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Ahead of print publication
Integrating professionalism into curriculum for medical students: Need of the hour


1 Department of Community Medicine, Medical Education Unit Coordinator and Member of the Institute Research Council, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth – Deemed to be University, Ammapettai, Nellikuppam, Chengalpet District, Tamil Nadu, India

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Date of Submission11-Jul-2021
Date of Decision06-Aug-2021
Date of Acceptance11-Aug-2021
Date of Web Publication29-Sep-2021
 

  Abstract 


Professionalism in the branch of medicine is one of the key attributes which a medical professional should acquire to be successful in their medical practice. It continues to be the most challenging areas for teaching, training, and assessing in both undergraduate and postgraduate period of medical training. Nevertheless, we cannot lose the opportunity to train medical students on such an essential aspect of professionalism, and the best bet we have is to integrate professionalism within the medical curriculum so that students realize its significance and teachers employ methods for its assessment. Further, there is no point in training or exposing medical students to professionalism without assessing them to measure their learning progression. In conclusion, despite being an indispensable component of medical professionalism, we have not made significant progress in training our future medical doctors about the same. This calls for the need to not only integrate professionalism within the medical curriculum but also ensure its periodic assessment in a systematic manner, and thus, the role of administrators and teachers is crucial.

Keywords: Assessment, curriculum, medical students, professionalism


How to cite this URL:
Shrivastava SR, Shrivastava PS. Integrating professionalism into curriculum for medical students: Need of the hour. Apollo Med [Epub ahead of print] [cited 2021 Nov 30]. Available from: https://www.apollomedicine.org/preprintarticle.asp?id=327151





  Introduction Top


Professionalism in the branch of medicine is one of the key attributes which a medical professional should acquire to be successful in their medical practice.[1] However, we must understand that professionalism is not like any academic subject which can be taught to the students in theory classes. It continues to be the most challenging areas for teaching, training, and assessing in both undergraduate and postgraduate periods of medical training.[1],[2] Nevertheless, we cannot lose the opportunity to train medical students on such an essential aspect of professionalism, and the best bet we have is to integrate professionalism within the medical curriculum so that students realize its significance and teachers employ methods for its assessment.[1],[2]


  Integrating Professionalism into Curriculum Top


The process of integrating professionalism within the curriculum is a challenging task and requires extensive efforts from the medical teachers and administrators.[2],[3],[4] Owing to the lack of clarity on what all domains together constitute professionalism, the first and foremost step is to define the same in such a way that it is acceptable to the local medical college. Evidence across different studies has reported that professionalism is generally a mixture of traits such as clinical competence, honesty, maintaining confidentiality and appropriate relationships with patients, and altruism.[1],[2],[3] However, this might differ between colleges, and thus, a feasible and comprehensive definition is a must.[2],[3]

This has to be followed by making the different stakeholders (viz., teachers, students, administrative staff) understand the concept, discussion on their views and finally reaching a consensus.[2],[4] This step is essential as it introduces a sense of ownership among the stakeholders, and thus, the process of integration of professionalism into curriculum becomes smooth. Another merit of this step is that students become aware of their expected behavior and professional attributes right at the start of their course, and subsequently keeps those in mind throughout their training period. In other words, the seeds of professionalism are sown at the very initial stages of the students' career.[3],[4] It is important that the domain of professionalism is integrated in all the professional year of training, and gradually, the students understand the importance of communication skills, ethics, etc., and the same is periodically reinforced.[3]


  Teaching Professionalism as a Part of Curriculum Top


The next step is to identify strategies that can be employed by medical teachers to teach professionalism to medical students. The need of the hour is that apart from giving emphasis to acquisition of medical knowledge, professionalism is also inculcated among students in their clinical skills and practice.[2],[4] It has been envisaged to give more impetus for experiential learning, reflection and reflective practice, role modeling, situated learning (viz., students learn in a structured manner under the guidance of a teacher).[5] As some of the medical colleges have transitioned to problem-based-cum-integrated teaching curriculum, the process of integrating professionalism has been easier. In fact, many of the medical colleges have even defined professional competencies, and it is expected that the medical student must attain the same by the time of completion of their training.[2],[3]


