Moral perception, educational environment, and development of medical professionalism in medical students during the clinical rotations in Peru

Montserrat San-Martín,Adelina Alcorta-Garza,Edgar M Rivera,Luis Vivanco

doi:10.1007/s40889-016-0017-8

Abstract

The aim of this study was to determine the relationship between a clinical environment and the development of empathy, teamwork, and lifelong learning in medical students who are doing their first clinical rotation. The Jefferson Scales of Empathy (JSE), Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), and Jefferson Scale of Physician Lifelong Learning (JeffSPLLL) were administered to 60 sixth-year medical students, before and after their first clinical rotation in five health care institutions. The Dundee Ready Education Environment Measure questionnaire (DREEM) was administered to measure their perception of the educational environment after the rotation was finished. Scores were compared to determine differences before and after the rotation. Other variables associated with gender, age, and moral perception, were included into the comparisons. A correlation analysis was also performed. The analyses confirmed a positive association among the measured elements of medical professionalism. Lifelong learning decreased (p = 0.03) after the rotation. Associations were found between the educational environment and the development of lifelong learning (P = +0.29; p = 0.03); and between the development of attitudes toward teamwork and the educational environment (P = +0.29; p = 0.03). During the rotational internship, the development of some components of professionalism in medical students is influenced by the clinical environment. Gender, age, and moral perception influence the development of some elements of medical professionalism and the perception of the educational environment.

Highlights

Ethics and medicine are two fields of knowledge that have been closely related since their origins
In countries such as Peru, where public hospitals have insufficient resources to respond to the social demands (Herrera-Añazco et al 2015a), teachers are confronted with important difficulties and challenges to adequately respond to the training needs of the students and the doctors in training (Herrera-Añazco et al 2015b)
The first objective of this study was to measure the effect that the first clinical rotation has on the development of empathy, the skills of inter-professional collaborative work, and lifelong medical learning in the medical student of a university of Peru

Summary

Introduction

Ethics and medicine are two fields of knowledge that have been closely related since their origins. Recent studies have warned about the challenges and difficulties that this model poses to health care institutions, which are forced to know how to combine professional responsibility toward the patient, with the responsibility of teaching the student (Duvivier et al 2014) In countries such as Peru, where public hospitals have insufficient resources to respond to the social demands (Herrera-Añazco et al 2015a), teachers are confronted with important difficulties and challenges to adequately respond to the training needs of the students and the doctors in training (Herrera-Añazco et al 2015b). The first objective of this study was to measure the effect that the first clinical rotation has on the development of empathy, the skills of inter-professional collaborative work, and lifelong medical learning in the medical student of a university of Peru. The fourth objective was to determine the existence of an association between the development of empathy, team work, and lifelong learning; as well as the relationship that exists between their development and the perception of the educational environment offered by the clinical rotation

Participants

Design

Results

Discussion

Compliance with ethical standards