Faculty development for learning and teaching of medical professionalism

Concordance of judgement: A tool to foster the development of professionalism in dentistry

INTRODUCTION

Developing professionalism notably involves learning how to make professional judgements in ambiguous situations. The Concordance of Judgement Test (CJT) is a learning tool that was proposed to develop professionalism competencies, but it was never performed in dentistry or used with a synchronous methodology. The present study evaluated the feasibility of the use of CJT in the context of dental education, to foster professionalism and stimulate reflexivity and discussion.

MATERIALS AND METHODS

After different steps of optimization, a questionnaire presenting 12 vignettes was submitted to 33 Canadian students. Second, after an additional optimization, a questionnaire of 7 vignettes was submitted to 87 French students. An immediate educational feedback was proposed after each vignette to promote reflexivity and discussions during the experience.

RESULTS

The overall experience of the students was reported as good, thanks to the feedback of real-life situations. This promoted reflexivity and stimulated discussion between students and educators regarding professionalism issues. The students considered CJT as a relevant and well-adapted tool, and reported positive feelings regarding the inter-university aspect of the activity. The mean score of the panel members was close to 80/100 and the mean score of the students was 5 to 10 points lower, which is in agreement with docimological performance.

CONCLUSION

The results suggested that the use of CJT in a synchronous way was a feasible and relevant tool to motivate the students to improve their professionalism, and to stimulate their reflexivity and discussion. The students reported positive experience with CJT, and we believe that this tool can be integrated in the dental curriculum.

Professionalism-training in undergraduate medical education in a multi-cultural, multi-ethnic setting in the Gulf Region: an exploration of reflective essays

BACKGROUND

Despite the established need to prioritize professionalism-training in developing future physicians, very few medical programs in the Gulf Region embed in their curricula discrete contextualized courses aimed at developing the corresponding competencies, while fostering self-directed learning. This study aims at exploring the perception of undergraduate medical students in a multi-cultural, multi-ethnic setting regarding their understanding of, and personal experience with professionalism through their engagement with the content of an innovative curriculum-based professionalism course, offered at a Medical School in Dubai, United Arab Emirates.

METHODS

The study used a qualitative phenomenological research design. Out of 33 students, 29 students had submitted reflective essays. The content of these essays was inductively analyzed following a six-step framework for conducting thematic analysis. The framework's steps include familiarizing oneself with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report.

FINDINGS

The inductive qualitative analysis generated the Professionalism Learning Journey model. This conceptual model includes four interconnected themes: Awareness, Acknowledgement, Realization, and Application. The generated model depicts the trajectory that the learners appear to experience while they are engaging with the content of the course.

CONCLUSION

Integrating a professionalism-training course into an undergraduate medical curriculum is likely to be positively appraised by the learners. It raises their awareness, enables them to value the subject matter and the sophistication of its application, and empowers them to put into practice the taught principles, on an individual basis and collectively. This is especially true when the course is entrenched in constructivism experiential learning theory and designed to foster self-directed learning. The introduced conceptual model, in conjunction with the innovative professionalism-training course curriculum, can serve as a template for other competencies and other schools.

Physicians' professionalism from the patients' perspective: a qualitative study at a single-family practice in Saudi Arabia

INTRODUCTION

Professionalism is a crucial component of medical practice. It is a culturally sensitive notion that generally consists of behaviors, values, communication, and relationships. This study is a qualitative study exploring physician professionalism from the patients' perspective.

METHODS

Focus group discussions with patients attending a family medicine center attached to a tertiary care hospital were carried out using the four gates model of Arabian medical professionalism that is appropriate to Arab culture. Discussions with patients were recorded and transcribed. Data were thematically analyzed using NVivo software.

RESULTS

Three main themes emerged from the data. (1) In dealing with patients, participants expected respect but understood delays in seeing physicians due to their busy schedules. In communication, participants expected to be informed about their health conditions and to have their questions answered. (2) In dealing with tasks, participants expected proper examination and transparency of diagnosis, but some expected the physician to know everything and did not appreciate them seeking outside opinions. They expected to see the same physician at every visit. (3) In physician characteristics preferences, participants preferred friendly smiling physicians. Some cared about the outer appearance of the physician whereas others did not.

