Madeleine D. Bruning, EdD CPNP; Frank R. Sinatra, MD; Sajjad A. Yacoob, MD, Year III Pediatric Clerkship, Keck School of Medicine at USC, Los Angeles, CA
Introduction: The recognition of professionalism as an integral component of medical education was first addressed by the American Board of Pediatrics in 1974. The essential attributes of professional behavior were catagorized into eight distinct components. However, there is no agreed upon definition of professionalism. In the clinical arena, professionalism is often taught informally and passively and “behavior” is observed and “caught” by students (Bruckner et al.,1999). Formal evaluation of professional behavior often eludes faculty and students and has been relegated to the realm of “you know when you see it” and is difficult to measure. (Logan, 2007). The LCME has mandated that medical schools assess the learning environment to identify positive and negative influences on the maintenance of professional standards, enhance the positive and mitigate the negative influences. (LCME Standard-MS-31A). Medical students must be aware that as they transition into residency, that they will be expected to learn and demonstrate behaviors that reflect a commitment to continuous professional development and ethical practice as required by the ACGME. They must be aware, insightful and understand the impact of their professional behaviors and attitudes on patient care. Objective: To determine if Year III Pediatric Clerks recognized professional and unprofessional actions, and upon recognition, did they express the desire to acquire positive and avoid negative behaviors in their reflective essays. Method: 152 reflective essays were reviewed for evidence that students observed, identified and expressed an understanding of good and bad professional behavior. Open coding was used to categorize emerging themes. Results: Four characteristics related to professionalism and the role of the physician emerged: coordination of care, conduit for continuity, patient advocate and teacher. Students’ statements further revealed the faculty’s role in the students’ development professional skills, involvement and actions during the patient encounters. Conclusion: The students’ reflective essays indicate that students recognize and express their awareness of professional behavior, identify behaviors and attributes of the professional physician and acknowledge specific actions that influence their professional behavior. LCME requirements -Long learning and Self knowledge ACGME Core Competencies – Professionalism and Communication.