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Student professionalism in clerkships.

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Most medical clerkship assessments lack detailed professionalism feedback. This study found that few narrative assessments provide specific examples, hindering student learning and development of professional behaviors.

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Area of Science:

  • Medical Education
  • Professionalism Assessment

Background:

  • Assessing professionalism in medical clerkships is challenging.
  • Existing literature often focuses on generalities or negative examples.
  • Current assessment tools frequently rely on Likert scales.

Purpose of the Study:

  • To investigate the frequency and detail of professionalism descriptions in end-of-clerkship narrative assessments.
  • To identify themes within detailed narrative feedback on professional behaviors.

Main Methods:

  • Qualitative thematic analysis of de-identified final clerkship narratives.
  • Utilized ATLAS.ti software and a six-step thematic approach.
  • Analyzed narratives from academic years 2018-2020.

Main Results:

  • Only 23% of narratives mentioned professionalism; 16% of those offered detailed descriptions.
  • Seven core themes emerged from detailed feedback: time management, follow-through, engagement, work ethic, communication, exceeding expectations, and situational awareness.
  • Identified behaviors range from basic to advanced, relevant to residency training.

Conclusions:

  • Narratives lacking specific examples of professionalism are ineffective for learning and assessment.
  • A hierarchical framework can guide students and supervisors in providing actionable feedback.
  • The proposed model promotes a growth mindset for professionalism development.