The title of this excellent book uses ‘Medical’ in the broadest possible sense, as the information contained within the book is generic to all healthcare teachers. It is a multi-author book, with t...

A Practical Guide for Medical Teachers.

Introduction: The suggestion that empathy “declines” or “erodes” as students progress through medical school has largely rested on observations reported from Jefferson Medical College in the United States using the Jefferson Scale of Physician Empathy (JSPE) developed by Hojat and colleagues. Now that the student version of JSPE has been administered to medical students in more than a dozen countries, it is timely to consider whether or not the Jefferson “case study” and the conclusions drawn from it are generalisable.Methods: A literature research was conducted on MEDLINE in mid-2014 to identify studies reporting administrations of the Student version of JPSE (JSPE-S) to cohorts of medical students and the means for studies and their sub-parts conducted in Japan, South Korea, China, Kuwait, India, Iran, UK, USA, Australia, Brazil, Colombia, the Dominican Republic and Portugal.Results: The means of these studies from a dozen countries outside the USA consistently cluster round 75% out of the possi...

Reconsidering the "decline" of medical student empathy as reported in studies using the Jefferson Scale of Physician Empathy-Student version (JSPE-S).

Principles of Assessment

Review of studies published in medical education journals over the last decade reveals that teaching medical professionalism is essential, yet challenging. According to a recent Best Evidence in Medical Education (BEME) guide, there is no consensus on a theoretical or practical model to integrate the teaching of professionalism into medical education. The aim of this article is to outline a practical manual for teaching professionalism at all levels of medical education. Drawing from research literature and author’s experience, Twelve Tips are listed and organised in four clusters with relevance to (1) the context, (2) the teachers, (3) the curriculum, and (4) the networking. With a better understanding of the guiding educational principles for teaching medical professionalism, medical educators will be able to teach one of the most challenging constructs in medical education.

Twelve Tips for teaching medical professionalism at all levels of medical education

Background: Evidence suggests that doctors and medical students use different strategies to evaluate unprofessional behaviour. Anecdotal evidence suggests that the public and profession may judge misdemeanours differently. Aims: To explore whether members of the public will judge examples of medical student misconduct more harshly than medical students and doctors. Methods: This was a pilot cross-sectional survey of the public, medical students and doctors. For 10 hypothetical examples of medical student misconduct and one of appropriate conduct in a questionnaire, participants were asked to (1) indicate the level of acceptability and (2) to choose the sanction they considered most appropriate for each. Results: Overall, doctors were harsher than students and the public were harsher than doctors in their choice of sanctions. The most lenient outcomes were selected by students for deception in an examination, nonattendance and dishonesty. The most punitive were chosen by the public for forgery, criminal conviction, misrepresenting qualifications, alcohol and drug misuse and lack of insight. Conclusions: The public judge misdemeanours among medical students more harshly than do medical students and medical professionals. This implies that views of lay members should be sought by medical schools when promoting professionalism and considering cases of medical student misconduct.

https://www.tandfonline.com/doi/pdf/10.3109/0142159X.2011.599450

Unprofessional behaviour in medical students: A questionnaire-based pilot study comparing perceptions of the public with medical students and doctors

Aim: To identify behaviours and attitudes that exhibit poor professionalism at the proto-professional stage of undergraduate health professions education, and investigate the extent and nature of agreement by faculty on appropriate responses by undergraduate students in the UK. Methods: A preliminary inventory of 69 items of behaviour and attitude was derived from literature review and 1-month observation at a UK teaching site. Reference Groups were formed by e-mail solicitation of senior medical educators in the UK and the Dundee Medical School to identify consensus on the relevant items and the appropriate responses. Results: The multi-stage study generated a preliminary inventory with 42 items and identified clear areas of consensus among faculty on appropriate responses by students to lapses in professionalism. Conclusions: There is a broad range of consensus on the relevance of more than 40 forms of poor professionalism at the protoprofessional undergraduate level and the appropriate responses that students should feel empowered to make to observed lapses. These data will give guidance in the development of e-learning programmes for UK students and to undergraduate Fitness to Practise Committees as they seek consistency in responding to lapses in professionalism by students and teachers at the undergraduate level.

Development of inventory for polyprofessionalism lapses at the proto-professional stage of health professions education together with recommended responses

Summary

Background: As part of a larger project to identify appropriate responses and sanctions for lapses in professionalism by health profession students and trainees – and their teachers – we formed reference groups of medical educators to give preliminary guidance. We hope that these data will help to generate ‘a greater consistency’ to fitness-to-practice procedures in UK medical schools, and across the health professions, as called for by the UK Council for Healthcare Regulatory Excellence in 2009.



Methods:  Having previously identified 42 forms of poor professionalism among students at the ‘proto-professional’ stage of undergraduate training, of which 37 could also occur in clinical teachers, we asked reference groups of UK medical educators (n = 27) and from one medical school (n = 35) to recommend appropriate responses by students if they observed lapses of professionalism in their teachers.



Results:  There was clear congruence within and between the two reference groups on recommended responses for 90 per cent of the lapses.



Discussion:  This congruence amounts to a broad range of consensus among 62 UK medical educators about whether students should ignore, challenge the individual, discuss with peers or report the lapse to a more senior person, if their teachers exhibit certain behaviours. We hope that these data will help to generate a national consensus on appropriate responses that can be used to foster a culture of ‘local resolution’ in which juniors feel empowered to address poor professionalism, as well as guide undergraduate fitness to practice procedures. Dissemination and validation of these findings will now be undertaken.

Recommended responses to lapses in professionalism.

Recent trends in medical education demand practicing physicians to be competent in playing multiple roles. Life-long learning skills underpinned by research & scholarly activity will enable them to play these roles adequately. Therefore, the introduction of structured training in research during early undergraduate years is pivotal. This would enable trainee physicians to develop essential skills; the institutions will grow in terms of visibility & ranking; the trainers and supervisors will be satisfied in terms of research productivity and, most importantly the patients will benefit in terms of improved clinical outcomes. 
doi: https://doi.org/10.12669/pjms.39.5.7137 
How to cite this: Burney AA, Burney IA, Dherwani K. Undergraduate research in medical schools in Pakistan: Relevance, Needs, and Importance. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7137 
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Kabir Dherwani

Papers

Development of inventory for polyprofessionalism lapses at the proto-professional stage of health professions education together with recommended responses

Recommended responses to lapses in professionalism.

Undergraduate research in medical schools in Pakistan: Relevance, Needs, and Importance