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Doukas DJ. Promoting professionalism through humanities-based transformation. Ann Med 2024; 56:2386039. [PMID: 39101221 DOI: 10.1080/07853890.2024.2386039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/22/2024] [Accepted: 06/05/2024] [Indexed: 08/06/2024] Open
Abstract
INTRODUCTION In the last two decades, academic medical centers in the United States have faced a new challenge, dealing with breaches of medical professionalism in their staff, house staff, and medical students. Medical education settings have largely directed their professionalism efforts toward responding reactively to negative outliers. DISCUSSION This paper contends that the warrant of medical education mandates a transformative path forward. While negative behavior must be responded to meaningfully, so, too, must positive role models of professional behavior be publicly lauded for their consequential culture change in their institutions, and promoted as positive role models. Further, the promotion of medical professionalism must be part of this culture by proactively engaging all learners and health care providers with medical ethics and humanities-based knowledge, critical thinking skills, and role modeling. CONCLUSION Professionalism programs should be vested with the authority to implement an affirmative educational program intended to nurture and promote medical professionalism in each medical student, resident, fellow, and attending and utilize methods to that end employing both virtue and care ethics.
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Affiliation(s)
- David J Doukas
- Program in Medical Ethics and Human Values, Tulane University School of Medicine, and IntegratedEthics Program Officer, Southeast LA Veterans Health Care System, New Orleans, LA, USA
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Keshmiri F, Raadabadi M. Perception and engagement in unprofessional behaviors of medical students and residents: a mixed-method study. BMC PRIMARY CARE 2023; 24:191. [PMID: 37723441 PMCID: PMC10506320 DOI: 10.1186/s12875-023-02153-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/06/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND The present study aimed to investigate perception and engagement in unprofessional behavior of residents and medical interns and explore the factors affecting their engagement in unprofessional behavior. METHOD This study has an explanatory (quantitative-qualitative) mixed-method design. This study was conducted at Shahid Sadoughi University of Medical Sciences in 2022-2023. Participants, including residents and medical interns (n = 169), were entered by stratified random sampling. A survey was conducted in the quantitative step. A by an unprofessional behavior in clinical practice questionnaire (29 items) was used. For each behavior, the participants were asked to report whether they (a) participated in the behavior and (b) stated that the behavior Is unprofessional. In the qualitative step, 17 participants contributed. The qualitative data were collected by semi-structured interviews and analyzed according to the conventional content analysis approach Graneheim and Lundman introduced. RESULTS The highest ratio of participants' engagement in unprofessional behavior was reported in 'failure to introduce yourself and nurses and physician assistants to the patient and his family' (n = 145 (85.8%)). The results showed the proportion of participants who engaged in unprofessional behavior more than those who did not participate. There were associations between participants' engagement in each behavior and their perception of that particular behavior as unprofessional. (p = 0.0001). In the following behaviors, although the participants acknowledged that these behaviors were unprofessional, those who participated in the unprofessional behaviors were significantly more than those who did not participate: failure to comply with clinic regulations and policy (p = 0.01), eating or drinking in the hallway of the clinic (p = 0.01), medical negligence in duties in the clinic setting (p = 0.04) and failure to perform duties in teamwork (p = 0.04). The qualitative results were explored in a theme entitled "internalized unprofessional culture," including three categories "encouraging contextual risk factors towards unprofessionalism," "suppressing of unprofessionalism reporting," and "disbelieving professionalism as a key responsibility." CONCLUSION The results indicated that most participants engaged in unprofessional behaviors. The findings resulted from the internalized unprofessional culture in the workplace. The findings showed that engagement in unprofessional behaviors resulted from personal and systemic factors. The weakness of responsibility recognition and identity formation as a professional facilitated the engagement in unprofessional behaviors at the personal level. Furthermore, systemic factors including the contextual risk factors (such as deficiency of explicit and hidden curriculum), and the suppression of unprofessionalism reporting mechanism as a hidden factor played an important role in normalizing unprofessional behavior and promoting engagement in unprofessional behaviors among the participants. Recognition of the nature and extent of students' unprofessional behaviors facilitates educational discussion among teachers and students in this field. The results might assist to establish an assessment system and feedback mechanism to solve the problem of the "failure to fail" problem. In addition, these results provide medical educators insights into the development of professional courses that equip learners with adherence to professionalism and coping skills to deal with unprofessionalism in the healthcare system.
