Notes from the Field: Professionalism and its effect on Medical Education

I recently attended the AAMC’s Central Group on Educational Affairs (CGEA) conference in Ohio. It was hosted by the University of Cincinnati and, unlike some of the other conferences we go to, we weren’t just standing by our booth creeping everyone out the whole time(!) We went to many conference sessions and met lots of great people.

The main theme of the conference was Professionalism and Professional Identity, and in this post I’m going to offer my take on how Professionalism and the other “softer” competencies are helping change medical education.

The keynote speaker, Dr. Maxine Papadakis kicked things off by discussing Professionalism and how it evolves over a professional’s career. Her presentation was my favorite kind: statistical analysis mixed with colourful anecdotes and conclusions. One point she made that really rang true for me is that professionalism is a practiced skill. It’s not something that you’re born with, or that a fresh-faced intern will have at the same level as a veteran physician. 

But I don’t think that this view of professionalism is the common view, even in medical education. For many years, professionalism has been assessed and managed differently than academic performance. Perhaps the assumption that professionalism is an innate trait is partly to blame. Dr. Papadakis cautioned for the need to evaluate professionalism to the same level as academic performance, and for a need to move away from 6-8 week summative assessments. She presented some of the interesting initiatives the University of California, San Francisco is doing to address this issue. This topic was also addressed a bit by my colleague Jason in a previous post.

There’s a trend here that is relevant to all medical educators: academic performance is the easiest of all the competencies to measure, but it’s certainly not the most important. However, changing the tools and methods we use to assess performance from academic performance alone to a broader view of competence represents a fundamental shift in curriculum design and assessment. Beware!

What I saw at the conference beyond the specific professionalism sessions all reinforced this point. Many schools are preparing longitudinal curricula, which are designed specifically to allow for trainees to see patients in more long-term settings, allowing for development of professional identity, empathy, and “softer” skills. There was also a focus on ACGME milestones for pre-GME, which underscores another change to traditional definitions and measures of competence.

Over the next few years, addressing these issues will be a key focus for one45. We want to help medical schools design, implement, and evaluate the softer competencies just as well as they can currently evaluate the hard ones. So what’s your take on how “softer” competencies are currently assessed in medical education? Drop me a line and let me know; I’d be happy to talk!

Brian Clare

About Brian Clare

Brian is the CEO of one45 Software. He joined one45 in 2003 and was one of the company's first developers. He currently serves in the MedBiquitous Curriculum Inventory Working Group as an Invited Expert.

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