First Year Medical Students' Perceptions of Professionalism
Authors: Encisco Ellen M , Edmondson Anna C , Nichols Carol A 
Published: November 2023

Introduction

Medical professionalism is widely discussed in healthcare. Studies have shown associations between medical students' unprofessional behavior and subsequent disciplinary action by medical boards once they are physicians. To comply with LCME standards and meet programmatic competencies, schools across the country, including the Medical College of Georgia (MCG), are utilizing a comprehensive approach for professionalism education.

Purpose & Hypothesis

The purpose of this study was to examine how medical students perceive professionalism and how those perceptions differ between students starting medical school and students who have completed one year of medical school. We hypothesized that after one year of medical school, students would choose more acceptable (by professionals' standards) survey answers compared to those chosen by students starting medical school.

Methods

An online survey was distributed to MCG Classes of 2019 & 2020. The Class of 2019 (n=83 respondents) completed the survey at the end of their first year of medical school; the class of 2020 (n=185 respondents) completed the survey at the beginning of their first year. The survey (adapted from the Knowledge & Attitude Assessments of Professionalism instrument, Blue et al., 2009) included demographic questions, free response questions, clinical vignette scenarios, multiple choice questions, and Likert statements addressing common professionalism principles and ethical issues in medicine. Free response questions were coded for keywords, and frequencies of keywords were summed and compared. Means (± SD and/or SEM) were computed for ratings of unprofessional behavior and Likert ratings. Responses to clinical vignette questions were coded and analyzed for knowledge of professionalism attributes. Likert scale data was averaged and analyzed using Mann‐Whitney U, Kruskal‐Wallis H, and Student's T‐tests.

Results

When defining professionalism in general, students most often included “respect” (> 30% of responses in both classes). When asked about professionalism for healthcare professional trainees specifically, students still most often cited “respect” (≥ 40% of responses in both classes). Medical students rated scenarios involving situations in a healthcare environment as more unprofessional (2019: 1.7 ± 0.9; 2020: 1.6 ± 0.9) than those in an academic environment (2019: 2.2 ± 1.2; 2020: 1.9 ± 1.1; p<0.001; scale: 1 = most unprofessional, 5 = least unprofessional). In clinical vignettes and questions designed to assess knowledge of professionalism attributes, respondents in both classes scored highest on questions about professional responsibility (2019: 70.0% ± 5.4; 2020: 66.0% ± 3.5) and lowest on professional commitment (2019: 44.3% ± 5.8; 2020: 43.8% ± 3.7; p<0.0001).

Conclusion

Overall, this study suggests that while students' definitions of professionalism in general and related to healthcare more specifically were similar, they view comparable professionalism situations from healthcare and academic environments differently. The results indicate an opportunity for MCG to provide additional education on specific aspects of professionalism and to emphasize the equal importance of maintaining a professional demeanor both in the academic and healthcare working environments.