Monday, August 2, 2004

More on Teaching Medical Professionalism

"Although disagreement persists among experts

as to which aspects of medical practice are

captured by the term “medical professionalism,”

in recent years there has nevertheless

been widespread agreement within academic

medicine that it is essential to teach about medical

professionalism to medical students and

residents."

From "Training Doctors for Professionalism: Some Lessons from Teaching Medical Ethics" by Mark Siegler, M.D. [note: this is a PDF/Adobe Acrobat file]


Another view regarding the teaching of professionalism to medical students and residents is found in the American Journal of Bioethics, V. 4 Nr.2 2004 pages 1-10

"The Professionalism Movement: Can We Pause?" by Delese Wear and Mark G. Kuczewski. Here is the abstract of the article which is also available on the Univ. of Pennsylvania bioethics website



"The topic of developing professionalism dominated the content of many academic medicine publications and conference agendas during the past decade. Calls to address the development of professionalism among medical students and residents have come from professional societies, accrediting agencies, and a host of educators in the biomedical sciences. The language of the professionalism movement is now a given among those in academic medicine. We raise serious concerns about the professionalism discourse and how the specialized language of academic medicine disciplines has defined, organized, contained, and made seemingly immutable a group of attitudes, values, and behaviors subsumed under the label of "professionalism." In particular, we argue that the professionalism discourse needs to pay more attention to the academic environment in which students are educated, that it should articulate specific positive behaviors, that the theory of professionalism must be constructed from a dialogue with those we are educating, and that this theoretical and practical discourse must aim at a deeper understanding of social justice and the role of medicine within a just society."




Finally, the following is a list of pertinent articles regarding the teaching of medical professionalism from: Virtual Mentor,

Ethics Journal of the American Medical Association,

December 2003, Volume 5, Number 12

©2003 American Medical Association

Publication notice from AMA:This publication may be downloaded and reproduced for educational purposes. Sale or distribution for non-educational purposes is prohibited.



Suggested Reading and Resources

Professionalism in Medical Education




Accreditation Council for Graduate Medical Education (ACGME). Common program requirements. Available at: http://www.acgme.org/DutyHours/dutyHoursCommonPR.asp. Accessed September 2, 2003.



Ambady N, Laplante D, Nguyen T, Rosenthal R, Chaumeton N, Levinson W. Surgeons' tone of voice: a clue to malpractice history. Surgery. 2002;132(1):5-9.



American Medical Association. H-275.956: Demonstration of Clinical Competence. (CME Rep. E, A-90; Reaffirmed: CME Rep. 5, A-99; Modified: Sub. Res. 821, I-02).



American Medical Association. Principle IV. Principles of Medical Ethics. In: Code of Medical Ethics Current Opinions, 2002-2003 edition. Chicago: AMA Press; 2002:xii.



American Medical Association. Principles of medical ethics. Code of Medical Ethics, 2002-2003. Available at: http://www.ama-assn.org/ama/pub/ category/2512.html. Accessed September 15, 2003.



American Medical Student Association Web site. AMSA Advocacy Guide: Understanding and Preserving Your Student Rights. Available at: http://www.amsa.org/adv/advguide.cfm. Accessed October 10, 2003.



Association of American Medical Colleges Web site. Medical School Graduation Questionnaire, All Schools Report, 2003. Available at: http://www.aamc.org/data/gq/allschoolsreports/start.htm. Accessed October 10, 2003.



Boulet J, McKinley D, Whelan GP, Van Zanten M, Hambleton RK. Clinical skills deficiencies among first year residents: utility of the ECFMG clinical skills assessment. Acad Med. 2002;77:S33-35.



Boulet JR, van Zanten M, McKinley DW, Gary NE. Evaluating the spoken English proficiency of graduates of foreign medical schools. Med Educ. 2001;35:767-773.



Epstein R, Hundert E. Defining and assessing professional competence. JAMA. 2002;287:226-35.



Fincher RM, Lewis LA. Learning, experience, and self-assessment of competence of third-year medical students in performing bedside procedures. Acad Med.1994;69:291-295



Ginsburg S, Regher G, Hatala R, et al. Context, conflict, and resolution: a new conceptual framework for evaluating professionalism. Acad Med. 2000;75:S6-11.



Hatem C. Teaching approaches that reflect professionalism. Acad Med. 2003;78:709-713.



Health Care Quality Improvement Act (HCQIA). 42 USC § 11101 et seq.



Hemmer P, Hawkins R, Jackson J, Pangaro L. Assessing how well three evaluation methods detect deficiencies in medical students’ professionalism in two settings of an internal medicine clerkship. Acad Med. 2000;75:167-173.



Hopkins MA, Kalet A, Janicek R, et al. Integrating communication skills teaching into the surgery clerkship. Focus. 2003;4:33-35.



Howe A. Professional development in undergraduate medical curricula—the key to the door of a new culture. Med Educ. 2002;36:353-359.



Jackson, P. Life in Classrooms. New York: Holt, Rinehart, and Winston; 1968:353.