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Affiliation(s)
- Fatemeh Keshmiri
- Medical Education Department, Educational Developmental Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- National Agency for Strategic Research in Medical Education, Tehran, Iran.
| | - Mehdi Raadabadi
- National Agency for Strategic Research in Medical Education, Tehran, Iran
- Health Policy and Management Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Javed K, Arooj M, Ashraf R, Kaukab N, Khan RA. 12 tips for introducing e-portfolios in undergraduate medical and dental curriculums. MEDEDPUBLISH 2023. [DOI: 10.12688/mep.19542.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
It is impossible to overlook the curricular advancements occurring all across the world. The evaluation methods should be revised in addition to the course objectives, programmes, and competences. If courses are evaluated the same way they have been in the past, we will not progress in education. We are on the verge of an educational revolution that will fundamentally alter how we educate and assess students. E-portfolios have now become recognized and valued by everyone in medical education and the workplace, including policymakers. For programmatic assessments, E-portfolios are the best supporting document one can use as a qualitative assessment. It can be used in many ways including career planning, assessment, and for structured feedback. E-Portfolio provides a secured database and then there are numerous ways to use this knowledge. It allows a learner to gather and exhibit proof of their accomplishments and proficiency in order to support the modern techniques of academic assessment. In this article, we suggest 12 tips for putting a portfolio programme for undergraduate students into practice. The suggestions are based on an extensive evaluation of the literature, and the authors' personal experiences helped lay the groundwork for the recommendations.
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Cunha SDM, Catrib AMF, Brilhante AVM, Brasil CCP, Feitosa ES, Ferreira MAD. The doctor I want to be: professional self-image in Brazil and Portugal. INTERFACE - COMUNICAÇÃO, SAÚDE, EDUCAÇÃO 2023. [DOI: 10.1590/interface.220489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This qualitative study evaluated the perception of academics about their self-image as future doctors and the factors that influenced the construction of their professional identity. Thirty-two sixth-year medical students in Brazil and Portugal were interviewed. Content analysis in the thematic modality and Goffman’s dramaturgy were used for data analysis and interpretation. The idealized self-image was revealed in two themes: the doctor centered on himself and the one who values the interpersonal relationship. A third theme showed the influence of the University and of elements brought a priori in the doctor’s identity. The results indicate the influence of the hidden curriculum in the construction of professional identity and reinforce the importance of social and humanistic aspects in medical education.
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Cunha SDM, Catrib AMF, Brilhante AVM, Brasil CCP, Feitosa ES, Ferreira MAD. O médico que eu quero ser: autoimagem profissional no Brasil e em Portugal. INTERFACE - COMUNICAÇÃO, SAÚDE, EDUCAÇÃO 2023. [DOI: 10.1590/interface.220374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Este estudo qualitativo avaliou a percepção de acadêmicos sobre sua autoimagem como futuros médicos e os fatores que influenciaram a construção da sua identidade profissional. Foram entrevistados 32 estudantes do sexto ano de Medicina no Brasil e em Portugal. Utilizou-se a análise de conteúdo na modalidade temática e a dramaturgia de Goffman para análise e interpretação dos dados. A autoimagem idealizada revelou-se em duas temáticas: o médico centrado em si e aquele que valoriza a relação interpessoal. Uma terceira temática mostrou a influência da universidade e de elementos trazidos a priori na identidade do médico. Os resultados indicam a influência do currículo oculto na construção da identidade profissional e reforçam a importância dos aspectos sociais e humanísticos na formação médica.
