How to identify, address and report students’ unprofessional behaviour in medical school

Abstract

This AMEE guide provides a research overview of the identification of, and responding to unprofessional behaviour in medical students. It is directed towards medical educators in preclinical and clinical undergraduate medical education. It aims to describe, clarify and categorize different types of unprofessional behaviours, highlighting students' unprofessional behaviour profiles and what they mean for further guidance. This facilitates identification, addressing, reporting and remediation of different types of unprofessional behaviour in different types of students in undergraduate medical education. Professionalism, professional behaviour and professional identity formation are three different viewpoints in medical education and research. Teaching and assessing professionalism, promoting professional identity formation, is the positive approach. An inevitable consequence is that teachers sometimes are confronted with unprofessional behaviour. When this happens, a complementary approach is needed. How to effectively respond to unprofessional behaviour deserves our attention, owing to the amount of time, effort and resources spent by teachers in managing unprofessional behaviour of medical students. Clinical and medical educators find it hard to address unprofessional behaviour and turn toward refraining from handling it, thus leading to the 'failure to fail' phenomenon. Finding the ways to describe and categorize observed unprofessional behaviour of students encourages teachers to take the appropriate actions. . She received her MD in 1986, and completed residency training in general practice at the University of Amsterdam in 1990. Marianne worked in general practice for 15 years, combining this work with teaching clerks in the workplace, and from 2001 with other educational activities at the Faculty of Medicine at the VU University. From 2010 onwards, she has been coordinating the educational theme 'Professional behaviour' at the school. Recently, Marianne received her PhD with distinction. Her research explores how educators and peer students perceive and respond to unprofessional behaviours of medical students.Arianne Teherani PhD, is a Professor of role in which she leads design, development, and policy for evaluation of the school's curriculum and programs. Arianne's main research interests are in the areas of professionalism, professional identity formation, and equity in medical education. She has led studies aimed at identification and remediation of unprofessional behaviours, the role of clinical education in shaping the professional identity of learners and teachers, and the role of assessment and learning environment practices in perpetuating educational disparities and interventions aimed at creating equity during medical school. . His current medical education research focuses on generic aspects of (post)graduate training, and on intensive care medicine specifically, including the supervision of national and international PhD students. In addition he performs research in the fields of organ donatio...

Self-Reported Academic Misconduct among Medical Students: Perception and Prevalence

“…In few developing countries, students sometimes depend on using unethical means to achieve their target, mostly when they are incapable of properly carrying out an assigned task [ 30 ]. Nonetheless, a significant negative correlation between Q1 and Q4 in all four domains of our study ( Table 2 ) indicates that understanding a behavior as wrong could psychologically influence a person to refrain from doing it [ 31 , 32 ]. Similarly, a moderate positive correlation observed between Q2 and Q3 indicates that observing a wrong behavior may potentially desensitize a person towards the action and hence could propel them to indulge in it ( Table 3 (A, B)).…”

Bang the gavel: animal experimentation on trial—an interdisciplinary mock trial at the school of health sciences

“…The students were graded as pass/fail for each student. To pass, the student needed to avoid the following unprofessional behaviors: 1) Involvement-absence from the mock trial, 2) Interaction-disruptive behavior or bullying, 3) Integrityacting without required consent, not obeying rules and regulations of the mock trial, 4) Introspection-not accepting feedback (14). The student needs to pass in order to get the credits from the class.…”

Unprofessional behaviour of GP residents and its remediation: a qualitative study among supervisors and faculty

“…Although lapses in professionalism are a part of learning [ 11 , 12 ], research has also revealed a clear association between unprofessional behaviour during undergraduate and postgraduate training and unprofessional behaviour in later practice [ 13 – 17 ]. The positive approach of teaching and assessing professionalism and supporting Professional Identity Formation (PIF) is increasingly receiving attention [ 7 , 18 – 20 ].…”

“…One important reason why lapses in professionalism are not identified or are identified too late, (often termed as ‘failure to fail’), is a lack of appropriate language to describe unprofessional behaviour and its remediation [ 12 , 23 ]. This ‘failure to fail’ implicitly promotes the idea that unprofessional behaviour is acceptable.…”

“…To overcome this problem, the Four I’s model for describing unprofessional behaviours was recently developed. The Four I’s model consists of descriptors for unprofessional behaviour, classified into four distinct categories; lack of I nvolvement (failure to engage) I ntegrity (dishonest behaviour); I nteraction (disrespectful behaviour); and I ntrospection (poor self-awareness) [ 12 , 24 ]. The descriptors and the four categories guide educators in how to document unprofessional behaviour, and in doing so, provide directions for effective remediation.…”