Department of Medicine Publications
Before the White Coat: Perceptions of Professional Lapses in the Pre-clerkship
Document Type
Article
Publication Date
1-2005
Journal
Medical Education
Volume
39
Issue
1
First Page
12
Last Page
19
URL with Digital Object Identifier
http://dx.doi.org/10.1111/j.1365-2929.2004.02028.x
Abstract
BACKGROUND: It has been shown that the professional development of clinical clerks is influenced by their experiences of unprofessional behaviour, but the perceptions of pre-clerkship students have received relatively little attention. Our purpose was to develop a greater contextual understanding of the situations in which pre-clerkship students encounter professional challenges, and to investigate what pre-clerkship students consider to be professional lapses in these situations.
METHODS: We conducted 4 focus groups (n = 22 students); transcripts were analysed by 3 researchers using grounded theory.
RESULTS: Pre-clerkship students reported lapses in the areas of communicative violation, role resistance, objectification, accountability and harm, validating our previous clerkship-based framework. However, they also reported numerous lapses committed by fellow students and many instances of lack of accountability to students, which were not reported by clerks. Many of their reports involved non-health care professionals.
CONCLUSIONS: The willingness of pre-clerkship students to report on fellow students was associated with a tendency to blame their colleagues, at the expense of a more reflective analysis, and their views on professionalism appeared to be generic rather than medicine-specific. We should reinforce students' appreciation of these generic values and add on medicine-specific values as the students progress, in order to better cultivate professionalism without entitlement.
Notes
Dr. Lorelei Lingard is currently a faculty member at The University of Western Ontario.