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Mallows JL. Qualitative study using grounded theory examining collegiality among emergency physicians. Emerg Med Australas 2022; 35:398-405. [PMID: 36372444 DOI: 10.1111/1742-6723.14128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/11/2022] [Accepted: 10/18/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Collegiality is considered to be any extra-role behaviour that is discretionary, not recognised by a formal reward system and that promotes the effective functioning of the organisation. Although there is much literature on the concept of collegiality, there are few studies examining collegiality in the medical profession and none looking at collegiality among emergency physicians (EPs). The aim of the present study is to explore the perceptions of different ED healthcare professionals on the meaning of collegiality among EPs, the benefits of collegiality and behaviours they identify as indicative of collegiality. METHODS This was a qualitative study using grounded theory. Data collection was via focus group interviews of three to four participants per group. Participants included EPs, emergency medicine trainees, senior emergency nurses and nurse practitioners. Three questions were explored: 'what does collegiality mean to you?'; 'what are the benefits of collegiality?'; and 'what specific behaviours do you see as part of collegiality?' RESULTS Ten focus group interviews involving a total of 33 participants were conducted. Several themes were identified for both the meaning of collegiality and the benefits of collegiality among EPs. Eight themes regarding collegial behaviour were identified: (i) mutual respect and trust; (ii) mutual support; (iii) attitude; (iv) work ethic; (v) staff welfare; (vi) patient management; (vii) handover; and (viii) education. CONCLUSION The present study identified distinct themes and behaviours indicative of collegiality among EPs. Promoting these behaviours could improve staff well-being, ED efficiency, patient safety and productivity.
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Affiliation(s)
- James L Mallows
- Emergency Department Nepean Hospital Sydney New South Wales Australia
- Discipline of Emergency Medicine The University of Sydney Nepean Clinical School Sydney New South Wales Australia
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Joshi T, Budhathoki P, Adhikari A, Poudel A, Raut S, Shrestha DB. Improving Medical Education: A Narrative Review. Cureus 2021; 13:e18773. [PMID: 34804650 PMCID: PMC8592289 DOI: 10.7759/cureus.18773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2021] [Indexed: 12/05/2022] Open
Abstract
With the advancement in basic and clinical sciences, medical education is also constantly evolving. The Accreditation Council for Graduate Medical Education (ACGME) has endorsed six core competencies to improve teaching and learning. This narrative review was conducted after searching the article databases (PubMed, PubMed Central, Embase, and Scopus) about the core competencies such as medical knowledge (problem-based learning), interpersonal communication, patient care, professionalism, practice-based learning and improvement, and system-based care endorsed by ACGME. We included randomized and quasi-experimental trials, cohorts, and case-control studies in this narrative review. In a problem-based learning modality, a real-life scenario is allocated to a group of students. Studies have shown that it is more effectively demonstrated by a better post-test score, improved concentration, and application of knowledge. Interpersonal communication skills promote collaboration with interdisciplinary teams, work quality, and patient adherence to treatment. Professionalism is a human attribute that creates a pleasant work environment and is an essential trait that improves patients' adherence to treatment. In system-based care, patients are benefitted through a well-structured plan of care. Finally, in practice-based learning, medical trainees learn to systematically evaluate the pattern of care and practice the best modality to improve the overall patient care and physician satisfaction. These core competencies need to be incorporated into all levels of medical training.
