APM ViewsStudent professionalism: a CDIM commentary1
Section snippets
Defining professionalism
Some educators have written that ethical behavior may be difficult to define (8). Nevertheless, recent efforts have made strides in defining physician professionalism. ABIM and others summarize the essence of professionalism as those values, attitudes, and actions that cause a physician to hold the patient interest above his or her own self-interest 6, 9. The components of professionalism are thus stated to be altruism, accountability, duty, service, honor, integrity, and respect for others (6)
Fostering and nurturing professionalism
The renewed interest in teaching professionalism has resulted in formalized courses and events at several institutions. The white coat ceremony has become part of many medical school orientations 11, 12. During the ceremony, students are advised that they must gain competence in the intellectual rigors of medical school training while maintaining compassion and humility. This ceremony also indicates a renewed commitment to teaching and supporting the fundamental concepts of professionalism
Evaluating professionalism
Clerkship directors rely heavily on clinical instructors to assess the competency of medical students (24). These evaluations typically emphasize the core professionalism dimensions of reliability and commitment as well as relationships with patients and colleagues 25, 26, 27, 28. Nevertheless, concerns exist regarding the quality of these evaluations. First, despite the call to model and teach professionalism, clinical instructors may fail to model appropriate behaviors (4). Second, when
Conclusions
Undergraduate medical educators recognize their educational and societal obligation to ensure their graduates possess and have demonstrated competency across the breadth of knowledge, skills, and attitudes. During clinical clerkships, instructors place great emphasis on qualities of professionalism in students. Unfortunately, instructors are not always willing or able to identify student problems and too often overlook problems in the hope that someone else will address the issue. Additionally,
Recommendations
- 1.
The fostering and nurturing of student professionalism is a paramount task that rests with medical schools and its faculty members. Creative and innovative ways (such as white coat ceremonies) are needed more than ever to imbue students with the fundamental ideals of the medical profession that will guide their daily lives.
- 2.
Evaluating professionalism is the responsibility of all undergraduate educators. All medical schools should undertake efforts to achieve a uniform, cross-clerkship commitment
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Why what we do matters
2001, American Journal of MedicineCitation Excerpt :Clinical competence and professionalism are intertwined. The unique role of clerkship directors was highlighted in a recent commentary by Raymond Wong, MD, and colleagues (6): “Clerkship directors are uniquely positioned to help define, foster, promote and evaluate the essential professional attitudes and behavior required of medical students.” Deficiencies in professionalism can be both detected and remediated.
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- 1
The opinions expressed in this paper are solely those of the authors and do not necessarily reflect the opinions of the Department of Defense, the United States Air Force, or other federal agencies.
- 2
Dr. Wong is Clerkship Director in the Department of Internal Medicine at Loma Linda University School of Medicine. Dr. Hemmer is Associate Clerkship Director in the Department of Medicine at the Uniformed Services University of the Health Sciences. Dr. Szauter is Clerkship Director in the Department of Internal Medicine at the University of Texas Medical Branch at Galveston.