DISCUSSION/CONCLUSIONS

The findings of the study explained only two themes of the four gates model namely dealing with patients and dealing with tasks. Cultural competence and how to benefit from patients' perceptions to be an ideal physician should be incorporated into the process of physicians' training.

Effective components of teachers' professionalism in viewpoints of various stakeholders

BACKGROUND

The teacher must conduct educational responsibilities in the best way by observing the ethical principles to meet students' educational needs. The aim of the study was to investigate the main factors of professionalism among faculty members from the viewpoints of various stakeholders including learners, peers, and educational officials, as well as the components were assessed from the viewpoints of the stakeholders.

MATERIALS AND METHODS

This was a descriptive analytical study conducted in two phases. In the first phase, a questionnaire was developed and validated to assess the professional behavior of faculty members. In the second phase, the evaluation of the teachers' professional behavior was done from the viewpoint of various stakeholders, including learners, middle and senior education managers and peers. The participants were faculty members from 10 schools enrolled in the study by census (n = 427). To extract the factors that constitute professional behavior in faculty members, exploratory factor analysis was used. Data were summarized using descriptive indices (mean, standard deviation, and percent). Exploratory factor analysis (EFA) was used to extract the factors that constitute professional behavior in faculty members. Data was analyzed by using SPSS software (version 23.0).

RESULTS

In the first phase, the questionnaire with 11 items was developed. The validity and reliability of the tool was confirmed. The mean (SD) of the faculty members' scores was 4.54(±0.34), with a minimum score of 2.33 and a maximum score of 5.00. The highest scores of faculty members were reported in the items of "altruism to colleagues and students" and the lowest scores were related to "feedback seeking and feedback acceptance". Professional behavior was categorized under two domains: accountability to professional duties and adherence to professional values. Fifty percent of the participants followed the adherence to professional values (P = 0.22), but less than 50% of the individuals followed the adherence to professional duties significantly (P = 0.002).

CONCLUSION

The results of the present study showed that adherence to professional duties was low in faculty members. Assessment of individuals' adherence in these two domains showed that faculty members' compliance in the domain of accountability to professional duties was significantly lower.

Does professionalism change with different sociodemographic variables? A survey of Arab medical residents

BACKGROUND

Medical professionalism reflects the commitment of physicians to their patients, society, themselves, and the profession. The study examined residents' attitudes towards professionalism and how these attitudes vary among the different demographic groups, namely gender, specialty, and year of residency.

METHODS

A proportionate random sampling strategy was used to select the study sample. Medical residents from six specialties at a large tertiary care teaching facility were invited to participate in an online survey. The survey used the modified Learners Attitude of Medical Professionalism Scale (LAMPS), which consists of five domains: respect, excellence, altruism, duty/accountability, and integrity. Chi-square, Student t-test, one-way ANOVA, factorial ANOVA, and post hoc analysis were used to examine the attitudinal differences towards professionalism among the different demographic factors.

RESULTS

The overall response rate was 82.7%. Overall, the residents' self-reported attitudes towards professionalism was positive. The highest score was for the "respect" domain (4.61), and the lowest was for "altruism" (3.67). No significant association was found between the mean scores and the three studied variables, namely, gender, specialty (surgical/nonsurgical), and level (senior/junior).

CONCLUSIONS

No significant differences were observed in the overall attitude towards professionalism among the residents regarding their year of residency, gender, and specialty. The low altruism score and absence of improvement of the total score regarding the residents' increasing experience in the profession are concerns that need remedial action. Therefore, we suggest that future research look for possible explanations by using multi-institutional surveys that explore not only the residents' attitudes, but also the trainers' attitudes and practice, work situations, the hidden curriculum, and culture. Key messagesAttitudes towards professionalism among different demographic groups of residents do not show similar variations as has been reported in the literature, albeit in different sociocultural contexts.The low altruism score and absence of improvement of the total score as the residents gained more experience in the profession are concerns that need remedial action.A longitudinal study involving more than one institution for both residents and their faculty members to compare faculty scores with those of residents, while controlling for specialty and gender, may help elucidate the factors affecting attitudes towards professionalism and suggest possible means of addressing unfavourable attitudes.

