Assessing Professionalism: A Theoretical Framework for Defining Clinical Rotation Assessment Criteria

Abstract

Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage "I know it when I see it" is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. This framework is expected to facilitate implementation in clinical teaching.

Fostering the Development of Professionalism in Veterinary Students: Challenges and Implications for Veterinary Professionalism Curricula

“…Objectivity, replicability, and generalisability are currently regarded as important attributes in veterinary medicine, and a strong adherence to scientific knowledge and empirical methods permeates the areas of medical and veterinary medicine. Medical and veterinary practice may, however, also benefit from alternative domains of knowledge and modes of enquiry [49,89]. Philosophy, sociology, and spirituality may represent domains where communication, compassion and social responsibility are better learned and practised.…”

The Veterinary Identity: A Time and Context Model

“…We have previously recognised that well-meaning workplace teaching strategies, aimed at optimising the students' experiences with complete clinical case material, absence of client complexity and a definitive diagnosis, may inadvertently narrow professional identity conceptions into a model of diagnosis and treatment. 39 Role modelling the complexity of the clinician identity, discussing fallibility, and demonstrating wider notions of success, will all be valuable in validating the students' newly formed professional identities. This will give them the courage to identify with new identity ideals and allow them to graduate from clinical programmes with the tools to develop with the evolution of their individual career trajectories.…”

Developing a Professional Studies Curriculum to Support Veterinary Professional Identity Formation

“…As part of our faculty development strategy, we therefore tasked clinical rotation leaders with the generation of an assessment framework for rotation professionalism teaching. 59 As well as encouraging faculty to reflect on their understanding of professionalism in student assessment and feedback, this activity also helped to foster a sense of ownership of professionalism concepts in rotation teaching, with ideas for teaching generated. A rethinking of appropriate teaching material was seen; patients without a diagnosis or resolution, and difficult or upset clients were identified as having (previously unappreciated) value for students.…”

“…The framework we generated emphasises five areas: interpersonal communication and interactions, awareness and respect for different values and priorities, taking responsibility for self, teamwork, and self-awareness of one's own identity. 59 Our approach to supporting reflective practice in our final year students remains a work-inprogress. While there is extensive support in the literature for the use of reflective portfolios, 60 we have been keen to avoid reported pitfalls, such as 'forced' or inauthentic reflections (inclusion of material that the students perceive will get them a better grade, rather than honest accounts of their development), inadequate feedback, and students perceiving that the efforts required are disproportionate to the outcomes achieved.…”