Abstract
This article was migrated. The article was not marked as recommended. Introduction: The escalating problem of unprofessionalism calls for 'teaching' medical professionalism in a more explicit manner. Early clinical exposure (ECE) presents the issues pertaining to medical professionalism to the students and reflection note writing evokes critical process of thought and analysis required for learning. The two, therefore, may be used for teaching medical professionalism. Methods:Two hundred students of Ist MBBS were taken for ECE to a medical intensive care unit (ICU). There, the students observed different ongoing activities and critical patients, a doctor discussed some cases with them and they also interacted with the relatives of patients admitted in the ICU. Thereafter, students wrote a 'reflection' note describing what did you see? so what? and now what? Students were given an Objective Structured Clinical Examinations (OSCE), one before the ECE and one after it, for assessing any change in their professional behaviour.Analysis of reflection notes was done thematically and of OSCE scores using paired t-test (p<0.05). Results: The analysis of reflection notes revealed the budding of different elements of professionalism among the students. Post-visit OSCE scores also showed significant improvement. Conclusion: Incorporation of reflection with ECE is helpful in laying the foundation of medical professionalism among pre-clinical students.
Highlights
The escalating problem of unprofessionalism calls for ‘teaching’ medical professionalism in a more explicit manner
While early clinical exposure will present the conundrums of medical professionalism to the students, reflection note writing will be instrumental in evoking the critical thought and analysis required for addressing them, thereby leading to budding of the elements of medical professionalism among them
The experience was rated as being quite relevant to pre-clinical phase (88.5%) by the students and found to be helpful in enhancing academic learning (95.0%). These findings suggest that the students were able to identify the elements of professionalism with the help of the intensive care unit (ICU) visit and their reflection on it
Summary
The escalating problem of unprofessionalism calls for ‘teaching’ medical professionalism in a more explicit manner. The tools of ‘early clinical exposure’ (ECE) (Benbassat and Schiffman, 1976; Ali M et al, 1977; Johnson and Scott, 1998; McLean 2004; Lie et al, 2006; Basak et al, 2009; Dornan et al, 2009; Helmich et al, 2011; Ali K et al, 2018) and ‘reflection’ (Charon, 2001; Sandars, 2009; Hargreaves, 2016) have been variously used to enhance learning: teaching clinical methods, case base learning, sensitizing students towards patient care, helping them develop their self–identity, motivating them, etc The authors believe these two tools when used in conjunction can be used to inculcate the elements of professionalism among pre-clinical students who are the future doctors. To reaffirm the impact of the ECE and reflection on professional behaviour in an objective manner, an Objective Structured Clinical Examination (OSCE) may be used (Davis, 2003; Turner and Dankoski, 2008; Brannick, ErolKorkmaz and Prewett, 2011; Patrício et al, 2013; Falcone, Claxton and Marshall, 2014)
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