  Informal and Hidden Curriculum and Professionalism Top


To impart training on professionalism within the medical curriculum, the teachers should emphasize both formal (such as small group sessions) and informal curriculum. The students should be exposed to communities of practice and informal settings (such as organizing a camp) and are then asked to reflect upon their experiences and learning.[2],[3] This strengthens the overall training aspect of professionalism and makes them self-directed and lifelong learners. The training of professionalism will be incomplete, if we do not give attention toward the hidden curriculum (such as the unwritten rules, code, and habits of the medical profession).[6]

This hidden curriculum is often learned by students through their role models, who are the medical teachers and students often persevere these traits in their future career, and thus, there is an immense need for mentoring the medical students.[6] Furthermore, the role of mentoring in inculcating professional behavior among medical students can also be not ignored. As a matter of fact, mentoring provides a unique opportunity for the medical students to learn about their mistakes (both cognitive and noncognitive), and thereby, they can develop a shared plan with their mentors for the gradual improvement and learning.


  Assessment of Professionalism Top


We can understand that if professionalism is difficult to define, it will be even more difficult to effectively assess. However, there is no point in training or exposing medical students to professionalism without assessing them to measure their learning progression.[3],[4] Although no single method has been found to be comprehensive, it is a good approach to employ a combination of methods to assess professionalism. These include workplace based assessments, multisource feedback, peer assessment, objective structured clinical examination, critical incident reports, maintenance of learning portfolios, simulations, stories, etc.[1],[2],[3] The purpose of assessment which is integrated within the curriculum is to provide feedback to the students and to give them number of learning opportunities to ensure their they improve subsequently.[3],[4]


  Conclusion Top


Despite being an indispensable component of medical professionalism, we have not made significant progress in training our future medical doctors about the same. This calls for the need to not only integrate professionalism within the medical curriculum but also ensure its periodic assessment in a systematic manner, and thus, the role of administrators and teachers is crucial.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Shrivastava SR, Shrivastava PS. Teaching professionalism and leadership skills to an Indian Medical Graduate. CHRISMED J Health Res 2019;6:112-3.  Back to cited text no. 1
  [Full text]  
2.
Zare S, Yamani N, Changiz T. How to develop an undergraduate medical professionalism curriculum: Experts' perception and suggestion. J Adv Med Educ Prof 2019;7:183-90.  Back to cited text no. 2
    
3.
Langendyk V, Mason G, Wang S. How do medical educators design a curriculum that facilitates student learning about professionalism? Int J Med Educ 2016;7:32-43.  Back to cited text no. 3
    
4.
O'Sullivan H, van Mook W, Fewtrell R, Wass V. Integrating professionalism into the curriculum: AMEE Guide No. 61. Med Teach 2012;34:e64-77.  Back to cited text no. 4
    
5.
Glod SA, Richard D, Gordon P, Fecile ML, Kees-Folts D, Kreher M, et al. A curriculum for clerkship students to foster professionalism through reflective practice and identity formation. MedEdPORTAL 2016;12:10416.  Back to cited text no. 5
    
6.
Azmand S, Ebrahimi S, Iman M, Asemani O. Learning professionalism through hidden curriculum: Iranian medical students' perspective. J Med Ethics Hist Med 2018;11:10.  Back to cited text no. 6
    

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Correspondence Address:
Saurabh RamBihariLal Shrivastava,
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV) – Deemed to be University, Thiruporur - Guduvancherry Main Road, Ammapettai, Nellikuppam, Chengalpet District - 603108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_73_21





 

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Abstract
Introduction
Integrating Prof...
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Informal and Hid...
Assessment of Pr...
Conclusion
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