Dr. Mark Archambault
Purpose Teaching and assessing professionalism in a physician assistant (PA) program is a requirement for accreditation by the Accreditation Review Commission on Education for the Physician Assistant (ARC-PA). Medical education has an obligation to the profession and the public to teach professionalism and to assess the student’s progress and if necessary, remediate those students who may have misconduct behavior. There has been much research done over the past sixty years that has studied professionalism in medical students beginning with an article by Robert Merton in 1957 on the sociology of medicine. 1 His studies have contributed to identifying the socialization of the medical student and the impact on developing professional behaviors. The topic seems to be very broad in concept and there is very limited consensus on the definition of professional misconduct and effective methods of remediation. There is substantial research that does demonstrate that the student misconduct that occurs in training, can also be found in the same practicing professionals who have had professional disciplinary actions imposed by state licensing boards. Methods This literature search was conducted using PubMed and MEDLINE queries for articles and studies related to misconduct and remediation in the education process. The literature search was limited to articles published in the last ten years and included search terms of professionalism definitions, medical student misconduct, and professionalism remediation methods. Results Several of the studies did seek to identify how professional misconduct is defined so consistent terminology can be assigned. They also studied more recent professional evaluation
2 tools and methods in medical students that included using frameworks including the theory of professional behavior (TBH). These concepts are the basis of several of the studies that were used to evaluate student’s process of developing professional behaviors. The process and evaluation of the remediation process was made more because it is difficult to establish a consistent method and utility of remediation. Conclusion Defining professionalism is a complex and difficult task. Social norms define professionalism and proper conduct. These norms are learned in medical training through the interactions with faculty, mentors, preceptors, other medical team members, and fellow classmates. If we can understand the social norms we can further define and predict lapses of professionalism by students. There is difficulty in developing remediation strategies because of the lack of consensus of professional misconduct definition. Once there is consensus on the terminology the remediation processes can be developed, and best practices established and eventually evidenced based remediation as well.
Fisher J. Defining Student Professional Misconduct and Effective Remediation. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2021; 3(3).
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