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Affiliation(s)
- Tilak Joshi
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
| | | | - Anurag Adhikari
- Intensive Care Unit, Nepal Korea Friendship Municipality Hospital, Madhyapur Thimi, NPL
| | - Ayusha Poudel
- Department of Emergency Medicine, Alka Hospital Pvt. Ltd., Kathmandu, NPL
| | - Sumit Raut
- Department of Internal Medicine, Kathmandu Medical College, Kathmandu, NPL
| | - Dhan B Shrestha
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, USA
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McDonald J, Graves J, Abrahams N, Thorneycroft R, Hegazi I. Moral judgement development during medical student clinical training. BMC MEDICAL EDUCATION 2021; 21:140. [PMID: 33653350 PMCID: PMC7927259 DOI: 10.1186/s12909-021-02572-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/15/2021] [Indexed: 05/16/2023]
Abstract
BACKGROUND Whereas experience and cognitive maturity drives moral judgement development in most young adults, medical students show slowing, regression, or segmentation in moral development during their clinical years of training. The aim of this study was to explore the moral development of medical students during clinical training. METHODS A cross-sectional sample of medical students from three clinical years of training were interviewed in groups or individually at an Australian medical school in 2018. Thematic analysis identified three themes which were then mapped against the stages and dimensions of Self-authorship Theory. RESULTS Thirty five medical students from years 3-5 participated in 11 interviews and 6 focus groups. Students shared the impacts of their clinical experiences as they identified with their seniors and increasingly understood the clinical context. Their accounts revealed themes of early confusion followed by defensiveness characterised by desensitization and justification. As students approached graduation, some were planning how they would make moral choices in their future practice. These themes were mapped to the stages of self-authorship: External Formulas, Crossroads and Self-authorship. CONCLUSIONS Medical students recognise, reconcile and understand moral decisions within clinical settings to successfully reach or approach self-authorship. Curriculum and support during clinical training should match and support this progress.
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Affiliation(s)
- Jenny McDonald
- School of Medicine, Western Sydney University, Penrith, NSW, Australia.
| | - Jane Graves
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Neeshaan Abrahams
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Ryan Thorneycroft
- School of Sociology, Western Sydney University, Penrith, NSW, Australia
| | - Iman Hegazi
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
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Changing Practice Through Meaningful Assignments: Ideas for Supporting RN-BSN Students. Nurs Educ Perspect 2020; 41:E26-E27. [PMID: 31306359 DOI: 10.1097/01.nep.0000000000000549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Although nurses entering RN-BSN programs often perceive that earning the BSN will be of little benefit, upon completion, they do believe they have made professional gains, demonstrating that they have experienced a change in perspective. Mezirow's theory of perspective transformation can guide educators to develop learning activities that allow RN-BSN students to find meaning in the BSN degree while enrolled in a program, rather than after the program has been completed. Examples of learning activities and student reflections are provided.
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Chan KD, Humphreys L, Mey A, Holland C, Wu C, Rogers GD. Beyond communication training: The MaRIS model for developing medical students' human capabilities and personal resilience. MEDICAL TEACHER 2020; 42:187-195. [PMID: 31608726 DOI: 10.1080/0142159x.2019.1670340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose: Human capabilities in medicine, including communication skills, are increasingly important within the complex, challenging and dynamic landscape of healthcare. Supporting medical students to manage unavoidable role-related stressors adaptively may help mitigate the anguish that is too commonly reported among the profession. We developed a model, "MaRIS", underpinned by contemplative pedagogy, to support medical students to enhance their human capabilities, across all three domains of Bloom's taxonomy, and their personal resilience. It is the first to integrate Mindfulness, affective Reflection, Impactive experiences and a Supportive environment into medical curriculum design. Here, we describe the theoretical basis underpinning MaRIS and present a preliminary study to evaluate its impact on students' subjectively-rated capabilities.Materials and Methods: A questionnaire capturing self-ratings of competence, empathy and resilience, as well as impressions of their experiences, was administered to foundation year medical students before (T0), during (T1) and after delivery (T2).Results: Fifty-five students completed the survey at all time points. Mean scores for all domains increased significantly from T0 to T1 and from T0 to T2. Free-text comments suggest learning impact across the cognitive, psychomotor and affective domains.Conclusions: MaRIS appears to facilitate medical students' establishment of the foundations for building the human capabilities and personal resilience required for professional practice.
