Medical professionalism and the clinical anatomist

Medical professionalism has become an important issue for medical education and practice. The core attributes of professionalism derive from the roles and responsibilities of professions and from the nature of medicine as a healing profession. In medical education, most of the focus on professionalism has been directed to the clinical arena, yet it is critically important that the attributes of professionalism be manifested in basic science courses--especially anatomy--as well as in clinical experiences, because the transformation from medical student to physician begins at the outset of medical school. Throughout history, anatomists have exemplified many of the attributes and values of professionalism, and clinical anatomists today still have much to offer. Anatomy faculty have an important responsibility to nurture and exemplify professionalism.     

Medical students speak: a two-voice comment on learning professionalism in medicine

We are two medical students. For one of us, medical school is just beginning; for the other, it is coming to an end. Our experiences are different, but our message is the same. Professionalism is a vital component in the field of medicine. Characteristics such as trustworthiness, compassion, integrity, honesty, leadership, and social responsibility must be embraced by the next generation of doctors so the future healthcare system will be one that patients and physicians admire and respect. To reach this goal, it is important to understand how medical students today view professionalism and how such a construct is integrated into medical education. We hope to provide insight into this area by reflecting on the lessons we have learned regarding professionalism in medical school. Professionalism, like the medical field itself, is a life-long learning process. By encouraging this process early in medical training, future doctors will be able to provide their patients with highest quality care.     

Medical education challenged by the learning society

This paper analyzes the limitations of dominant paradigms in education and identifies the necessity of research-situated learning in real environments and how medical education must be involved with knowledge management in real, complex, adaptive systems, and concludes with the need for constructing novel educative paradigms with regard to new educational paradigms.     

Perspective: Medical education in medical ethics and humanities as the foundation for developing medical professionalism

Medical education accreditation organizations require medical ethics and humanities education to develop professionalism in medical learners, yet there has never been a comprehensive critical appraisal of medical education in ethics and humanities. The Project to Rebalance and Integrate Medical Education (PRIME) I Workshop, convened in May 2010, undertook the first critical appraisal of the definitions, goals, and objectives of medical ethics and humanities teaching. The authors describe assembling a national expert panel of educators representing the disciplines of ethics, history, literature, and the visual arts. This panel was tasked with describing the major pedagogical goals of art, ethics, history, and literature in medical education, how these disciplines should be integrated with one another in medical education, and how they could be best integrated into undergraduate and graduate medical education. The authors present the recommendations resulting from the PRIME I discussion, centered on three main themes. The major goal of medical education in ethics and humanities is to promote humanistic skills and professional conduct in physicians. Patient-centered skills enable learners to become medical professionals, whereas critical thinking skills assist learners to critically appraise the concept and implementation of medical professionalism. Implementation of a comprehensive medical ethics and humanities curriculum in medical school and residency requires clear direction and academic support and should be based on clear goals and objectives that can be reliably assessed. The PRIME expert panel concurred that medical ethics and humanities education is essential for professional development in medicine.     

Communication and professionalism

The text of this lecture was presented in July 1999 at the international Chicago meeting on Communication in Medicine. The topic 'Communication and professionalism' has been approached by drawing on the work at the Association of American Medical Colleges (AAMC). The challenge is to align medical education content with societal needs, practice patterns and scientific developments. In this perspective, the goals of medicine have been presented, however, also related to experienced real life situations, the changes within medical practice and the erosion of the doctor-patient relationship. It is stressed that we must produce excellent clinicians, who have good communication skills, and being able to use those skills in the care of their patients. This implies that the current focus on communication in medicine is very important in the medical education.     

Teaching professionalism to residents.

The need to teach professionalism during residency has been affirmed by the Accreditation Council for Graduate Medical Education, which will require documentation of education and evaluation of professionalism by 2007. Recently the American Academy of Pediatrics has proposed the following components of professionalism be taught and measured: honesty/integrity, reliability/responsibility, respect for others, compassion/empathy, self-improvement, self-awareness/knowledge of limits, communication/collaboration, and altruism/advocacy. The authors describe a curriculum for introducing the above principles of professionalism into a pediatrics residency that could serve as a model for other programs. The curriculum is taught at an annual five-day retreat for interns, with 11 mandatory sessions devoted to addressing key professionalism issues. The authors also explain how the retreat is evaluated and how the retreat's topics are revisited during the residency, and discuss general issues of teaching and evaluating professionalism.     

Physician professionalism for a new century

During the past 50 years, physicians have become increasingly dissatisfied with certain aspects of their profession. Dissatisfaction has intensified with the advent of managed care in the late 20th century, the medical liability crisis, and the growing divergence between the professional and personal expectations placed upon physicians and their practical ability to meet these expectations. These and other factors have encroached on physician autonomy, the formerly ascendant professional value within medicine. As the underlying values and practical realities of the broader American health care system have changed, the professional values and practices of physicians have failed to adapt correspondingly, resulting in a "professionalism gap" that contributes to physician dissatisfaction. To improve the outlook and efficacy of modern American physicians, the profession must adopt a new values framework that conforms to today's health care system. This means foregoing the 20th century's preferred "independent physician" model in favor of a new professional structure based on teamwork and collaboration. Convincing established physicians to embrace such a model will be difficult, but opportunities exist for significant progress among a new generation of physicians accustomed to the realities of managed care, flexible practice models, and health information technology. The teaching of clinical anatomy, given its incorporation of student collaboration at the earliest stages of medical education, offers a prime opportunity to introduce this generation to a reinvigorated code of professionalism that should reduce physician dissatisfaction and benefit society.     

Are we serious about teaching professionalism in medicine?

Medical professionalism is an increasingly common topic of discussion in the medical education literature. Much of the recent literature on this subject addresses areas of weakness in the educational curricula of medical schools and residency programs. But students are living a world in which professional behavior is being redefined, often in ways that run contrary to the medical education curriculum. This article outlines three fundamental challenges that powerfully affect the ability to promote professionalism in students and young physicians. To overcome these challenges, the author suggests four steps that can be taken in the medical education community. First, medical schools should address cost and access to care as first-order intellectual problems and should encourage research programs in these areas. Second, schools should develop programs to humanize science and restore scientific integrity beyond the requirements of compliance programs. Next, medical school leaders should celebrate those who best embody moral leadership in the profession. Finally, the medical education community should acknowledge that the availability of affordable health care to the public depends on the practice choices of medical school graduates and should accept greater responsibility for this outcome.     

医学院校专业化教师队伍建设的途径

教师的专业化发展已成为高校师资队伍建设的关键,高校教师队伍的整体素质决定学校教育的发展水平。本文从教师专业素质内涵出发,比较了国内外高校教师构成现状,探讨了加强医学院校教师队伍可持续发展的途径。