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Contact: Media Relations Officer, (202) 828-0041.
Medical Schools Recognize Importance of Professionalism
But Educational Strategies Vary Widely
Washington, D.C., August 31, 1999 -- The teaching of professionalism in U.S. medical schools needs to be improved, according to a study conducted by researchers from the Association of American Medical Colleges (AAMC). Published in the September 1 Journal of the American Medical Association (JAMA), the study reports that while most medical schools address professionalism in some fashion the educational strategies used to teach this important topic may not be adequate.
"While most medical schools seem to recognize that explicit learning experiences are necessary to promote professional values and behaviors in medical students, the strategies used to achieve that goal appear inadequate," writes the study's lead author Herbert M. Swick, M.D. "The results of this study suggest that the teaching of professionalism in U.S. medical schools needs to be enhanced." Dr. Swick, currently a scholar in residence at AAMC, is affiliated with the Department of Neurology, University of Kansas, Kansas City.
To determine whether professionalism is being taught to medical students, and if so, in what manner, Dr. Swick et al. conducted a two-stage survey of all 125 U.S. medical schools in the fall of 1998. In the study's first stage, a one-page survey instrument was sent to each medical school to gain general information about professionalism training. In the second stage, a more detailed survey instrument was sent to the schools that reported they offered some instruction in professionalism to learn about the format as well as the goals and objectives of the curricular offerings.
The AAMC study found that of the 116 responding medical schools:
- 89.7 percent offered some formal instruction related to professionalism;
- 78.9 percent addressed professionalism through orientation, often a "white-coat ceremony";
- 60 percent incorporated professionalism as a component of multiple courses;
- 28.9 percent taught professionalism in one course or as an integrated sequence of courses; and,
- 33.6 percent offered professionalism faculty development programs.
The AAMC study queried the responding medical schools on four key attributes of professionalism. Dr. Swick et al. found that of the 41 schools that provided their course materials for review about 75 percent of the schools covered the attribute "adhere to high ethical and moral standards" and 41 percent addressed the attribute "respond to societal needs and reflect a social contract with the communities served." The remaining attributes "subordinating one's self-interest to the interest of others" and "envincing core humanistic values" were covered by 66 percent and 54 percent of the schools, respectively.
Dr. Swick et al. note that 10 percent of the respondents to the initial survey did not have any recognized curriculum content that addressed professionalism and that only one half of the schools with content had formal methods for assessing the professional behaviors of students.
"As the U.S. health care system continues to become more complex and less consumer friendly, the need to educate physicians who embody the key attributes of professionalism cannot be understated," said AAMC President Jordan J. Cohen, M.D. "Unfortunately, as important as professionalism is, Dr. Swick's study shows that the educational offerings by U.S. medical schools, at this time, need considerable strengthening."
To assist medical schools in the task of educating students about professionalism and other key physician attributes, the AAMC launched the Medical Schools Objective Project (MSOP) in 1996. Through national consensus, the MSOP provides medical schools with guidance about the knowledge and skills necessary for physicians to meet their patients' expectations. AAMC believes physicians must be compassionate and empathetic in caring for patients, and must be trustworthy and truthful in all of their professional dealings. Physicians must also bring to the study and practice of medicine character traits, attitudes, and values that underpin ethical and beneficent medical care.
Joining Dr. Swick from the AAMC on the study are co-authors Philip Szenas, Deborah Danoff, M.D., and Michael Whitcomb, M.D.
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The Association of American Medical Colleges represents the 125 accredited U.S. medical schools; the 16 accredited Canadian medical schools; some 400 major teaching hospitals, including 74 Veterans Administration medical centers; 87 academic and professional societies representing nearly 88,000 faculty members; and the nation's 67,000 medical students and 102,000 residents.
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