Parents as Teachers and Evaluators of Medical Student Professionalism

Abstract

Teaching and evaluating professionalism in medicine has become an increasingly important task in medical student and resident education. The publication of a report noting that unprofessional behaviors of physicians were “strongly associated with prior unprofessional behavior as a medical student” led to increased interest in the assessment of professionalism competencies of students, residents, and physicians. One element of professionalism reflects the patient/clinician relationship and communication. The many ways to evaluate student competency in this area include OSCEs, standardized patients, videotaping student interaction with patients, role playing, and direct observation of student interaction with patients. The USMLE Clinical Skills exam is one example of addressing medical student competence in communication skills using a high stakes exam. Failure in this exam would mean the inability to obtain a medical license. Recent efforts have expanded student and resident evaluation to a “360 Degree” process, where everyone interacting with students and residents, including patients, evaluates student or resident competency. No studies, however, address the role of parents in both teaching medical students and assessing their competency in pediatrics, although some studies address the role of patients as teachers or their role and effectiveness of patients as evaluators of student competency. Researchers find the involvement of patient instructors valuable both to medical student education and to the patients themselves. Liu and colleagues, in this issue of Ambulatory Pediatrics, contribute an important finding about parents’ assessment of medical student communication skills. Their excellent work lays the groundwork for further research in assessing medical student professionalism. This study is a pioneer in the use of patient narratives to understand the complexity and perspectives of patients about student performance. Moreover, the science of assessment of student professionalism, communication, and relationship skills is still in its infancy with high stakes exams using standard-