Abstract
BackgroundThe development and maintenance of students’ professional behaviour and attitude is of increasing importance in medical education. Unprofessional behaviour in doctors has the potential to jeopardise patient safety, compromise working relationships, and cause disruption and distress. The General Medical Council issues guidance to medical schools and students describing the standards that should be attained.Nottingham University medical school introduced a ‘Concerns’ form in 2009, to create a standardised, transparent and defensible means of recording and handling complaints about adverse attitudes or behaviours. This paper reports an audit of the system over the first three years.MethodsThe routinely-held database was enhanced with further detail collected from relevant student records. The data were explored in terms of the types of complaint, students who were reported, the people who reported them, and the actions taken afterwards. The data were also mapped to the current GMC guidance.Results189 valid forms were generated, relating to 143 students. The form was used by a wide variety of people, including clinical and non-clinical teachers, administrators, Hall Wardens, and fellow students. The concerns ranged from infringements of regulations to serious fitness to practise issues. Most were dealt with by faculty or pastoral care staff but some required escalation to formal hearings. The complaints were mapped successfully to GMC documentation, with the highest proportions relating to the GMC categories ‘Good Clinical Care’ and ‘Working with Colleagues’.Male and ethnic minority students appeared to be more likely to have a Concern raised, but this is a tentative conclusion that requires a larger sample. Undergraduate (as opposed to Graduate Entry) students may also be at greater risk.ConclusionsA simple form, freely available, but designed to prevent frivolous or malicious use, has provided valuable data on unprofessional behaviour and the responses elicited. Some parts of the form require improvements, and these are underway to provide more efficient use, audit and review in future.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6920-14-196) contains supplementary material, which is available to authorized users.
Highlights
The development and maintenance of students’ professional behaviour and attitude is of increasing importance in medical education
Teherani et al categorised unsatisfactory behaviours demonstrated by students undertaking clinical performance examinations [3]. These were grouped, in decreasing order of frequency, as a diminished capacity for self-improvement, impaired relationships with patients, irresponsibility, poor initiative, and unprofessional behaviour associated with anxiety
At Nottingham we have developed a ‘Concerns’ form, which has been in use since 2009
Summary
The development and maintenance of students’ professional behaviour and attitude is of increasing importance in medical education. The issue of professional behaviour in medical students is a current ‘hot topic’ in medical education. As professionalism in doctors comes increasingly under the spotlight, so does the need to instil the right behaviours and attitudes in students, and to monitor adverse incidents. Teherani et al categorised unsatisfactory behaviours demonstrated by students undertaking clinical performance examinations [3]. These were grouped, in decreasing order of frequency, as a diminished capacity for self-improvement, impaired relationships with patients, irresponsibility, poor initiative, and unprofessional behaviour associated with anxiety. Studies from Australia [4] and the Netherlands [5] support the conclusion that there is international concern over the occurrence, identification, and remediation of unsatisfactory behaviours
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