Kohn LT, Corrigan JM, Donaldson MS, eds. Committee on Quality of Health Care in America, Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington DC: National Academies Press. 2001.



Kohn LT, Corrigan JM, Donaldson MS, eds. Committee on Quality of Health Care in America, Institute of Medicine. To Err is Human: Building a Safer Health System. Washington DC: National Academies Press; 2000.



LaCombe MA. On professionalism. Am J Med. 1993;94:329.



Liaison Committee on Medical Education. Function & Structure of a Medical School, 1990 Accreditation Standards. Available at: http://www.lcme.org/standard.htm, current.



Lowenstein J. Can you teach compassion? In: Lowenstein J. The Midnight Meal and Other Essays about Doctors, Patients, and Medicine. New Haven, CT: Yale University Press; 1997:12-19.



Ludmerer KM. Instilling professionalism in medical education. JAMA. 1999;282:881.



Mansky, PA, Physician Health Programs and the potentially Impaired physician with a substance use disorder. Psychiatr Serv. 1996;47:465-467.



Mansky, PA. Chapter 46, Impaired physicians. In: Galanter M and Kleber HD, eds. Textbook of Substance Abuse Treatment, 3rd ed. Washington, DC: American Psychiatric Press, Inc. In Press.



Medical Professionalism Project. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002:136; 243-246.



Medterms Web site. Prayer of Maimonides. Available at: http://www.medterms.com/script/main/ Art.asp?ArticleKey=7295. Accessed September 15, 2003.



Moore PJ, Adler NE, Robertson PA. Medical malpractice: the effect of doctor-patient relations on medical patient perceptions and malpractice intentions. West J Med. 2000;173:244-250.



National Board of Medical Examiners. Special Medical Student Liaison Meeting Minutes. Philadelphia. NBME Special Medical Student Liaison Meeting. 2001-2002.



Physicians for Human Rights Web site. Islamic Code of Medical Ethics. Available at: http://www.physiciansforhumanrights.org/research/methics/methicsoath.html.



Regier DA, Farmer ME, Rae DS, et al: Comorbidity of mental disorders with alcohol and other drug abuse. JAMA. 1990;268:1012-1014.



Reid WH. Recognizing and dealing with impaired clinicians, Part 1: Recognition and reporting. J Med Prac Manage. 2001;17:97-99.



Sieminska MJ, Szymanska M, Mausch K. Development of sensitivity to the needs and suffering of a sick person in students of medicine and dentistry. Med Health Care Philos. 2002;5:263-71.



Silver HK, Glicken AD. Medical student abuse. Incidence, severity, and significance. JAMA. 1990;263:527-532.



Stern D. Practicing what we preach? An analysis of the curriculum of values in medical education. Am J Med. 1998;104:569-75.





Stewart M, Brown JB, Boon H, et al. Evidence on patient-doctor communication. Cancer Prev Control. 1999;3:25-30.



Stillman PL, Regan MB, Swanson DB, et al. An assessment of the clinical skills of fourth-year students at four New England medical schools. Acad Med. 1990;65:320-326.



Talbott GD, Gallegos KV and Angres DH. Impairment and Recovery in Physicians and other Health Professionals. In: Graham AW and Schultz TK, eds. Principles of Addiction Medicine. 2nd ed. Chevy Chase, MD: American Society of Addiction Medicine, Inc; 1998:1263-1279.



Taraban R, Rynearson K, Stalcup KA. Time as a variable in learning on the World-Wide Web. Behav Res Methods Instrum Compute. 2001;33:217-225.



The sick physician. Impairment by psychiatric disorders, including alcoholism and drug dependence. JAMA. 1973;223:684-7.



United States Medical Licensing Examination Web site. Clinical Skills Exam: FAQs. Available at: http://www.usmle.org/news/cse/csefaqs2503.htm. Accessed October 21, 2003.



Vincent C, Young M, Phillips A. Why do people sue doctors ? A study of patients and relatives taking legal action [comment]. Lancet. 1994;343:1609-1613.



Virmani v Novant Health, Inc, 259 F3d 284 (4th Cir 2001).



Virtual Hospital Web site. Sir William Osler: Aphorisms from His Bedside Teachings and Writings, #47. Available at: http://www.vh.org/adult/provider/history/osler. Accessed September 25, 2003.



Virtual Hospital Web site. Sir William Osler: Aphorisms from His Bedside Teachings and Writings, #3. Available at: http://www.vh.org/adult/provider/history/osler/1.html. Accessed September 25, 2003.



Waldman JD, Spector RA. Malpractice claims analysis yields widely applicable principles. Pediatr Cardiol. 2003;24:109-117.



Yedidia M, Gillespie C, Kachur E, et al. Effect of communications training on medical student performance. JAMA. 2003;290:1157-1165.



Yedidia MJ, Gillespie CC, Kachur E, et al. Effect of communications training on medical student performance. JAMA. 2003;290:1157-1165.









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