Author: Kaul B, Teal C.R and Greenberg S.B Publication Year: 2015
Summary: Medical students and faculty perceive appropriate consequences for lapses in medical professionalism differently. This study explores these differences.
Description: Introduction: There has been a renewed emphasis placed on teaching and evaluating professionalism; however, little research has been done on addressing lapses when identified. In order to develop guidelines on remediation, we must first understand how learners and faculty view "unprofessional behavior." The goal of this study was to examine differences in perspective between medical students and faculty regarding appropriate consequences for lapses in medical professionalism.

Methods: An observation cohort design was utilized to survey a cross-sectional sample of medical students and Internal Medicine faculty at Baylor College of Medicine. Participants were asked to assign ordinal level sanctions to twenty-five scenarios involving first-time lapses in professionalism with optional area for open-ended text. A mixed methods analysis was conducted on data collected.

Results: 513 medical students and 37 faculty members completed the surveys. There was a significant decrease in the severity of sanctions applied between preclinical and clinical years. The faculty were more like preclinical students in their pattern of sanction assignment. Clinical students were less likely to choose "expulsion" than their preclinical counterparts but no cohort had >35% of respondents selecting expulsion.

Conclusion: Clinical students were more lenient than preclinical students and faculty in the severity of sanctions applied. There was no significant difference between preclinical students and faculty on these measures. All cohorts favored remediation suggesting that short of expulsion, there is a lack of consensus regarding appropriate consequences for lapses in professionalism.

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