Trigger films to teach core competencies of ethics and professionalism to first-year medical and nursing students

Professionalism and communication were formally introduced in India's Competency-Based Curriculum (CBC) as part of the five roles of an Indian medical graduate and 10 core competencies in the Bachelor of Science Nursing program. It may be challenging to teach the complexity of clinical medical ethics to undergraduate students at a young age in the absence of direct patient interaction. Trigger films (TFs) are brief (3-10 min) clips that have been used in the West to provoke debate, promote reflection, and assist trainees in dealing with ethical dilemmas. The aim of this study was to determine whether TFs can be used to teach professionalism and ethics to undergraduate medical and nursing students as an innovative and interesting tool and to see whether this results in any changes in knowledge. A 2-h module supported by an introductory PowerPoint presentation and using four TFs on the four pillars of ethics (beneficence, nonmaleficence, autonomy, and justice) was developed and piloted in the foundation course for the new cohort of medical and nursing students. Quantitative, open-ended feedback was taken from learners after module delivery, and knowledge was assessed with a retrospective pre-post questionnaire. The majority of students found TFs an innovative and interesting tool to teach medical ethics. There was a gain in knowledge of autonomy (52%), beneficence (48%), nonmaleficence (46%), and justice (38%). TFs can be effective tools to impart core competencies in ethics and professionalism to both nursing and medical students in the new CBC.NEW & NOTEWORTHY Teaching ethics is an important part of the medical curriculum, and since first-year students are not in direct contact with patients it is necessary to think of innovative methods that can be used to teach. We have done the pilot testing for the same, using trigger films among undergraduate medical and nursing students.

Preclinical and Clinical Medical Students' Perception of the Learning Environment: A Reference to the Forensic Medicine and Clinical Toxicology Course

PURPOSE

Understanding learning environments is vital for developing curricula. This study aims to evaluate medical students' achievements and perception of learning environments considering the Forensic Medicine and Clinical Toxicology course as an analog for the curricular transition process.

METHODS

A cross-sectional study was conducted among undergraduate medical students at the Faculty of Medicine, Tanta University, from August 2020 to October 2021. Using the Dundee Ready Education Environment Measure (DREEM) questionnaire, the perception of 621 students (of which 307 were enrolled in the integrated curriculum and 314 in the traditional curriculum) were compared. Furthermore, the appropriate tests of significance and correlations were used to compare students' perception according to their enrollment, age, gender, and previous year grade point average.

RESULTS

The mean overall DREEM score was 121.04 ± 22.35, implying a more positive than negative learning environment, that is, a more positive learning perception, with students' perceptions of teachers moving in the right direction, students' academic self-perceptions getting more on the positive side, more positive attitudes regarding student's perceptions of the learning environment, and not-too-bad student's social self-perception. Medical students enrolled in the integrated curriculum showed higher DREEM scores, with significantly better learning and academic self-perceptions (p < 0.05). Knowledgeable, qualified faculties are the most significant characteristic feature in both systems. A significant number of students achieved excellent grades in the integrated curriculum (n = 740 out of 1076, 68.8%) than in the traditional one (n = 470 out of 961, 48.9%) (p < 0.0001).

CONCLUSION

This study revealed a smooth, successful transition from the traditional to integrated curriculum among Egyptian medical students. The main areas for improvements are focusing on factual teaching, implementing student-centered teaching activities, promoting students' memorizing, and engaging students in activities that may help them enjoy learning.

Redefining the concept of professionalism in nursing: an integrative review

Objective

In today's world with sweeping changes, nurses are responsible for providing high-quality and cost-benefit care, which would almost be impossible unless they achieve their high professional status. To date, no precise and comprehensive definition of professionalism in nursing has been evidently proposed. In fact, many of the previously proposed definitions are either complicated or ambiguous. Moreover, there is no consensus in the literature on an exhaustive definition for “a professional nurse.” The present study aimed to illustrate the concept of professionalism in nursing and identify its defining characteristics.

Methods

In this study, concept analysis was conducted using Whittemore et al.'s method for the integrated review. A comprehensive search of electronic, scientific databases including Eric, PubMed, Scopus, Web of Science, EBSCO, PsychoINFO, Embass, MagIran, IranDoc, SID, and IRANMEDEX was carried out using the keywords such as professionalism, professional behavior, nursing professionalism (NP), professional attribute, and nursing.