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Affiliation(s)
- Kwong D Chan
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Linda Humphreys
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Amary Mey
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
| | - Carissa Holland
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Cathy Wu
- School of Medicine, Griffith University, Gold Coast, Australia
| | - Gary D Rogers
- Griffith Health Institute for the Development of Education And Scholarship (Health IDEAS), Griffith University, Gold Coast, Australia
- School of Medicine, Griffith University, Gold Coast, Australia
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Andersen S, Stentoft D, Emmersen J, Rasmussen S, Birkelund S, Nøhr S. Contention over undergraduate medical curriculum content. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2019; 10:230-231. [PMID: 31859263 PMCID: PMC7246117 DOI: 10.5116/ijme.5de7.7516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 12/04/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Stig Andersen
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
| | - Diana Stentoft
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
| | | | - Sten Rasmussen
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
| | - Svend Birkelund
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Susanne Nøhr
- Department of Clinical Medicine, Faculty of Medicine, Aalborg University, Denmark
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Kadar GE, Thompson HG. Obesity bias among preclinical and clinical chiropractic students and faculty at an integrative health care institution: A cross-sectional study. THE JOURNAL OF CHIROPRACTIC EDUCATION 2019; 33:8-15. [PMID: 30044139 PMCID: PMC6417871 DOI: 10.7899/jce-17-15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 01/15/2018] [Accepted: 03/05/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE: The purpose of this study was to assess the prevalence of obesity bias among preclinical and clinical chiropractic students and faculty at an integrative health care academic institution. METHODS: This was a cross-sectional quantitative, single-method survey with group comparison using the Beliefs About Obese Persons scale (BAOP) and the Attitudes Toward Obese Persons scale. Both instruments were administered as a single 28 question survey via email to 450 students and 46 faculty members in a doctor of chiropractic (DC) program. Differences were determined by 2 tailed t tests. RESULTS: The response rate for faculty and students was 31% and 65%, respectively. One hundred forty-three DC students, preclinical ( n = 65) and clinical ( n = 78), and 30 DC faculty, preclinical ( n = 15) and clinical ( n = 15) completed the survey. Both students and faculty harbored antiobesity attitudes and moderate antiobesity beliefs. Students demonstrated slightly more positive attitudes toward obese persons than did preclinical faculty. Although preclinical faculty did not demonstrate more biased attitudes than did preclinical students ( p = .057), they were more biased than clinical students ( p = .26). On the BAOP, preclinical faculty scored significantly lower than both preclinical students and clinical students ( p = .013 and .017, respectively). CONCLUSION: Obesity bias was common among clinical and preclinical chiropractic students and faculty at our institution. A cultural shift that reduces bias may require changes in both the curriculum and cocurriculum.
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Seymour P, Watt M, MacKenzie M, Gallea M. Professional Competencies ToolKit: Using Flash Cards to Teach Reflective Practice to Medical Students in Clinical Clerkship. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2018; 14:10750. [PMID: 30800950 PMCID: PMC6342359 DOI: 10.15766/mep_2374-8265.10750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 08/14/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Early clinical experiences can be overwhelming to medical students. The Professional Competencies ToolKit (ProComp ToolKit) gives medical students a framework on which to build these early experiences and reflect on issues related to professionalism as each patient encounter unfolds. METHODS The ProComp ToolKit is a set of 28 flash cards, grouped within six domains of professional competency. Each flash card is a tool for learning, defining a topic in a catchy title and laying out a specific set of skills to be acquired within the clinical setting. Tasks and tips on each flash card guide students through the process of clinical observation, self-observation, and patient interactions. Students meet in small groups with facilitators every 2 weeks throughout the year to discuss these experiences. At the end of the year, students write a narrative based on the flash card that was most meaningful to their professional identity development. RESULTS We demonstrated how the student narratives that emerged from using the flash cards, exchanged in a small-group setting, led to group problem solving and validation of students' experiences and values. In the narratives, students discussed the origin of negative behaviors and attitudes that can become normalized in patient care while asserting the primacy of patient-centered care and devising self-awareness strategies. DISCUSSION Our experience using the ProComp ToolKit shows that teaching reflective practice can successfully be integrated into students' clinical experiences. Professionalism skills can be reflected upon such that they become habitual and integral to students' developing professional identities.
