Johnston Jennifer Laura, Cupples Margaret Elizabeth, McGlade Kieran John, Steele Keith
GP/Clinical Teaching Fellow, Department of General Practice, Queen's University Belfast, UK.
Educ Prim Care. 2011 Sep;22(5):321-7. doi: 10.1080/14739879.2011.11494026.
Using a novel tool based on General Medical Council (GMC) standards, this cross-sectional survey aimed to assess UK medical students' professional attitudes at different stages of the curriculum, and to investigate the influence of the hidden curriculum on these attitudes through exposure to unprofessional behaviour during the medical course.
An anonymous online questionnaire was developed, reflecting core professional competences outlined in Good Medical Practice. First, third and fifth year students received Section 1: 'Attitudes to professionalism'; third and fifth year students also received Section 2: 'Exposure to unprofessional behaviour'. 'Professionalism score' (Section 1) and 'Exposure score' (Section 2) were analysed using ANOVA. Thematic analysis was used to analyse free text.
Response rate was 50.8% (363/714). Female (F=18.24, p < 0.001) and first year students (F=12.22, p < 0.001) had significantly higher Professionalism scores. Professionalism scores for male students showed a significant stepwise decline from first year to fifth year. Fifth year students had significantly higher Exposure scores (F=23.4, p < 0.001). Qualitative themes included bullying, lack of accountability and sexism.
Sensitivity to professionalism, as defined by the GMC, was higher and exposure to unprofessional behaviour lower in first year compared to fifth year. Addressing the hidden curriculum is crucial to protect professional development; GP teachers should be aware of these findings and are ideally placed to provide mentorship and support to medical students.
本横断面调查使用一种基于英国医学总会(GMC)标准的新型工具,旨在评估英国医学生在课程不同阶段的职业态度,并通过在医学课程中接触不专业行为来调查隐性课程对这些态度的影响。
开发了一份匿名在线问卷,反映了《良好医疗实践》中概述的核心专业能力。一年级、三年级和五年级学生收到第1部分:“对职业精神的态度”;三年级和五年级学生还收到第2部分:“接触不专业行为”。使用方差分析对“职业精神得分”(第1部分)和“接触得分”(第2部分)进行分析。采用主题分析法分析自由文本。
回复率为50.8%(363/714)。女生(F=18.24,p<0.001)和一年级学生(F=12.22,p<0.001)的职业精神得分显著更高。男生的职业精神得分从一年级到五年级呈显著的逐步下降。五年级学生的接触得分显著更高(F=23.4,p<0.001)。定性主题包括欺凌、缺乏问责制和性别歧视。
与五年级相比,一年级学生对GMC定义的职业精神的敏感度更高,接触不专业行为的情况更低。解决隐性课程问题对于保护职业发展至关重要;全科医生教师应了解这些发现,并且最适合为医学生提供指导和支持。