Results

In the present study, a comprehensive search of 11 electronic databases retrieved 5738 articles. Then, 2837 duplicate articles were removed by endnote (version 8). Based on a preliminary examination of the titles and abstracts as well as the inclusion and exclusion criteria, 1517 articles were excluded. In addition, 137 articles were removed for scientific reasons. Finally, 52 articles in English and Persian were selected. Content analysis of the articles revealed four major themes, namely, individual prerequisite, professional prerequisite, appropriate structure, and socio-individual factors.

Conclusions

Professionalism in nursing is a major, multidimensional concept according to the literature that included individual prerequisites, professional prerequisites, appropriate structures, and socio-individual factors. In fact, professionalism in nursing comprises a wide range of personal characteristics, self-regulation, professional values, striving to acquire and enhance professional expertise, professional interactions, social, professional, and legal responsibility, and creation of a sense of belonging, and professional development.

Supporting the Professional Identity Development of Nursing Alumni: A Phenomenology Study

BACKGROUND: Professional identity is the expected outcome of nursing educational institutions reflected in the values, beliefs, attitudes, and behavior of nursing alumni as professional nurses. Nursing alumni’s experiences at the Bachelor nursing program in Universitas Muhammadiyah Yogyakarta (UMY) related to professional identity development (PID) at various nursing careers need to be explored. AIM: This study aims to describe Ners alumni in PID at Universitas Muhammadiyah Yogyakarta (UMY). METHODS: This study was a phenomenological approach with a maximum variation sampling technique. Seventeen nursing alumni who have been working as professional nurses for a minimum of two years and worked in various nursing careers were recruited. A semi-structured interview between 60-90 minutes was conducted. Data analysis used Colaizzi’s methods and Nvivo 12TM Plus. RESULTS: There were two themes emerged from data; 1) Internal motivation to enhancing nursing career, with two sub-themes: having a great personal motivation and developing expertise, 2) External support driving nursing career, with five sub-themes: family encouragement, supports from a leader, accreditation and credential, exemplary role model and positive nursing image. CONCLUSION: Nursing alumni engaged in a variety of professional roles that contributed to the nursing workforce. The supporting of PID impacts personal and professional capability and strengthens nurses’ careers.

Teaching professionalism in medical residency programs: a scoping review protocol

BACKGROUND

Professionalism is a core competency of medical residents in residency programs. Unprofessional behavior has a negative influence on patient safety, quality of care, and interpersonal relationships. The objective of this scoping review is to map the range of teaching methods of professionalism in medical residency programs (in all specialties and in any setting, whether in secondary, primary, or community care settings). For doing so, all articles which are written in English in any country, regardless of their research design and regardless of the residents' gender, year of study, and ethnic group will be reviewed.

METHODS

This proposed scoping review will be directed in agreement with the methodology of the Joanna Briggs Institute for scoping reviews. The six steps of Arksey and O'Malley methodological framework for conducting scoping reviews, updated by Levac et al. (Implement. Sci. 5(1): 69, 2010) will be followed. The findings from this study will be merged with those of the previous Best Evidence Medical Education (BEME) systematic review. All published and unpublished studies from 1980 until the end of 2019 will be reviewed, and the previous BEME review will be updated by the findings of the articles from the beginning of 2010 until the end of 2019. All research designs and all credible evidence will be included in this review.

CONCLUSIONS

Conducting this scoping review will map the teaching methods of professionalism and will provide an inclusive evidence base to help the medical teachers in the choosing for proper teaching methods for use in their teaching practice.

SYSTEMATIC REVIEW REGISTRATION

Not registered.

Effectiveness and Needs Assessment of Faculty Development Programme for Medical Education: Experience from Saudi Arabia

Objectives

Faculty members are the most important resource in any institution of higher education as medical education has been, and continues to be, a priority for medical colleges in Saudi Arabia. This study aimed to assess faculty members' perceptions of faculty development programmes (FDPs) in supporting important goals in medical education. In addition, this study aimed to assess faculty members' perceived needs.

Methods

This cross-sectional study was conducted between August 2016 and August 2017 and involved participants from six universities in Saudi Arabia's Western Province. The survey consisted of 31 items designed to assess FDP effectiveness and 49 items designed to assess needs in FDPs.

