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Student professionalism: a CDIM commentary1

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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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References (41)

  • D.T. Stern

    Practicing what we preach? An analysis of the curriculum of values in medical education

    Am J Med

    (1998)
  • J.J. Cohen

    Leadership for medicine’s promising future

    Acad Med

    (1998)
  • R.R. Reed et al.

    The deprofessionalization of medicinecauses, effects, and responses

    JAMA

    (1987)
  • Educating medical students: assessing change in medical education—the road to implementation (ACME-TRI report). Acad...
  • J.H. Burack et al.

    Teaching compassion and respectattending physicians’ responses to problematic behaviors

    J Gen Intern Med

    (1999)
  • Project Professionalism

    (1995)
  • Learning objectives for medical student education—guidelines for medical schoolreport 1 of the medical school objectives project

    Acad Med

    (1999)
  • S.L. Swenson et al.

    Navigating the wardsteaching medical students to use their moral compasses

    Acad Med

    (1996)
  • P.P. Reynolds

    Reaffirming professionalism through the education community

    Acad Med

    (1994)
  • M.A. Mufson

    Professionalism in medicinethe department chair’s perspective on medical students and residents

    Am J Med

    (1997)
  • D. Wear

    On white coats and professional developmentthe formal and hidden curricula

    Ann Intern Med

    (1998)
  • W.T. Branch

    Deconstructing the white coat

    Ann Intern Med

    (1998)
  • G. Makoul et al.

    The future of medical school courses in professional skills and perspectives

    Acad Med

    (1998)
  • H.M. Swick et al.

    Fostering the professional development of medical students

    TLM

    (1995)
  • D. Wear

    Professional development of medical studentsproblems and promises

    Acad Med

    (1997)
  • C. Feudtner et al.

    Do clinical clerks suffer ethical erosion? Students’ perceptions of their ethical environment and personal development

    Acad Med

    (1994)
  • R. Bissonettte et al.

    A data-generated basis for medical ethics educationcategorizing issues experienced by students during clinical training

    Acad Med

    (1995)
  • M.A. Papadakis

    Do as I say, not as I do

    Am J Med

    (1998)
  • M.J. Green et al.

    Do actions reported by physicians in training conflict with consensus guidelines on ethics?

    Arch Intern Med

    (1996)
  • M.W. Satterwhite et al.

    Medical students’ perceptions of unethical conduct at one medical school

    Acad Med

    (1998)
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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.

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