Preclinical medical student observations associated with later professionalism concerns

Burns, Cynthia; Lambros, Maria; Atkinson, Hal H.; Russell, Greg; Fitch, Michael T.

doi:10.1080/0142159x.2016.1230185

Cited by 25 publications

(25 citation statements)

References 26 publications

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“…Failure to identify and subsequently address violations of professionalism allows the behaviour to persist and even flourish, and is associated with future indiscretions . Conversely, prompt identification of and response to unprofessional behaviour improves satisfaction, retention, patient safety and productivity .…”

Section: Introductionmentioning

confidence: 99%

“…7 Failure to identify and subsequently address violations of professionalism allows the behaviour to persist and even flourish, and is associated with future indiscretions. 16,17 Conversely, prompt identification of and response to unprofessional behaviour improves satisfaction, retention, patient safety and productivity. 18 Reporting to institutional committees is an important mechanism to identify unprofessional behaviour and is the initial step in addressing such behaviours.…”

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confidence: 99%

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Student-derived solutions to address barriers hindering reports of unprofessional behaviour

et al. 2017

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Introduction Barriers hinder medical students from reporting breaches in professional behavior, which can adversely impact institutional culture. No studies have reported student perspectives on how to address these barriers successfully. Our study 1) evaluated the likelihood of reporting based on violation severity, 2) assessed barriers to reporting, and 3) elicited students’ proposed solutions. Methods Four medical students designed a cross-sectional study in 2015. In response to seven scenarios, students rated likelihood to report the violation, indicated perceived barriers, and identified solutions. Additional questions investigated the perceived importance of professionalism, confidence in understanding professionalism, and trust in administrative protection from negative consequences. Results 272 students in their clinical years (MS2-4) responded to the survey (RR=50%). Students were 70-90% likely to report major violations, but less than 30% likely to report minor or moderate violations. Barriers included concerns about an uncomfortable relationship (41%), potential negative repercussions on grades or opportunities (23%), and addressing by direct discussion rather than reporting (23%). Solutions included simplified reporting, control over report release date, improved feedback to reporters, training for real-time resolution of concerns, and a neutral resource to help students triage concerns. No differences existed between classes regarding the importance or understanding of professionalism. In linear regression, only importance of professionalism predicted likelihood of reporting and this did not change with training. Conclusions Hindered by common barriers, students are unlikely to report a violation unless it is a serious breach of professionalism. Student-derived solutions should be explored by medical school administrators to encourage professionalism violation reporting.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Student-derived solutions to address barriers hindering reports of unprofessional behaviour

et al. 2017

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“…While such results are powerful reflections of the impact of professional behavior on patient care and a physician’s career, medical schools also need surrogate measures which allow them to identify as early as possible, among all students who misstep, that critical subpopulation at highest risk of additional problems while enrolled [17,23,32]. Using professionalism reports like ECNs as a screening method in the way described offers schools another tool to help identify those students most in need of assistance.…”

Section: Discussionmentioning

confidence: 99%

Student response to reports of unprofessional behavior: assessing risk of subsequent professional problems in medical school

Ainsworth

Szauter

2018

Medical Education Online

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Background: An early concern note (ECN) program is used by some medical schools to identify, counsel, and intervene when students exhibit unprofessional behavior. Student maturity, insight, propensity for reflection, and receptiveness to feedback have been suggested as predictors of future behavior. Objective: We hypothesized that (a) classifying students with a first ECN based on their response to the report would identify students at risk of repeat ECNs better than the action that prompted it and (b) receipt of multiple ECNs would identify students at risk of adverse academic events.Design: For this study, 459 ECNs were classified based on students’ (1) recognition that their behavior was inappropriate and (2) acceptance of responsibility for the behavior. Student academic progress and receipt of subsequent ECNs were tracked.Results: Students who recognized their behavior was inappropriate and accepted responsibility after an initial ECN received subsequent ECNs at lower rates (14–19%) than students who disagreed with the significance of their behavior or were resistant to accepting responsibility (36–59%). Students with limited insight and adaptability appeared to be at highest risk. Seventy-one percent of students with three or more ECNs encountered adverse academic events during enrollment.Conclusion: Student reactions to reports of unprofessional behavior may be useful as a tool to help assess risk of recurrent lapses. Students with diminished capacity to recognize behaviors as unprofessional or accept responsibility for them appear to be at highest risk for additional adverse academic and professionalism events while in medical school.

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“…In addition, clinical performance assessments or evaluations often include some measure of professional conduct as a metric. Although professional conduct can be difficult to measure, absences can be included as a consideration (Burns et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

The impact of student absences on grade outcomes in a neurology clerkship setting

Cruz¹,

Riddell²,

Gamaldo³

et al. 2019

MedEdPublish

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Purpose: To evaluate the potential association between student absenteeism and performance on the National Board of Medical Examiners Clinical Neurology Subject Exam (NBME), a Standardized Patient Exam (SPEX) and the overall clinical performance (CPA) in the Neurology Core Clerkship (NCC). Methods: All medical students rotating through the required 4-week NCC at Johns Hopkins University School of Medicine (JHUSOM) were enrolled in this IRB-approved, retrospective cohort study. Student absences, NBME, SPEX, CPA, and overall final clerkship grades were recorded. Results: Between 2014-2017, 252 students were enrolled. Of the total sample, 68 students (27.0%) were absent from the clerkship. The median absence length was one day, and the range was 0.25 to 7.00 days. The total "other" absences dependent variable (defined in the text) was negative and statistically significant for the NBME (p = 0.01). This model suggests that for an average student, a one day's absence for reasons we categorized as "other", will lead to a slightly more than two-point decrease (2.36) in the NBME percent correct score. Conclusion: Data presented here supports that the NBME graded component decreases with increased "other" absenteeism supporting that increased absences may have a negative effect on student performance in the NCC.

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Preclinical medical student observations associated with later professionalism concerns

Cited by 25 publications

References 26 publications

Student-derived solutions to address barriers hindering reports of unprofessional behaviour

Student-derived solutions to address barriers hindering reports of unprofessional behaviour

Student response to reports of unprofessional behavior: assessing risk of subsequent professional problems in medical school

The impact of student absences on grade outcomes in a neurology clerkship setting

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