Results

A total of 210 faculty members participated in the study (response rate = 52.5%) and identified 49 needs. Faculty members perceived personal improvement in delivering medical education and the provision of greater educational involvement as the most effective considerations in an FDP. The respondents considered 13 needs to be of utmost importance; the remaining were considered important.

Conclusion

This study assessed and identified faculty needs and important skills to consider when establishing an FDP. Furthermore, it provided information addressing the needs of, or gaps between, current and desired conditions in medical education in Saudi Arabia. The study also identified the most important elements (i.e. personal improvement) of faculty-perceived effectiveness for a successful FDP in medical education.

How Culture Is Understood in Faculty Development in the Health Professions: A Scoping Review

PURPOSE

To examine the ways in which culture is conceptualized in faculty development (FD) in the health professions.

METHOD

The authors searched PubMed, Web of Science, ERIC, and CINAHL, as well as the reference lists of identified publications, for articles on culture and FD published between 2006 and 2018. Based on inclusion criteria developed iteratively, they screened all articles. A total of 955 articles were identified, 100 were included in the full-text screen, and 70 met the inclusion criteria. Descriptive and thematic analyses of data extracted from the included articles were conducted.

RESULTS

The articles emanated from 20 countries; primarily focused on teaching and learning, cultural competence, and career development; and frequently included multidisciplinary groups of health professionals. Only 1 article evaluated the cultural relevance of an FD program. The thematic analysis yielded 3 main themes: culture was frequently mentioned but not explicated; culture centered on issues of diversity, aiming to promote institutional change; and cultural consideration was not routinely described in international FD.

CONCLUSIONS

Culture was frequently mentioned but rarely defined in the FD literature. In programs focused on cultural competence and career development, addressing culture was understood as a way of accounting for racial and socioeconomic disparities. In international FD programs, accommodations for cultural differences were infrequently described, despite authors acknowledging the importance of national norms, values, beliefs, and practices. In a time of increasing international collaboration, an awareness of, and sensitivity to, cultural contexts is needed.

Impact of faculty development programme on self-efficacy, competency and attitude towards medical education in Bhutan: a mixed-methods study

BACKGROUND

Soon after Bhutan's first medical university was established in 2012, Faculty Development Programmes (FDPs) were adopted for efficient delivery of postgraduate medical curriculum. Medical education was an additional responsibility for the clinicians who already had multi-dimensional roles in the healthcare system where there is acute shortage of healthcare professionals. We studied the impact of FDPs on postgraduate medical education in Bhutan.

METHODS

This was a mixed-methods study with a quantitative (cohort study - quasi-experimental with 18 participants) and concurrent explanatory qualitative component (focused group discussion (FGD) with 11 teaching faculty members). The 18 participants were given a structured FDP designed by the University. The FGD assessed teacher self-efficacy and competency using standard tools before and after the FDP. Thematic analysis of the FGD explored the impact of FDPs in the delivery of postgraduate residency programmes.

RESULTS

There were significant increase in the teacher self-efficacy (31 vs 34, p = 0.009) and competency scores (56 vs 64, p = 0.011). There were significant improvements in self-efficacy in the domain of the teaching relevant subject contents and developing creative ways to cope with system constraints. In teaching-learning assessments, there was a significant appreciation of the effectiveness of lectures and tutorials and the use of essay questions. The FGD demonstrated the acceptance of FDPs and its importance in quality improvement of postgraduate medical education, professional development of teachers and improvement of their communication skills. The teachers have now migrated from the conventional methods of teaching to workplace-based teaching and assessment. The FDPs also resulted in review and revision of postgraduate medical curriculum soon after the first batch graduated in 2018. Lack of adequate support from relevant stakeholders and lack of a medical education centre in the University were seen as major challenges.

CONCLUSIONS

The FDPs have brought tangible professionalization of postgraduate medical education at an early stage of the medical university. There is a need for continued efforts to strengthen, sustain and consolidate the gains made thus far.

The International Literature on Teaching Faculty Development in English-Language Journals: A Scoping Review and Recommendations for Core Topics

BACKGROUND

With increasing physician mobility, there is interest in how medical schools and postgraduate medical education institutions across the world develop and maintain the competence of medical teachers. Published reviews of faculty development (FD) have predominantly included studies from the United States and Canada.

