Nurturing professionalism in medical schools. A systematic scoping review of training curricula between 1990–2019

Abstract

Introduction: Professionalism is an evolving, socioculturally informed multidimensional construct that influences doctor-patient relationships, patient satisfaction and care outcomes. However, despite its clinical significance there is little consistency in how professionalism is nurtured amongst medical students. To address this gap a systemic scoping review of nurturing professionalism in medical schools, is proposed.

Methods: Levac’s framework and the PRISMA-P 2015 checklist underpinned a 6-stage systematic review protocol. Concurrent use of Braun and Clarke’s approach to thematic analysis and directed content analysis was used to identify the key elements in nurturing professionalism.

Results: 13921 abstracts were identified from six databases, 854 full-text articles reviewed, and 162 full-text included articles were included. The 4 themes identified through thematic analysis are consistent with findings of the directed content analysis. These were the definition of professionalism, the approaches, content, barriers and enablers to teaching professionalism.

Conclusion: Informed by a viable definition of professionalism and clear milestones nurturing professionalism nurturing professionalism begins with culturally appropriate training in clinical competence, humanistic qualities and reflective capacity. This process requires effective evaluations of professional identity formation, and the impact of the learning environment underlining the need for longitudinal assessments of the training process.

Keywords:

• Medical professionalism
• professionalism training
• medical education
• medical students

Disclosure statement

The authors report no declarations of interest.

Additional information

Notes on contributors

Yun Ting Ong

Yun Ting Ong is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Cheryl Shumin Kow

Cheryl Shumin Kow is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Yao Hao Teo

Yao Hao Teo is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Lorraine Hui En Tan

Lorraine Hui En Tan is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Ahmad Bin Hanifah Marican Abdurrahman

Ahmad Bin Hanifah Marican Abdurrahman is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Nicholas Wei Sheng Quek

Nicholas Wei Sheng Quek is a final-year undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Kishore Prakash

Kishore Prakash is a final-year undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Clarissa Wei Shuen Cheong

Clarissa Wei Shuen Cheong is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Xiu Hui Tan

Xiu Hui Tan is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Wei Qiang Lim

Wei Qiang Lim is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Jiaxuan Wu

Jiaxuan Wu is an undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Laura Hui Shuen Tan

Laura Hui Shuen Tan is a final-year undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Kuang Teck Tay

Kuang Teck Tay is a final-year undergraduate medical student at the Yong Loo Lin School of Medicine, National University of Singapore.

Annelissa Chin

Annelissa Chin, MSc (Info & Lib), is a Senior Librarian at the Medical Library at National University of Singapore (NUS) Libraries.

Ying Pin Toh

Ying Pin Toh, MBBS, MRCPaed, is a resident currently training in family medicine under the National University Health System (NUHS) cluster. Prior to entering residency training, she had worked in both adult and paediatric palliative care services with a special interest in paediatric palliative care.

Stephen Mason

Stephen Mason, PhD, PG, BA(Hons), is lead of the Research and Development Division of the Marie Curie Palliative Care Institute Liverpool.

Lalit Kumar Radha Krishna

Lalit Kumar Radha Krishna, MBChB, FRCP, FAMS, MA(Medical Education), MA(Medical Ethics), PhD(Medical Ethics), is a Senior Consultant at the Division of Supportive and Palliative Care in National Cancer Centre Singapore. A/Prof Lalit is presently pursuing an MD in Palliative Medicine at the Marie Curie Palliative Care Institute, University of Liverpool.