News & Commentary
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A Health Affairs study out today that finds doctors are not always honest with their patients raises important questions about professionalism in medicine.
Professionalism is more than a set of attitudes. It’s a set of behaviors and actions that can be instilled and cultivated through medical education. In 2010, the Josiah Macy, Jr. Foundation and the Institute on Medicine as a Profession (IMAP) jointly launched an initiative to teach professionalism to the next generation of physicians. Last year, five academic medical centers received awards to design and implement innovative programs to teach professionalism to students and residents:
- The program at Baylor College of Medicine, “Professionalism Tipping Points: Teaching Innovations in Clinical Medical Education,” teaches students the tenets of professionalism through clinical case studies that involve issues of conflict-of-interest, discrimination in health care delivery, and unjust distribution of resources. Students also participate in a professionalism workshop and undertake writing exercises to reflect on instances when they have observed issues of professionalism in clinical practice.
- State University of New York, Stony Brook has implemented a program that trains the clinical teaching staff to model and teach professionalism. The program, “Community Faculty Development on Medical Ethics and Professionalism,” uses clinical scenarios to teach faculty to work with students who engage in unprofessional behavior during clinical interactions. Faculty learn to lead small group sessions to discuss professionalism issues that students observe in clinical practice.
- The University of California, Davis program “Development of a Physician Community Leadership Curriculum,” expands family medicine residents’ training experiences beyond the examination room and the hospital bed. Residents spend six rotations with health policy organizations or community groups to better understand the social influences on health and gain skills to more effectively advocate for their patients and their communities.
- The University of Massachusetts program, “Clinical Interprofessional Professionalism Curriculum,” engages medical students and graduate nursing students in role-playing situations and reflective writing exercises to teach the values of professionalism. In addition, this program seeks to foster relationships between these two student groups through shared classroom experiences and by attending clinical rounds together.
- The University of South Florida – Lehigh Valley (Pennsylvania) program, “Tools and Strategies for Modeling and Reinforcing Professionalism,” engages third-year medical students and pediatric and internal medicine residents on both campuses in six comprehensive professionalism modules that incorporate reflective writing, small group discussions, clinical rounds, and role-playing to address issues of professionalism. The program directors are also convening a series of professionalism-focused conferences for medical residents on both campuses.
We received overwhelming interest in the Education and Training to Professionalism Initiative and in January committed additional funds to expand it. Over the next three years, fifteen new educational programs in professionalism will be launched. IMAP will also be compiling a report on best practices to guide health professions schools on implementing professionalism education. Read more about the grant here.
Additional reading: David Rothman, president of IMAP, and Macy president George Thibault discuss the goals of the Education and Training to Professionalism Initiative.