Comments on “Defining professionalism in medical education: A systematic review”

Dear Sir

Professionalism teaching is often delivered to medical undergraduates through stereotypical, rule-based, ethical scenarios. It was with great interest, however, that we read the recent meta-analysis by Birden et al. (2014) which considered the definition of professionalism in the context of medical education. One key point argued is that professionalism is better taught through role models, both good and bad, through a narrative dialogue which considers the behaviours of doctors within the context of modern medical practice.

This theory is the guiding principle which underlies the recent introduction of a new professionalism tutorial at Cardiff University School of Medicine, UK, replacing previous didactic teaching. The session, based on the idea of medical “heroes and anti-heroes”, encouraged students to design and deliver short presentations on recent obituaries or fitness to practice cases. In turn, these presentations generated discussions amongst other students in the tutorial.

We used evaluation forms to gain feedback from students on their perspective of this new style of professionalism teaching. Of 81 responses, 73% of the students felt that this interactive method of learning was more effective than a lecture-based approach, and 95% of the students found the session to be at least fairly effective in teaching the duties of a doctor. Sixty-five percent of the students felt that the session was effective or very effective in teaching what constitutes unprofessional behaviour by medical professionals. One criticism we found, however, was that the students felt unprepared for the session, due to the fact that no structured learning outcomes were provided. Despite this, students commented that this facilitated engaging discussions, as a wide range of presentations were produced.

From this research, it is clear that the theories drawn together by the Birden et al. article can be realistically translated into improved medical teaching for undergraduates. Professionalism is a key aspect of medical training, as highlighted by the General Medical Council’s document “Tomorrow’s Doctors” (General Medical Council 2009). It is our hope that through better professionalism education, many of the ethical pitfalls encountered by doctors further into their careers can be prevented.

Declaration of interest: The authors report no conflicts of interest.