Preclinical medical student observations associated with later professionalism concerns

Abstract

Purpose: Professionalism is a core physician competency and identifying students at risk for poor professional development early in their careers may allow for mentoring. This study identified indicators in the preclinical years associated with later professionalism concerns.

Methods: A retrospective analysis of observable indicators in the preclinical and clinical years was conducted using two classes of students (n = 226). Relationships between five potential indicators of poor professionalism in the preclinical years and observations related to professional concerns in the clinical years were analyzed.

Results: Fifty-three medical students were identified with at least one preclinical indicator and one professionalism concern during the clinical years. Two observable preclinical indicators were significantly correlated with unprofessional conduct during the clinical years: Three or more absences from attendance-required sessions (odds ratio 4.47; p=.006) and negative peer assessment (odds ratio 3.35; p=.049).

Conclusions: We identified two significant observable preclinical indicators associated with later professionalism concerns: excessive absences and negative peer assessments. Early recognition of students at risk for future professionalism struggles would provide an opportunity for proactive professional development prior to the clinical years, when students’ permanent records may be affected. Peer assessment, coupled with attention to frequent absences, may be a method to provide early recognition.

Acknowledgements

Ethical approval: This study was approved by the Institutional Review Board (IRB) of Wake Forest School of Medicine.

Disclosure statement

The authors report no declarations of interest. None of the authors have financial conflicts of interests to disclose. There was no funding or support for this manuscript. All authors had full access to all the data in the study and take responsibility for the integrity of the data and accuracy of the data analysis.

Notes on contributors

Cynthia A. Burns, MD, is the Director of the Internal Medicine Clerkship & Acting Internships, Associate Professor, Department of Internal Medicine, Section on Endocrinology & Metabolism, Wake Forest School of Medicine.

M. Ann Lambros, PhD, is an Associate Professor, Department of Economics , Wake Forest University.

Hal H. Atkinson, MD, MS, is the Director of the Internal Medicine Residency Program, Associate Professor, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine.

Gregory B. Russell, MS, is a Senior Biostatistician, Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine.

Michael T. Fitch, MD, PhD, is a Professor and Vice Chair for Academic Affairs, Department of Emergency Medicine, Wake Forest School of Medicine.