Presentation on theme: "Beth Choby, MD FAAFP Renate Rosenthal, PhD Bill Brescia, Ed D"— Presentation transcript:
1 Teaching professionalism to first year medical students using team-based learning Beth Choby, MD FAAFPRenate Rosenthal, PhDBill Brescia, Ed DDepartment of Medical EducationUniversity of Tennessee Health Science CenterMemphis, TN
2 Timeline for session Introduction and welcome 5 minutes Introduction and welcome minutesParticipant discussion minutesDidactic presentation minutesTBL scenarios min eachLarge group discussion min eachQuestions and wrap-up minutes
3 Introductions Dr. Beth Choby, MD FAAFP Dr. Renate Rosethal, PhD Dr. Bill Brescia, EdD
4 Audience queryWhat methods do you currently use for teaching professionalism in the early medical school curriculumHow effective are they?
5 Professionalism Widely used Carries so many connotations/nuances that meaning is blurredSupreme Court Justice Potter Stewart 1964 “I know it when I see it”Add various graphics of “professionals”
6 Professionalism- can you define it? Criterion-based approachProfession provides important public servicePractice requires considerable skillDraws on body of knowledge exclusive to itselfRequires moral component intrinsic to practice and has code of ethicsRequires autonomy of practiceNeeds a strong voiceSupreme Court Justice Potter Stewart 1964 “I know it when I see it”Graham C, et al. Widening debate about medical professionalism. Med Education 2013:47:
7 Van der Camp Identified 90 constituent elements of professionalism Three domains: interpersonal, public and intrapersonal professionalismAltruism, accountability, integrity and respect only items commonly citedSuggests a lack of consensus within medical community about definitionVan de Camp K, et al. How to conceptualize professionalism: a qualitative study.Med Teach 2004; 26(8):
8 LCME Standard MS-31“A medical education program must ensure that its learning environment promotes the development of explicit and appropriate professional attributes in its medical students (i.e., attitudes, behaviors, and identity)”Liaison Committee on Medical Education: Functions and structure of a medical schoolStandards for Accreditation of Medical Education Programs Leading to the MD degree.
9 How essential is professionalism training in the pre-clinical years? Unprofessional behavior during medical school associated with subsequent disciplinary action by medical boardsSeeing authority figure behaving rudely to a colleague reduced a subject’s performance on both routine and creative tasks (Porath and Erez)Students who witness rude behavior toward fellow student similarly perform worse on memory and creative tasksKulac E, et al. Medical students’ participation in and perception of unprofessionalBehaviors: comparison of preclinical and clinical phases. Adv Physiol Educ 2013; 37:Porath CL, et al. does rudeness really matter? The effects of rudeness on task performanceAnd helpfulness. Acad Manage J 2007; 50:
10 How do students see it?Attributes cited by medical students when asked to define professionalismAdd Table 1 from Sullivan p. 257
11 Byszewski, et al. 2012“Students want professionalism to have a prominent place at their school, but not necessarily in their didactic curriculum”“Students cringe and feel patronized when professionalism is discussed”Disconnect between faculty and students regarding “professional” behaviorsing during class/leaving class early not view by students as unprofessional; current generation of learners with different perspectives of professionalism as it relates to specific behaviors; making expectations explicit is critical
12 Cuesta-Briand et al. 2014Main emerging themes from students’ views on professionalism were “adopting professional persona”, adhering to code of practice/professional guidelines, and treating others with respectProfessional persona enacted by appropriate dress and detachment when speaking with patients (elicited student dislike and skepticism)Told what to wear as “superficial face” of professionalismCuesta-Briand B, et al. ‘A world of difference’: a qualitative study of medical students’Views on professionalism and the ‘good doctor’ BMC Med education 2014;14:77
13 More student perceptions ‘Good doctor’ ≠ ‘Professional doctor’Students see as two separate constructs with different characteristics and only some overlapProfessionalism “activated on demand to perform as expected”“Professional and ethical chameleons” to navigate training
14 Overlap areasRespect, communication, team work and adequate knowledge base seen as core to professionalismInternally-motivated behavior? Starting scaffold for talking with students
15 Teaching professionalism in medical school Principles of Clinical Medicine courseLongitudinal “doctoring” experienceNew format after curriculum overhaulWent from 1 week experience every 6-8 weeks (block system) to continuous sequential courseClasses every semester (4 hours credit) in first two years of medical school (pre-clinical)Professionalism previously taught in large lecture setting? Student buy in“Preaching” concernsContinued issues with attire and “professionalism” issues
16 New course= new thinking Curriculum design geared toward flipped classroom and interactive learningWe have a beautiful new TBL complex, so…How can we use it?Can you teach professionalism using a TBL format?
17 Teaching professionalism by TBL Recruited faculty presentersLiterature search to identify pre-readingsDevelopment of the IRAT/GRAT assessmentScenario developmentDevelopment of the documentation rubrics
18 “Life in the morning of a medical student” Please open the designated folder and review the scenario “life in the morning of a medical student”After discussing with your group, complete the provided sheetTime allotmentSmall group review/discussion minutesLarge group discussion minutes
19 “Life in the afternoon of a medical student” Small group review/discussion 10 minutesLarge group discussion minutes
20 “Later that evening……” Small group review/discussion 10 minutesLarge group discussion minutes
21 What the students said? Coverage of male vs. female type professionalism issues?Student discussions three months after the TBL
22 What the faculty saw Attire issues Students able to identify issues that previously might have gone under the radar
23 Plans for next yearIncorporation of student comments and further validation of scenariosPre- and post-TBL knowledge and attitudes assessment6 and 12 month follow-up on experiences and knowledge
24 Questions and networking Please take some time to exchange contact information with people you have metThank for attending and have a wonderful conference!