OBJECTIVE

We synthesized the international FD literature (beyond the US and Canada), focusing on FD type, intended audience, study format, effectiveness, differences among countries, and potential unique features.

METHODS

We identified English-language publications that addressed FD for medical faculty for teaching and related activities, excluding US and Canadian publications.

RESULTS

A search of 4 databases identified 149 publications, including 83 intervention studies. There was significant growth in international FD publications for the most recent decade, and a sizable number of studies were from developing economies and/or resulted from international collaborations. Focal areas echo those in earlier published reviews, suggesting the international FD literature addresses similar faculty needs and organizational concerns.

CONCLUSIONS

The growth in publications in recent years and a higher proportion of reporting on participant reactions, coupled with less frequent reporting of results, transfer to practice, and impact on learners and the organization, suggest this is an evolving field. To enhance international FD, educators and researchers should focus on addressing common needs expressed by faculty, including curriculum design and evaluation, small group teaching, assessing professionalism and providing feedback. Future research should focus on approaches for developing comprehensive institutional FD programs that include communities of learning and practice and evaluating their impact.

Toward a Global Definition of Professionalism for Nutrition and Dietetics Education: A Systematic Review of the Literature

BACKGROUND

Professionalism of health care practitioners is central to safe and ethical health care, and forms part of the trust that the public places in health care practitioners. Lapses in professionalism in health care present considerable challenges and can have serious consequences and outcomes. Teaching, learning, and assessing professionalism is an important component of nutrition and dietetics education. There is scant peer-reviewed published research related to professionalism in nutrition and dietetics. Providing a definition of professionalism will support progress in curriculum planning and design, teaching, learning and assessment of students, and ongoing professional development of educators and practitioners.

OBJECTIVE

The aim of this study was to conceptualize and define professionalism for the purpose of teaching nutrition and dietetics.

DESIGN

This study included a critical systematic literature review of original research and a targeted and systematic search of national and international dietetics competency standards, exploring the concept and definitions of professionalism in nutrition and dietetics. Competency standards were chosen as an additional focus in the systematic literature search, as they are the key framework documents that guide curriculum development and education standards internationally. Thematic analysis was used to synthesize extracted data and an inductive, interpretivist approach was then applied in conceptualizing a definition of professionalism.

RESULTS

Seven studies and six national and international sets of competency standards were included in the literature review. Four major themes conceptualizing a definition of professionalism for nutrition and dietetics were identified from the integration of the original research and targeted gray literature reviews: 1) personal attributes; 2) interpersonal communication; 3) approach to practice; and 4) commitment to lifelong learning.

CONCLUSIONS

Defining professionalism for nutrition and dietetics supports progress toward shared understandings, building trust, and assisting in dietetics education and practice. It can be used to support and extend teaching, learning, and assessment of professionalism.

Teaching professionalism: some features in Canadian physiotherapy programs

The role of "professionalism" is core to many health professions including Physical Therapy (PT), and the development of competence in professionalism is a key requirement of entry-to-practice PT programs. However, the actual curriculum, teaching methodologies, and evaluation methods currently used to develop professional competence during PT training programs in Canada are unclear. This study explored current teaching practices, evaluation and curricular content related to professionalism in Canadian entry-to-practice PT programs. Results showed that teaching practices related to professionalism were not necessarily congruent with methods promulgated by educational theory and relied heavily on lecture, while more appropriate strategies such as simulation and role play were under-utilized. The numbers of different teaching methods utilized for specific aspects of professionalism were variable. Emphasis on different curricular areas related to professionalism also varied: communication was given the most emphasis while change management was under-represented. It is posited that teaching methods related to professionalism could be improved and curricular content and emphasis should also be reconsidered.

The use of virtual patient scenarios as a vehicle for teaching professionalism

OBJECTIVES

This study aimed to measure students' perceptions of virtual patient scenarios (VPs) for developing ethical reasoning skills and to explore features in VP design that are necessary to promote professionalism.

