Purpose: To identify and examine how students respond to and engage with formal professionalism teaching strategies, and what factors outside the formal curriculum may influence professional development.
Method: Individual semistructured interviews were conducted with 56 students completing the preclinical curriculum at the University of Washington School of Medicine in 2004 and 2005. Interviews were recorded, transcribed, and analyzed using qualitative methods.
Results: Students identified role modeling as an important modality for learning professionalism, even during their preclinical years. Role models included classroom faculty and peers, in addition to physicians in clinical settings. Small-group discussions and lectures helped some students identify and analyze the professional behaviors they observed, but they elicited negative responses from others. Students believed their professionalism derived from values, upbringing, and experiences prior to medical school. Some students reflected on their evolving professionalism while working directly with patients.
Conclusions: Medical schools should ensure that students are exposed to excellent role models—ideally, faculty who can articulate the ideals of professionalism and work with students longitudinally in clinical settings. Lectures about professionalism may alienate rather than inspire students. Students’ premedical experiences and values influencing professionalism should be acknowledged and appreciated. Bedside teaching and reflection on students’ inner experience as they begin to work directly with patients deserve further exploration as opportunities to teach professionalism.
Dr. Baernstein is associate professor, Department of Medicine, University of Washington School of Medicine, Seattle, Washington, and a member of the college faculty.
Dr. Amies Oelschlager is assistant professor, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington, and a member of the college faculty.
Dr. Chang is assistant professor, Department of Medicine, University of Washington School of Medicine in Seattle, Washington, and a member of the college faculty.
Ms. Wenrich is affiliate instructor, Department of Medical Education and Biomedical Informatics, and director of special projects and advisor to the dean, University of Washington School of Medicine, Seattle, Washington.
Correspondence should be addressed to Dr. Baernstein, Harborview Medical Center, 325 Ninth Avenue, Box 359702, Seattle, WA 98104; telephone: (206) 744-3263; fax: (206) 744-3563; e-mail: (firstname.lastname@example.org).