A shared professional framework for anatomy and clinical clerkships

Threats to the professionalism of medical practice in the United States have resulted in an intense focus by educational organizations on what professionalism is, on how to define it, and how to evaluate it. This essay discusses alternative educational frameworks in which professionalism can be located. As the traditional analytic framework (knowledge, skills, and attitudes) and developmental frameworks are more familiar, emphasis will be placed on a "synthetic" framework that expresses a student's progress as "reporter," "interpreter," and "manager/educator." This "RIME" framework attempts to capture the classic rhythm of observation-reflection-action that is familiar to all scientists and clinicians, and attempts to express in less generic, more behavioral terms how skills, knowledge, and attitudes must all be brought to bear at the same time by a successful student. It is argued that the complexity of professional development can be embraced with simplicity, without being simplistic.