Document Type : Original Article

Authors

1 Virtual School of Medical Education and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran Department of Medical Education, Virtual University of Medical Sciences, Tehran, Iran

2 Department of Medical Education, Virtual University of Medical Sciences, Tehran, Iran

3 Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

INTRODUCTION: Professionalism is an important measure of the efficacy of the medical education.
Some studies showed that dominant values changed during clinical education, and some negative
values might replace positive ones. In this regard, this study aimed to explore barrier to professionalism
in clinical medical education.
METHODS: This was a qualitative study conducted with the content analysis method. A total of 34
interviews with 23 participants were done.
RESULTS: Two hundred forty‑eight original codes were extracted from the research data, which were
classified under the theme of “Academic Exhaustion” and the four following categories: “stressful
environment, “human conflict,” “Poor Inter professional collaboration,” and “emotional exhaustion.”
DISCUSSION: It can be admitted that having full knowledge of the factors influencing professionalism
from the viewpoint of stakeholders can improve the environmental and organizational conditions to
prevent professional misconduct.

Keywords

1. Determining problems experienced by student nurses in their
work with clinical educators in Turkey. Nurse Educ Today
2007;27:491‑8.
2. Lowenstein AJ, Bradshaw MJ. Fuszard’s Innovative Teaching
Strategies in Nursing. 3rd ed. Boston, MA: Jones and Bartlett;
2004.
3. Chan DS. Validation of the clinical learning environment
inventory. West J Nurs Res 2003;25:519‑32.
4. Walking the balance BEAM: The art and science of becoming a
successful clinical teacher. Fam Med 2002;34:498‑9.
5. Lowenstein AJ, Bradshaw MJ. Fuszard’s Innovative Teaching
Strategies in Nursing. 3rd ed. Maryland: An Aspen Publication; 2001.
6. The value of nursing: A literature review. Nurs Ethics
2007;14:716‑40.
7. Professionalism in medical education, an American perspective:
From evidence to accountability. Med Educ 2006;40:607‑17.
8. Goldstein EA, Maestas RR, Fryer‑Edwards K, Wenrich MD,
Oelschlager AM, Baernstein A, Kimball HR. Professionalism in
medical education: an institutional challenge. Academic Medicine.
2006 Oct 1;81(10):871‑6.
9. Accreditation Council of Graduate Medical Education. Program
Director Guide to the Common Program Requirements. Version 2;
2007. Available from: http://www.acgme.org/Portals/0/PDFs/
commonguide/CompleteGuide_v2%20.pdf. [Last accessed on
2017 Apr 20].
10. Frohna JG. The American Board of Pediatrics and The Association
of Pediatric Program Directors. Teaching and Assessing
Professionalism: A Program Director’s Guide. 2008.
11. Van Mook WN, van Luijk SJ, O’Sullivan H, Wass V,
Harm Zwaveling J, Schuwirth LW, et al. The concepts of
professionalism and professional behavior: Conflicts in both
definition and learning outcomes. Eur J Int Med 2009;20: E85‑9.
12. The desired moral attitude of the physician: (I) empathy. Med
Health Care Philos 2012;15:103‑13.
13. Viewpoint: Today’s professionalism: Engaging the mind but not
the heart. Acad Med 2005;80:892‑8.
14. Defining medical professionalism: A qualitative study. Med Educ
2007;41:288‑94.
15. Medical professionalism: Can it be taught? Acad Med 2005;
80:883‑4.
16. Addressing the hidden curriculum: Understanding educator
professionalism. Med Teach 2007;29:54‑7.
17. University of Toronto Governing Council. Standards of Professional
Practice Behaviour for all Health Professional Students; 2008.
Available from: http://www.governingcouncil.utoronto.ca/Ass
ets/Governing+Council+Digital+Assets/Policies/PDF. [Last
accessed on 2015 Jan 16].
18. Swing SR. The ACGME outcome project: Retrospective and
perspective. Med Teach 2007;29:648‑54.
19. Three approaches to qualitative content analysis. Qual Health
Res 2005;15:1277‑88.
20. Spannagel C, Gläser‑Zikuda M, Schroeder U. Application of
qualitative content analysis in user‑program interaction research.
Q Soc Res 2005;6:1-17.
21. Qualitative content analysis in nursing research: Concepts,
procedures and measures to achieve trustworthiness. Nurse Educ Today 2004;24:105‑12.
22. Rigor or reliability and validity in qualitative research: Perspectives,
strategies, reconceptualization, and recommendations. Dimens
Crit Care Nurs 2017;36:253‑63.
23. Nurses’ perceptions of preoperative teaching for ambulatory
surgical patients. J Adv Nurs 2008;63:619‑25.
24. Clinical support roles: A review of the literature. Nurse Educ
Pract 2004;4:177‑83.
25. Jager AJ, Tutty MA, Kao AC. Association between physician
tension and identification with medicine as a calling. Mayo Clin
Proc 2017;92:415‑22.
26. A schematic representation of the professional identity formation
and socialization of medical students and residents: A guide for
medical educators. Acad Med 2015;90:718‑25.
27. Thomas EJ, Sexton JB, Helm Reich RL. Discrepant attitudes about
teamwork among critical care nurses and physicians. Crit Care
Med 2003;31:956‑9.
28. Bridges D, DavidsonRA, Soule OdegardP, MakiIV, Tomkowiak J.
Inter professional collaboration: Three best practice models of
inter professional education. Medical education online. 2011 Jan
1;16(1):6035.
29. Gaberson KB, Oerman MH. Clinical Teaching Strategies in
Nursing. 3rd ed. New York: Springer Publishing Company;
2010.