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      Knowledge of medical professionalism in medical students and physicians at Shahid Beheshti University of Medical Sciences and affiliated hospitals—Iran

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          Abstract

          Although medical professionalism is a fundamental aspect of competence in medicine and a distinct facet of physicians’ competence, evidence suggests that the subject of professionalism is not taught or assessed as part of medical students’ curricula in Iran and many other countries. Assessing the knowledge of medical students and physicians about medical professionalism seems to be helpful in identifying the weaknesses of training in the field of professionalism and devise plans for future training on the subject.

          The present cross-sectional, quantitative, observational, and prevalence study recruited 149 medical interns, clinical residents, physicians, and professors working in hospitals selected through stratified random sampling using a questionnaire designed by the researchers and confirmed for its validity and reliability. The results were analyzed by Stata at a significance level of 0.05.

          Out of 149 cases, 61.64% were male with the mean age of 30.81 years. A total of 66 participants (44.29%) (95% confidence interval [CI]: 36.44%–52.44%) had heard and 83 (55.70%) (95% CI: 47.55%–63.55%) had not heard the term “medical professionalism” before the study. After adjusting for potential confounders, age and degree did not have statistically significant difference in assessed knowledge of medical professionalism, but sex had (mean difference: 5.88, P = 0.045), and the mean of the female was significantly higher than that of the male participants. The mean percentage of correct answers was 47.67.

          The present study demonstrated that the medical professionals working in the national healthcare system have an unfavorable theoretical knowledge about medical professionalism in Iran; although this does not indicate that their practices are unethical, it should be noted that one of the prerequisites of possessing a high level of medical professionalism and for establishing a proper relationship between the medical community and the patients is to have a proper knowledge of this concept. Improving behaviors and performances in medical professions requires adequate training on the concepts of medical professionalism and consequently the assessment of the levels of professionalism achieved in medical professionals.

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          Measuring patients' trust in their primary care providers.

          Existing scales to measure trust in physicians have differing content and limited testing. To improve on these measures, a detailed conceptual model was constructed and a large item pool (n = 78) was generated following a detailed conceptual model and expert review. After pilot testing, the best-performing items were validated with a random national sample (n = 959) and a regional sample of HMO members (n =1,199). Various psychometric tests produced a 10-item unidimensional scale consistent with most aspects of the conceptual model. Compared with previous scales, the Wake Forest physician trust scale has a somewhat improved combination of internal consistency, variability, and discriminability. The scale is more strongly correlated with satisfaction, desire to remain with a physician, willingness to recommend to friends, and not seeking second opinions; it is less correlated with insurer trust, membership in managed care, and choice of physician. Correlations are equivalent with lack of disputes, length of relationship, and number of visits [corrected].
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            Medical professionalism in the new millennium: a physician charter.

            , , (2015)
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              Wanted: role models - medical students’ perceptions of professionalism

              Background Transformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education. Methods Survey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA). Chi-square and Fischer’s exact test (for cell count less than 5) were used to derive p-values for categorical variables by level of student learning. Results The response rate was 45.6% (255 of 559 students) for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship). Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to “celebrate” professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was highlighted in the answers to the open ended questions. Conclusions Students identify the need for strong positive role models in their learning environment, and for effective evaluation of the professionalism of students and teachers. Medical school leaders must facilitate development of these components within the MD education and faculty development programs as well as in clinical milieus where student learning occurs.
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                Author and article information

                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MEDI
                Medicine
                Wolters Kluwer Health
                0025-7974
                1536-5964
                November 2016
                11 November 2016
                : 95
                : 45
                : e5380
                Affiliations
                [a ]Department of Medical Ethics
                [b ]School of Traditional Medicine
                [c ]Shahid Beheshti University of Medical Sciences
                [d ]Iran University of Medical Sciences, Tehran, Iran.
                Author notes
                []Correspondence: Mehrzad Kiani, Medical ethics department, school of atraditional medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran (ISLAMIC REPUBLIC OF) (e-mail: mehrkia55@ 123456gmail.com)
                Article
                05380
                10.1097/MD.0000000000005380
                5106075
                27828869
                b2d9b813-d4c0-4730-86b7-ebca56006faf
                Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved.

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0

                History
                : 8 November 2015
                : 2 October 2016
                : 3 October 2016
                Categories
                5400
                Research Article
                Observational Study
                Custom metadata
                TRUE

                medical professionalism,medical ethics,medical education

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