Professionalism and medical education: a theme issue

clinanat.gif  The July 2006 issue of Clinical Anatomy is a theme issue on professionalism. Here are the abstracts of several of the articles, with links to full text.  PubMed Records

Swick HM. Medical professionalism and the clinical anatomist. Clin Anat 2006; 19(5):393-402.

Abstract: 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.
 

Page DW. Professionalism and team care in the clinical setting. Clin Anat 2006; 19(5):468-472.

Abstract: The introduction of an 80-hr work week mandates frequent sign-out or transfer of patient information sessions among training physicians. At the same time, patients are increasingly more complex and cared for by teams employing technologically driven interventions. In order for team care to work, residents and medical students must master the elements of professionalism, upon which solid leadership and clear communication rests. Early instruction should include topics, such as clarity of language, cultural sensitivity, a subordination of self-interest to the needs of the patient, and a dedication to lifelong learning of cognitive and motor skills. This exposure to professionalism may begin in the dissection room and continue seamlessly through residency and into practice.

Holsinger JW, Jr., Beaton B. Physician professionalism for a new century. Clin Anat 2006; 19(5):473-479.

Abstract: 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.

Krych EH, Vande Voort JL. Medical students speak: a two-voice comment on learning professionalism in medicine. Clin Anat 2006; 19(5):415-418.

Abstract: 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.

Lachman N, Pawlina W. Integrating professionalism in early medical education: the theory and application of reflective practice in the anatomy curriculum. Clin Anat 2006; 19(5):456-460.

Abstract: Renewed emphases on teaching professionalism require physicians to develop the ability to critically reflect upon their own decisions. Innovative programs that address teaching professionalism within medical curricula have been implemented in almost all medical schools. The foundation for many of these programs is “reflection,” which is regarded as a core skill in professional competence. In order to achieve the desired outcomes and meet the demands of a required curriculum, an understanding of educational concepts in the designing of medical curricula is essential. Educators recognize that, for most medical students, professional growth is initiated during the first year of the medical curriculum and, therefore, traditionally pure content delivery courses such as first year anatomy course are being utilized now in order to explore issues related to critical thinking and professionalism. As a result, learning strategies such as “reflective practice” are beginning to play an important role in curriculum design. This article provides an overview of the theory of reflective practice, and demonstrates how reflective practice may be integrated into the anatomy curriculum. In order to incorporate reflective exercises into a curriculum, the basic elements of a reflective process are defined, strategies to implement reflective exercises within the course are described, and the benefits of reflective practice are highlighted. Therefore, in creating an environment that fosters reflective learning, the gap between theory and practice may be consolidated, which in the context of anatomy promotes the issue of teaching for relevance and clinical application.

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