Phd ceremony Ms. H. Dekker: Teaching and learning professionalism in medical education

For centuries, medical students have developed their professional values and beliefs while participating in a traditional apprenticeship relationship with their clinical teachers. This implicit approach it is no longer felt to be sufficient to prepare students for professional practice. Prompted by alarming headlines in the media, the general public have come to realize that medical professionalism is under threat. Therefore, there is a widely acknowledged call for professionalism to be trained explicitly. However, the concept of professionalism is complex to define. This makes the question of how professionalism should be learned and taught a difficult one. In this thesis an overview is presented of a professional development course for clerks. The rationale underpinning the course is that professionalism is a reflective, second-order competence. Small group sessions in which students learn to reflect on self-selected topics provide a suitable training context in which professionalism can be developed. As part of their portfolio assignments, students have to write reflective essays. Our findings suggests that written feedback on students’ reflective essays should be formulated as questions, be positive in tone and tailored to the individual student’s reflective level in order to stimulate students to reflect at a slightly higher level. Teachers are important role models for young trainee doctors. Unfortunately, sometimes they show unprofessional behaviour. Perceptions of what is or is not appropriate behaviour differ largely. Applying a fixed code of conduct is therefore troublesome. We recommend making students and teachers aware that other people’s boundaries might not be the same as their own.