An Introductory Qualitative Exploration of Medical Student Perceptions of Professionalism at One Medical University

Professionalism as a competency in medical education has been defined in multiple ways. Irby and Hamstra offered three frameworks of professionalism in medical education. This study examines medical students' definitions of professionalism to assess whether they align with these frameworks.

We administered an open-ended questionnaire to 92 medical students at a single university in the United States. We conducted thematic coding of responses and calculated code frequencies.

The response rate was 54%. There were no observable differences between the responses of students in clinical versus preclinical training phases. The majority of comments (84%) reflected aspects of multiple frameworks from Irby and Hamstra and three emergent themes were identified. Most respondents (96%) cited aspects of the behavior-based framework. Most students' (66%) responses also aligned with the virtue-based framework. Emergent themes were "hierarchical nature of medicine," "academic environment/hidden curriculum," and "service and advocacy." "Service and advocacy" can be viewed as contexts for Irby and Hamstra's identity formation framework, but references did not align with the full definition.

Our findings suggest that students view professionalism through multiple frameworks and indicate a predominance of the behavior-based framework. Experiences with organizational culture and values may be important in students' definitions of professionalism.