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Affiliation(s)
- Patricia Seymour
- Clinical Instructor, Department of Family Medicine, University of British Columbia Faculty of Medicine
| | - Maggie Watt
- Program Director, Integrated Community Clerkship, University of British Columbia Faculty of Medicine
| | - Mark MacKenzie
- Clinical Associate Professor, Department of Family Practice, University of British Columbia Faculty of Medicine
- Program Director, Family Practice Residency Program, University of British Columbia Faculty of Medicine
| | - Michael Gallea
- First-Year Resident, Department of Family Medicine, McMaster University Michael G. DeGroote School of Medicine
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Chandran S, Kishor M, Bhargava S, Jayaram R, Sundararajan R, Prabhu P, Sathyanarayana Rao TS. An innovative concept book guide for MBBS students. Indian J Psychiatry 2017; 59:525-526. [PMID: 29497208 PMCID: PMC5806345 DOI: 10.4103/psychiatry.indianjpsychiatry_419_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Suhas Chandran
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India. E-mail:
| | - M Kishor
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India. E-mail:
| | - Smriti Bhargava
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India. E-mail:
| | - Rohan Jayaram
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India. E-mail:
| | - Ramaswamy Sundararajan
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India. E-mail:
| | - Preethi Prabhu
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India. E-mail:
| | - T S Sathyanarayana Rao
- Department of Psychiatry, JSS Medical College and Hospital, JSS University, Mysore, Karnataka, India. E-mail:
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Evaluation of a collaborative project to develop sustainable healthcare education in eight UK medical schools. Public Health 2017; 150:134-148. [DOI: 10.1016/j.puhe.2017.05.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/27/2017] [Accepted: 05/22/2017] [Indexed: 11/21/2022]
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Franco RS, Franco CAG, Kusma SZ, Severo M, Ferreira MA. To participate or not participate in unprofessional behavior - Is that the question? MEDICAL TEACHER 2017; 39:212-219. [PMID: 28024438 DOI: 10.1080/0142159x.2017.1266316] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Medical education provides students with abundant learning opportunities, each of which is embodied with messages concerning what is expected from students. This paper analyses students? exposure to instances of unprofessional behavior, investigating whether they judge such behavior to be unprofessional and whether they also participate in unprofessional behavior. METHODS The survey developed in the Pritzker School of Medicine at the University of Chicago was the basis of this questionnaire that was answered by 276 students from two medical schools in Brazil and Portugal. RESULTS Unprofessional behavior was observed frequently by students in both universities, and the mean participation rates were similar (26% and 27%). Forty-five percent of students? participation in unprofessional behavior was explained by academic year, prior observation, and judgment. DISCUSSION The results indicate that once students have observed, participated in or misjudged unprofessional behavior, they tend to participate in and misjudge such behavior. The frequency with which students judged behaviors they had observed or participated in as ?borderline? or unprofessional could mean that they are experiencing moral distress. CONCLUSION Proper discussion of unprofessional behavior should foster a broad debate to encourage empowered students, faculties, and physicians to co-create a more professional environment for patient care.
