An exploration of reflective writing and self-assessments to explain professionalism lapses among medical students

dc.contributor.advisorFrankel, Richard M.
dc.contributor.authorHoffman, Leslie Ann
dc.contributor.otherBrokaw, James J.
dc.contributor.otherPike, Gary R. (Gary Robert), 1952-
dc.contributor.otherShew, Ronald L.
dc.contributor.otherVu, T. Robert
dc.date.accessioned2015-02-23T16:33:49Z
dc.date.available2015-02-23T16:33:49Z
dc.date.issued2014-07
dc.degree.date2014en_US
dc.degree.disciplineDepartment of Anatomy & Cell Biologyen
dc.degree.grantorIndiana Universityen_US
dc.degree.levelPh.D.en_US
dc.descriptionIndiana University-Purdue University Indianapolis (IUPUI)en_US
dc.description.abstractBackground: Recent literature on medical professionalism claims that self-awareness and the ability to reflect upon one’s experiences is a critical component of professionalism; however there is a paucity of empirical evidence to support this claim. This study employed a mixed methods approach to explore the utility of reflective writing and self- and peer assessments in explaining professionalism lapses among medical students. Methods: A retrospective case-control study was conducted using students from Indiana University School of Medicine (IUSM) who had been disciplined for unprofessional behavior between 2006-2013 (case group; n=70). A randomly selected control group (n=230) was used for comparison. Reflective ability was assessed using a validated rubric to score students’ professionalism journals. Mean reflection scores and assessment scores were compared using t-tests. Logistic regression analysis was used to determine the impact of reflection scores and self- and peer assessment scores on the likelihood of having been disciplined for unprofessional behavior. Subsequent qualitative analysis further explored when and how students learned professionalism during their clinical experiences. Results: The study found that students in the case group exhibited lower reflective ability than control students. Furthermore, reflective ability was a significant factor in explaining the odds that a student had been cited for professionalism lapses. There were no differences in self-assessment scores between the two groups, but students in the case group had significantly lower peer assessment scores than control students. Peer assessment scores also had the greatest influence on the odds that a student had been cited for professionalism deficiencies during medical school. Qualitative analysis revealed that students learn professionalism from role models who demonstrated altruism and respect (or lack thereof). Conclusions: These findings suggest that students should be provided with guidance and feedback on their reflective writing to promote higher levels of reflection, which may reduce the number of students who are cited for professionalism lapses. These findings also indicate that peer assessments can be used to provide students with insightful feedback regarding their professional development. Finally, role models have a strong influence on students’ professional development, and therefore must be cognizant of the implicit messages their behaviors convey.en_US
dc.identifier.urihttps://hdl.handle.net/1805/5931
dc.identifier.urihttp://dx.doi.org/10.7912/C2/2107
dc.language.isoen_USen_US
dc.rightsAttribution-NonCommercial-ShareAlike 3.0 United States
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/us/
dc.subjectprofessionalismen_US
dc.subjectreflectionen_US
dc.subjectpeer assessmenten_US
dc.subjectmedical studentsen_US
dc.subject.lcshAltruism -- Research -- Evaluation -- Analysisen_US
dc.subject.lcshMedical education -- Philosophy -- Researchen_US
dc.subject.lcshMedical students -- Training of -- Research -- Evaluation -- Analysisen_US
dc.subject.lcshMedical students -- Attitudesen_US
dc.subject.lcshMedical ethics -- Study and teachingen_US
dc.subject.lcshPeer reviewen_US
dc.subject.lcshSelf-perception -- Research -- Methodologyen_US
dc.subject.lcshDiscourse analysis, Narrativeen_US
dc.subject.lcshRespect for persons -- Research -- Analysisen_US
dc.subject.lcshCommunication in medicineen_US
dc.subject.lcshFeedback (Psychology) -- Researchen_US
dc.subject.lcshQualitative researchen_US
dc.subject.lcshRole models -- Researchen_US
dc.subject.lcshIndiana University School of Medicine -- Researchen_US
dc.subject.lcsht-test (Statistics) -- Research -- Methodologyen_US
dc.subject.lcshReflection (Philosophy)en_US
dc.subject.lcshStudents -- Self-rating ofen_US
dc.subject.lcshProfessional ethicsen_US
dc.titleAn exploration of reflective writing and self-assessments to explain professionalism lapses among medical studentsen_US
dc.typeThesisen
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