Medical professionalism in the formal curriculum: 5th year medical students’ experiences

BMC Medical Education

Karen Forbes¹  Amelia J Stockley¹ 

[1] Department of Palliative Medicine, University of Bristol, Horfield Road, Bristol BS2 8ED, UK

关键词: Ticking-boxes;    Formal curriculum;    Faculty development;    Curriculum development;    Professionalism;   

Others  :  1090031
DOI  :  10.1186/s12909-014-0259-0

 received in 2014-06-25, accepted in 2014-11-19,  发布年份 2014

【 摘 要 】

Background

The standards and outcomes outlined in the General Medical Council’s publication ‘Tomorrow’s Doctors’ include proposals that medical professionalism be included in undergraduate curricula. Learning the values and attitudes necessary to become a ‘doctor as a professional’ has traditionally been left largely to the informal and hidden curricula. There remains no consensus or confirmed evidence upon which to base best practice for teaching in this area. In 2010, as part of a revision of the fifth year curriculum the University of Bristol Medical School introduced tutorials which focused on students’ achievement of the learning objectives in ‘Tomorrow’s Doctors Outcomes 3: the doctor as a professional’. This study sought to explore the students’ experiences of these tutorials in order to develop the evidence base further.

Methods

Sixteen medical students participated in three focus-group interviews exploring their experiences of medical professionalism tutorials. A course evaluation questionnaire to all fifth year students also provided data. Data were analysed using the principles of Interpretative Phenomenological Analysis.

Results

Four main themes were identified: students’ aversion to ‘ticking-boxes’, lack of engagement by the students, lack of engagement by the tutors and students’ views on how medical professionalism should be taught.

Conclusions

A curriculum innovation which placed the achievement of medical professionalism in the formal curriculum was not unanimously embraced by students or faculty. Further consideration of the students’ aversion to ‘ticking-boxes’ is warranted. With continued demand for increased accountability and transparency in medical education, detailed check-lists of specific learning objectives will continue to feature as a means by which medical schools and learners demonstrate attainment. Students’ experiences and acceptance of these check-lists deserves attention in order to inform teaching and learning in this area. Learner and faculty ‘buy in’ are imperative to the success of curriculum change and vital if the students are to attain the intended learning objectives. Effective faculty development and student induction programmes could be employed to facilitate engagement by both parties.

【 授权许可】

   
2014 Stockley and Forbes; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Goldie J, Dowie A, Cotton P, Morrison J: Teaching professionalism in the early years of a medical curriculum: a qualitative study. Med Educ 2007, 41:610-617.
• [2]Illing J, Morrow G, Kergon C, Burford B, Spencer J, Peile E, Davies C, Baldauf B, Allen M, Johnson N, Morrison J, Donaldson M, Whitelaw M, Field M: How prepared are medical graduates to begin practice? A comparison of three diverse UK medical schools. In Final Report for the GMC Education Committee. General Medical Council, Northern Deanery; 2008.
• [3][http://www.gmc-uk.org/Tomorrow_s_Doctors_0414.pdf_48905759.pdf] webcite General Medical Council: Tomorrow’s Doctors. 2009 [cited 2014 3rd December]. Available from: .
• [4]Bryden P, Ginsburg S, Kurabi B, Ahmed N: Professing professionalism: Are We Our Own worst enemy? faculty Members’ experiences of teaching and evaluating professionalism in medical education at One school. Acad Med 2010, 85(6):1025-1034.
• [5]Davis M, McDonald J: Course material: Centre for Medical Education, University of Dundee, Postgraduate certificate in medical education. Module CD11 2011, 5-25.
• [6]Smith J, Flowers P, Larkin M: Interpretative Phenomenological Analysis. SAGE Publications Ltd, London; 2009.
• [7]McCurdy F, Weisman L: Teaching newborn medicine to third-year medical students: use of a checklist. Arch Pediatr Adoesc Med 1995, 149(1):49-52.
• [8]Papin K: Teaching and learning moments: the checklist. Acad Med 2007, 82(6):717.
• [9]Amery J, Lapwood S: A study into the educational needs of children’s hospice doctors: a descriptive quantitative and qualitative survey. Palliat Med 2002, 18:727.
• [10]Stephenson A, Adshead L, Higgs R: The teaching of professional attitudes within UK medical schools: reported difficulties and good practice. Med Educ 2006, 40:1072-1080.
• [11]Baernstein A, Oelschlager A, Chang T, Wenrich M: Learning professionalism: perspectives of preclinical medical students. Acad Med 2009, 84(5):574-581.
• [12]Arnold E, Blank L, Race K, Cipparrone N: Can professionalism be measured? The development of a scale for use in the medical environment. Acad Med 1998, 73(10):1119-1121.
• [13]Steinert Y, Cruess S, Cruess R, Snell L: Faculty development for teaching and evaluating professionalism: from programme design to curriculum change. Med Educ 2005, 39:127-136.
• [14]Kenny N, Mann K, MacLeod H: Role modeling in Physicians’ professional formation: reconsidering an essential but untapped educational strategy. Acad Med 2003, 78(12):1203-1210.
• [15]Monrouxe L, Rees C, Hu W: Differences in medical students’ explicit discourses of professionalism: acting, representing, becoming. Med Educ 2011, 45:585-602.
• [16]Rabow M, Wrubel J, Remen R: Promise of professionalism: personal mission statements among a National Cohort of Medical Students. Ann Fam Med 2009, 7(4):336-342.
• [17]Hilton S, Slotnick H: Proto-professionalism: how professionalism occurs across the continuum of medical education. Med Educ 2005, 39:58-65.
• [18]Hager P, Gonczi A, Athansou J: General issues about assessment of competence. Assessment and Evaluation in Higher Education 1994, 19:3-16.
• [19]Jackson N, Jamieson A, Khan A: Assessment in Medical Education and Training: A Practice Guide. Radcliffe Publishing, Oxford; 2007.