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Affiliation(s)
- Renato Soleiman Franco
- a Medicine School, Pontifical Catholic University of Paraná , Curitiba , Brazil
- b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal
| | - Camila Ament Giuliani Franco
- a Medicine School, Pontifical Catholic University of Paraná , Curitiba , Brazil
- b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal
| | - Solena Ziemer Kusma
- a Medicine School, Pontifical Catholic University of Paraná , Curitiba , Brazil
| | - Milton Severo
- b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal
| | - Maria Amélia Ferreira
- b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal
- c Faculty of Medicine , University of Porto , Porto , Portugal
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Barnhoorn PC, Bolk JH, Ottenhoff- de Jonge MW, van Mook WN, de Beaufort AJ. Causes and characteristics of medical student referrals to a professional behaviour board. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8:19-24. [PMID: 28088777 PMCID: PMC5275748 DOI: 10.5116/ijme.584b.d591] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 12/10/2016] [Indexed: 05/17/2023]
Abstract
OBJECTIVES To describe the nature of unprofessional behaviour displayed by medical students, as well as the characteristics of students referred to the professional behaviour board. METHODS A descriptive mixed methods approach was taken, in which qualitative data on unprofessional behaviour, as well as quantitative data on the demographics of referred students were collected during the study period between June 1, 2009 and January 1, 2014. In order to compare the referred students with the total student population, data on gender, nationality and phase in the curriculum of the total student population, collected from the student administration desk, were also used. RESULTS In the study period, a total of 107 referrals were reported, concerning 93 different students (3% of the total student population). Sixty-five of the 107 referrals (61%) concerned male students. Thirty referrals (28%) concerned non-Dutch students. Most referrals (71%) occurred during clinical rotations. The referrals were equally distributed over three professional behaviour domains: dealing with oneself, dealing with others, and dealing with tasks/work. 'Withdrawn behaviour' was reported 17 times, 'insufficient Dutch language proficiency' 14 times, 'impertinent emails' 9 times and 'placing privacy-sensitive photos on the internet' 3 times. CONCLUSIONS Although only a minority of students are referred to a professional behaviour board, this study shows that student characteristics such as gender and nationality may correlate to a higher incidence of unprofessional behaviour. Further explanatory and exploratory research is needed to unravel this relationship, and to study the influence of curriculum reforms on these relationships, respectively.
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Affiliation(s)
- Pieter C. Barnhoorn
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | - Jan H. Bolk
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
| | | | - Walther N.K.A. van Mook
- Department of Intensive Care Medicine, Maastricht University Medical Centre, The Netherlands
| | - Arnout Jan de Beaufort
- Department of Public Health and Primary Care, Leiden University Medical Centre, The Netherlands
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Li J, Assanangkornchai S, Lu L, Jia M, McNeil EB, You J, Chongsuvivatwong V. Development of internalized and personal stigma among patients with and without HIV infection and occupational stigma among health care providers in Southern China. Patient Prefer Adherence 2016; 10:2309-2320. [PMID: 27877022 PMCID: PMC5108600 DOI: 10.2147/ppa.s112771] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND HIV/AIDS-related stigma is a major barrier of access to care for those infected with HIV. The aim of this study was to examine, validate, and adapt measuring scales of internalized, personal, and occupational stigma developed in Africa into a Chinese context. METHODS A cross-sectional study was conducted from January to September 2015 in Kunming, People's Republic of China. Various scales were constructed on the basis of the previous studies with modifications by experts using exploratory and confirmatory factor analyses (EFA + CFA). Validation of the new scales was done using multiple linear regression models and hypothesis testing of the factorial structure invariance. RESULTS The numbers of subjects recruited for the development/validation samples were 696/667 HIV-positive patients, 699/667 non-HIV patients, and 157/155 health care providers. EFA revealed a two-factor solution for internalized and personal stigma scales (guilt/blaming and being refused/refusing service), which were confirmed by CFA with reliability coefficients (r) of 0.869 and 0.853, respectively. The occupational stigma scale was found to have a three-factor structure (blaming, professionalism, and egalitarianism) with a reliability coefficient (r) of 0.839. Higher correlations of factors in the HIV patients (r=0.537) and non-HIV patients (r=0.703) were observed in contrast to low-level correlations (r=0.231, 0.286, and 0.266) among factors from health care providers. CONCLUSION The new stigma scales are valid and should be used to monitor HIV/AIDS stigma in different groups of Chinese people in health care settings.
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Affiliation(s)
- Jing Li
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
- School of Public Health, Kunming Medical University
| | - Sawitri Assanangkornchai
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Lin Lu
- Yunnan Center for Disease Prevention and Control
- Correspondence: Lin Lu, Yunnan Center for Disease Prevention and Control, 158 Dongsi Street, Xishan District, Kunming 650022, Yunnan Province, People’s Republic of China, Email
| | - Manhong Jia
- Yunnan Center for Disease Prevention and Control
| | - Edward B McNeil
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Jing You
- Infectious Diseases Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China
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