Creating a Culture of Professionalism

Objective: Northeastern Ohio Universities College of Medicine (NEOUCOM) is committed to raising the consciousness of its medical community about the concept of professionalism and professional responsibility and, in doing so, to fostering and nurturing conscientious responses by medical students and faculty to the professional development issues affecting them. Description: In 1995, NEOUCOM, with the leadership of its president and dean, created the Office of Professional Development and the Student Professional Development Advisory Committee. In 1996–97 they developed an integrated program in professionalism. A continuous advising program spanning the four years of medical school—Professional Development Advising Teams (PDAT)—was set up, and the Professional Development Assessment Form (PDAF), an instrument used by students and faculty to identify key attributes and defined expectations for professionalism, was created. Each Professional Development Advising Team consists of two faculty advisers, one from the medical school campus, the other from a clinical hospital, and six to eight medical students. The PDAT meets three times a year during the four year sof medical school. The Professional Development Assessment Form has eight separate categories with definitions and specific questions evaluating student professionalism. The categories are reliability and responsibility, honesty/integrity, maturity, respect for others, critique, altruism, interpersonal skills, and impairment—psychological/chemical.1,2 Students use the PDAF to assess their professional development. Advisers, clinical faculty, and staff use the PDAF with students to create a shared understanding of professionalism, communicate an expectation for professionalism, and provide feedback regarding professionalism. Discussion: The formal inculcation of student professionalism withgin the NEOUCOM community has been ongoing since 1996. The PDAT program currently includes all 400+ medical students and 93 faculty advisers, and there is a waiting list of faculty members who wish to become PDAT advisers. Students and faculty use the PDAF in all four years of the curriculum. Students in the class of 1999 included professionalism as an integral part of the class oath they developed and then recited at commencement. Students regularly discuss with faculty advisers appropriate professional behaviors in academic and clinical settings. Faculty narrative evaluations of students professionalism have improved since introduction of the PDAF. In one clinical setting, a group of junior medical students initiated a written evaluation of peers' professionalism. Both the PDAT and the PDAF will continue to be part of the ongoing culture of professionalism at NEOUCOM. During the next year, expansion of this integrated approach to professionalism will include (1) encouraging faculty to document positive examples of professionalism, (2) adding the patient perspective in the ongoing discussion of professionalism, (3) creating a student-centered portfolio system, (4) empowering students to appropriately evaluate peers' professionalism, and (5) evaluating the effectiveness of this integrated approach to professionalism.