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Approaches to assessment and remediation of professionalism in Australian and New Zealand medical schools

Oral Presentation
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Oral Presentation

12:00 pm

28 February 2024

M212

Assessment of professionalism

Presentation Description

Conor Gilligan1
Karen D'Souza2, Lynette Clearihan3, Charlotte Denniston4, Vicki Jones5, Zsuzsoka Kecskes6, Margaret Schnitzler7 and Tim Wilkinson8
1 EACH
2 School of Medicine Deakin University
3 Monash University
4 University of Melbourne
5 University of Auckland
6 University of Wollongong
7 University of Sydney
8 University of Otago




Background
Professionalism is a high stakes competency in healthcare – its presence linked to a safety culture and its absence linked to poor patient outcomes. We sought to understand how medical schools in Australia and New Zealand are defining, teaching and assessing professionalism, with particular interest in the type and effectiveness of remediation strategies being used.


Summary of work
A mixed methods survey of all Medical Schools in Australia and New Zealand regarding their approaches to students learning about professionalism was undertaken in 2021 to identify good practice and develop guidance for future practice. 


Results
22 of 23 medical schools responded. Although 86% had a definition of professionalism, these often comprised a number of components – from values to behaviours, attributes, codes of conduct to statements or demonstration of these. 

All assessed professionalism however only 63% defined the expected attributes of a future doctor and linked these with assessment. 

Most medical schools used a variety of assessment modalities - observed clinical encounters (n=21/23) and incident reporting (n=21/23) were the most common. There were variable approaches to remediating professionalism lapses and lack of certainty about effectiveness of these approaches.


Discussion and Conclusions 
Lack of a clear definition and expected behavioural attributes of professionalism undermines the effectiveness of systematic programs of assessment. Measuring and remediating issues in professionalism can be addressed in varying ways, either as a judgement (hurdle or summative assessment) or as a diagnosis (set of observed behaviours), with the option of using formal policies and procedures, however their effectiveness is not well studied. 


Take-home messages / implications for further research or practice 
Assessment of professionalism requires a 'whole of system' approach through being explicit about what attributes or components of professionalism are expected, taught, role-modelled and assessed. Remediation of professional behavioural lapses is an area requiring further cross- institutional study. 


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