patient-related posts often thematized (1) trust and breach of trust, (2) difficulties and discomfort at work, and (3) comical aspects of everyday life as a healthcare professional.

Discussion

We found that a considerable number of Instagram posts from healthcare-associated accounts included patients and that these posts were diverse in terms of contents and offensiveness. Awareness that professional values also apply online is important for both healthcare students and healthcare providers. Social media memes can act as an educational resource to facilitate discussions about (e-)professionalism, the challenges and coping of everyday life, and ethical conflicts arising in healthcare settings.

Supporting the development of a professional identity: General principles

While teaching medical professionalism has been an important aspect of medical education over the past two decades, the recent emergence of professional identity formation as an important concept has led to a reexamination of how best to ensure that medical graduates come to "think, act, and feel like a physician." If the recommendation that professional identity formation as an educational objective becomes a reality, curricular change to support this objective is required and the principles that guided programs designed to teach professionalism must be reexamined. It is proposed that the social learning theory communities of practice serve as the theoretical basis of the curricular revision as the theory is strongly linked to identity formation. Curricular changes that support professional identity formation include: the necessity to establish identity formation as an educational objective, include a cognitive base on the subject in the formal curriculum, to engage students in the development of their own identities, provide a welcoming community that facilitates their entry, and offer faculty development to ensure that all understand the educational objective and the means chosen to achieve it. Finally, there is a need to assist students as they chart progress towards becoming a professional.

Similarities and variances in perception of professionalism among Saudi and Egyptian Medical Students

Background & Objective:

Professionalism has a number of culturally specific elements, therefore, it is imperative to identify areas of congruence and variations in the behaviors in which professionalism is understood in different countries. This study aimed to explore and compare the recommendation of sanctions by medical students of College of Medicine, King Saud University (KSU), Riyadh, Saudi Arabia and students from three medical colleges in Egypt.

Methods:

The responses were recorded using an anonymous, self-administered survey “ Dundee Polyprofessionalism Inventory I: Academic Integrity”. In the study 750 medical students of College of Medicine, KSU, Riyadh were invited and a questionnaire was electronically sent. They rated the importance of professionalism lapses by choosing from a hierarchical menu of sanctions for first time lapses with no justifying circumstances. These responses were compared with published data from 219 students from three medical schools in Egypt.

Results:

We found variance for 23 (76.66%) behaviors such as “physically assaulting a university employee or student” and “plagiarizing work from a fellow student or publications/internet”. We also found similarities for 7 (23.33%) behaviors including “lack of punctuality for classes” and drinking alcohol over lunch and interviewing a patient in the afternoon”, when comparing the median recommended sanctions from medical students in Saudi Arabia and Egypt.

Conclusion:

There are more variances than congruence regarding perceptions of professionalism between the two cohorts. The students at KSU were also found to recommend the sanction of “ignore” for a behavior, a response, which otherwise was absent from Egyptian cohort.

Professional attitudes and behaviors acquired during undergraduate education in the College of Dentistry, King Saud University

OBJECTIVES

The purpose of the study was to investigate and evaluate the professional attitudes and behaviors acquired by students and recently graduated dentists during undergraduate education at King Saud University.

METHODS

This cross-sectional survey used a 27-item questionnaire covering four cumulative theoretical dimensions of professionalism. Questionnaires were distributed to fifth-year students, interns, and demonstrators in the College of Dentistry during the academic year 2010-2011, and 203 completed questionnaires were used in analyses. Descriptive statistics were used to summarize responses. Crosstab and chi-squared tests were used, with statistical significance set at P < 0.05.

RESULTS

The response rate was 79.3% (43.6% of males, 94% of females). Eighty-seven questionnaires were collected from fifth-year students, 92 from interns, and 24 from demonstrators. Many (59%) participants demonstrated high levels of professional attitudes and behaviors, whereas 40% did not comply with the elements of professionalism. Analyses revealed highly significant differences in certain responses with regard to gender, academic level, and grade point average.

CONCLUSIONS

Although some participants did not possess all professional qualities, all participants possessed at least some elements of professionalism measured in this study. We thus recommend a strategic effort to develop targeted plans emphasizing professionalism at all levels of the dental school curriculum. High-profile role modeling, lectures, seminars, and academic ceremonies are ways of achieving professional development among dental students in parallel with their acquisition of basic scientific knowledge and clinical skills. This approach will formally and informally communicate that professionalism is a core value.

Saving and Ignoring Lives: Physicians’ Obligations to Address Root Social Influences on Health—Moral Justifications and Educational Implications

The predominant influences on health are social or upstream factors. Poverty, inadequate education, insecure and toxic environments, and inferior opportunities for jobs and positions are inequitable disadvantages that adversely affect health across the globe. Many causal pathways are yet to be understood. However, elimination of these social inequalities is a moral imperative of the first order. Some physicians by word and deed argue that medical doctors should oppose the “structural violence” of social inequalities that greatly shorten lives and wreak so much suffering.