METHODS

Sixty-five dental students participated in learning sessions that involved collaborative practice with five VPs (four high fidelity and one low fidelity), followed by reflection sessions. Students' perceptions towards the use of VPs in developing ethical reasoning skills were assessed using a questionnaire that involved 10 closed and three open-ended questions.

RESULTS

High-fidelity VPs were perceived as significantly better for developing ethical reasoning skills than low-fidelity VPs. Analyses of answers to open-ended questions revealed two new features that are specific for VPs intended for teaching professionalism, which are VP dramatic structure and how it should end.

CONCLUSION

VPs intended for teaching professionalism need to have high fidelity, follow a specific dramatic structure and should include multiple plausible endings. The use of VPs as part of a collaborative activity that is followed by a reflection session is perceived as an effective tool for the development of ethical reasoning skills in dental education.

Implementation of Competency-Based Pharmacy Education (CBPE)

Implementation of competency-based pharmacy education (CBPE) is a time-consuming, complicated process, which requires agreement on the tasks of a pharmacist, commitment, institutional stability, and a goal-directed developmental perspective of all stakeholders involved. In this article the main steps in the development of a fully-developed competency-based pharmacy curriculum (bachelor, master) are described and tips are given for a successful implementation. After the choice for entering into CBPE is made and a competency framework is adopted (step 1), intended learning outcomes are defined (step 2), followed by analyzing the required developmental trajectory (step 3) and the selection of appropriate assessment methods (step 4). Designing the teaching-learning environment involves the selection of learning activities, student experiences, and instructional methods (step 5). Finally, an iterative process of evaluation and adjustment of individual courses, and the curriculum as a whole, is entered (step 6). Successful implementation of CBPE requires a system of effective quality management and continuous professional development as a teacher. In this article suggestions for the organization of CBPE and references to more detailed literature are given, hoping to facilitate the implementation of CBPE.

Becoming a Doctor in Different Cultures: Toward a Cross-Cultural Approach to Supporting Professional Identity Formation in Medicine

Becoming a doctor is fundamentally about developing a new, professional identity as a physician, which in and of itself may evoke many emotions. Additionally, medical trainees are increasingly moving from one cultural context to another and are challenged with navigating the resulting shifts in their professional identify. In this Article, the authors aim to address medical professional identity formation from a polyvocal, multidisciplinary, cross-cultural perspective. They delineate the cultural approaches to medical professionalism, reflect on professional identity formation in different cultures and on different theories of identity development, and advocate for a context-specific approach to professional identity formation. In doing so, the authors aim to broaden the developing professional identity formation discourse to include non-Western approaches and notions.

Progress integrating medical humanities into medical education: a global overview

PURPOSE OF REVIEW

The article reviews the most recent developments in integrating humanities into medical education. Global implications and future trends are illustrated.

RECENT FINDINGS

The main concern of medical humanities education is teaching professionalism; one important aspect that has emerged is the goal of nurturing emotion through reflexivity. Relating effectively to all stakeholders and being sensitive to inequitable power dynamics are essential for professional social accountability in modern medical contexts. Mediating doctors' understanding of the clinical encounter through creative arts and narrative is part of most recent pedagogic innovations aimed at motivating learners to become empowered, engaged and caring clinicians. Scenario-based and discursive-oriented evaluations of such activities should be aligned with the medical humanities' problem-based learning curriculum. Medical humanities education fosters professional reflexivity that is important for achieving patient-centered care.

SUMMARY

Countering insufficient empathy with reflective professionalism is an urgent challenge in medical education; to answer this need, creative arts and narrative understanding have emerged as crucial tools of medical humanities education. To ensure competent professional identity formation in the era of translational medicine, medical humanities programs have adopted scenario-based assessments through inclusion of different voices and emphasizing personal reflection and social critique.

Awareness of ethical issues in medical education: an interactive teach-the-teacher course

PURPOSE

We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course.

METHOD

Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism.

RESULTS

We found a significant self-perceived increase in the participants' ability to identify and describe ethical issues and students' dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students' perspectives and teachers' and students' behaviors. In addition, participants' feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender.

CONCLUSION

Ethics of education is an important issue for medical teachers. Teachers' self-perceived competence can be increased by working on case vignettes in small groups.

Twelve Tips for teaching medical professionalism at all levels of medical education

Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author's experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.