Fostering the Development of Professionalism in Veterinary Students: Challenges and Implications for Veterinary Professionalism Curricula

The importance of professional skills teaching and assessment within veterinary education has recently been highlighted in the veterinary education literature. This academic discourse follows the acknowledgement by both veterinary employers and graduates themselves that new graduates often lack the professional skills and attitudes needed for success in clinical veterinary practice. Traditionally, veterinary curricula have focused solely on teaching content knowledge and clinical skills; however, veterinary education curricula clearly must also contain dedicated instruction in veterinary professionalism. This must include instruction in communication skills, emotional intelligence, cultural awareness, teamwork abilities, dispute resolution strategies and the awareness that multiple approaches may be required to resolve challenges. It has become unrealistic to expect students to rely on observation and role modelling to foster the development of professionalism. There is a need to incorporate explicit learning activities that reinforce the knowledge, attitudes, values, and behaviours that characterise veterinary professionalism. While role modelling remains a key aspect of the veterinary professionalism learning that takes place through the informal/hidden curriculum, many students have often had more experiences with negative role models than with positive ones. This can lead to the development of a tolerance or normalisation of negative behaviours and a decline in students’ perceptions of professionalism. This article aims to continue recent conversations on professional skills teaching within veterinary education, define what is meant by veterinary professionalism and consider the plethora of terminology used when trying to establish a definition, highlight those attributes of veterinary professionalism deemed important by veterinary stakeholders for career success and employability, and explore the challenges of incorporating the teaching and assessment of professional traits into veterinary education.

Twelve tips for integrating leadership development into undergraduate medical education

Healthcare systems need effective leadership. All healthcare professionals can and should "learn to lead" and this requires a clear focus on leadership development from the earliest stages of a career. Within medicine, undergraduate students should be provided with opportunities to thrive and develop their skills in terms of leadership, management and followership. Drawing from the existing evidence base, the authors' expertise and the latest "thought leadership", these 12 tips provide practical guidance to universities and associated provider organizations, and to academic and clinical faculty, on how to integrate leadership development into their undergraduate medical programs. These 12 tips will help educators provide medical education that incorporates leadership as a core part of a professional's identity, and help students gain a deeper understanding of themselves and the teams, organizations and system they work within.

Competencies necessary for becoming a leader in the field of community medicine: a Japanese qualitative interview study

OBJECTIVES

To clarify competencies for inclusion in our curriculum that focuses on developing leaders in community medicine.

DESIGN

Qualitative interview study.

SETTING

All six regions of Japan, including urban and rural areas.

PARTICIPANTS

Nineteen doctors (male: 18, female: 1) who play an important leadership role in their communities participated in semistructured interviews (mean age 48.3 years, range 34-59; mean years of clinical experience 23.1 years, range 9-31).

METHOD

Semistructured interviews were held and transcripts were independently analysed and coded by the first two authors. The third and fourth authors discussed and agreed or disagreed with the results to give a consensus agreement. Doctors were recruited by maximum variation sampling until thematic saturation was achieved.

RESULTS

Six themes emerged: (1)'Medical ability': includes psychological issues and difficult cases in addition to basic medical problems. High medical ability gives confidence to other medical professionals. (2)'Long term perspective': the ability to develop a long-term, comprehensive vision and to continuously work to achieve the vision. Cultivation of future generations of doctors is included. (3) 'Team building':the ability to drive forward programmes that include residents and local government workers, to elucidate a vision, to communicate and to accept other medical professionals. (4)'Ability to negotiate': the ability to negotiate with others to ensure that programmes and visions progress smoothly (5) 'Management ability': the ability to run a clinic, medical unit or medical association. (6) 'Enjoying oneself': doctors need to feel an attraction to community medicine, that it be fun and challenging for them.

CONCLUSIONS

We found six competencies that are needed by leaders in the field of community medicine. The results of this study will contribute to designing a curriculum that develops such leaders.

A fresh look at Miller's pyramid: assessment at the 'Is' and 'Do' levels

In its silver jubilee, we celebrate the ground-breaking pyramid of George Miller by submitting a fresh look at it. We discuss two questions. (i) Does the classical pyramidal structure perfectly portray the relationships of the four levels that were described by Miller? (ii) Can the model of Miller fulfill the unmet needs of assessors to measure evolving essential constructs and accommodate the increasingly sophisticated practice of assessment of health professionals? In response to the first question, Miller's pyramid is revisited in view of two assumptions for pyramidal structures, namely: hierarchy and tapering. Then we suggest different configurations for the same classical four levels and indicate when to use each one. With regard to the second question, we provide a rationale for amending the pyramid with two further dimensions to assess personal qualities of students at the 'Is' level and their performance in teams at the 'Do' (together) level. At the end of the article, we yearn to think outside the pyramid and suggest the Assessment Orbits framework to assess students as individuals and in teams. The five Assessment Orbits alert educators to assess the emerging cognitive and non-cognitive constructs, without implying features such as hierarchy or tapering that are ingrained in pyramidal structures. The 'Is' orbit attends to the personal qualities of graduates 'who' we may (or may not) trust to be our physicians. Assessment of teams at the 'Do' level (together) offers a paradigm shift in assessment from competitive ranking (storming) among students toward norming and performing as teams.

A systematic review of physician leadership and emotional intelligence

OBJECTIVE

This review evaluates the current understanding of emotional intelligence (EI) and physician leadership, exploring key themes and areas for future research.

LITERATURE SEARCH

We searched the literature using PubMed, Google Scholar, and Business Source Complete for articles published between 1990 and 2012. Search terms included physician and leadership, emotional intelligence, organizational behavior, and organizational development. All abstracts were reviewed. Full articles were evaluated if they addressed the connection between EI and physician leadership. Articles were included if they focused on physicians or physicians-in-training and discussed interventions or recommendations.

APPRAISAL AND SYNTHESIS

We assessed articles for conceptual rigor, study design, and measurement quality. A thematic analysis categorized the main themes and findings of the articles.

RESULTS

The search produced 3713 abstracts, of which 437 full articles were read and 144 were included in this review. Three themes were identified: (1) EI is broadly endorsed as a leadership development strategy across providers and settings; (2) models of EI and leadership development practices vary widely; and (3) EI is considered relevant throughout medical education and practice. Limitations of the literature were that most reports were expert opinion or observational and studies used several different tools for measuring EI.

CONCLUSIONS

EI is widely endorsed as a component of curricula for developing physician leaders. Research comparing practice models and measurement tools will critically advance understanding about how to develop and nurture EI to enhance leadership skills in physicians throughout their careers.