Using Graphic Medicine to Explore Perceptions of Professionalism in Early Medical Education: A Pilot Study

Lapses in professionalism remain a critical concern in medical education, with early unprofessional behaviors linked to adverse outcomes in clinical practice. Traditional interventions focus on reflection and mentorship, but alternative approaches such as graphic medicine may provide new opportunities for awareness and discussion.

This pilot study sought to evaluate comics depicting professional and unprofessional behaviors as a tool for measuring medical student awareness of professionalism, and assess perceptual discrepancies between students and supervising faculty.

Faculty at the University of Louisville School of Medicine provided examples of professional and unprofessional student behaviors. These examples were transformed into comics using ChatGPT, each depicting both classroom and clinical contexts. M2/M3 medical students and supervising faculty were then asked to rate the professionalism depicted in each comic using a Qualtrics-based survey and to provide qualitative feedback on the graphic medicine approach.

Faculty (N=14) and students (N=20) differed in their perception of professionalism, with students rating unprofessional behaviors as less extreme in comparison. Conversely, professional behaviors were rated more positively by faculty than by students. While both groups considered the comics realistic and engaging, participants questioned their effectiveness as a learning tool in the survey format. Students also completed the survey more quickly than faculty on average, suggesting less engagement with the material in its existing survey format.

Discrepancies in perceptions of professionalism between students and faculty may explain lapses in medical professionalism exhibited by M2/M3 students at the University of Louisville. Though provided in survey format, graphic medicine may serve as an engaging entry point for discussion, through integration into small-group or reflective learning environments, for effective prevention of medical professional decline.