Investigating US medical students' motivation to respond to lapses in professionalism.

Context: As unprofessional behaviour in physicians can compromise patient safety, all physicians should be willing and able to respond to lapses in professionalism. Although students endorse an obligation to respond to lapses, they experience difficulties in doing so. If medical educators knew how s...

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Publicado en:Medical Education Vol. 52; no. 8; pp. 838 - 851
Autores principales: Mak‐van der Vossen, Marianne, Teherani, Arianne, van Mook, Walther N. K. A., Croiset, Gerda, Kusurkar, Rashmi A.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Aug2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2018
      vid: 52
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/medu.13617
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        atl: Investigating US medical students' motivation to respond to lapses in professionalism.
      aug:
        au:
          Mak‐van der Vossen, Marianne
          Teherani, Arianne
          van Mook, Walther N. K. A.
          Croiset, Gerda
          Kusurkar, Rashmi A.
        affil: Department of Research in Education, VUmc School of Medical Sciences, Amsterdam University Medical Centers, Amsterdam, the Netherlands
      sug:
        subj:
          Students, Medical Psychosocial Factors
          Motivation
          Professionalism
          Peer Group
          Faculty, Medical
          Human
          United States
          Qualitative Studies
          Research Personnel
          Semi-Structured Interview
          Education, Medical
          Clinical Conferences
          Policy Making
          Fear
          Success
          Costs and Cost Analysis
          Social Values
          Schools, Medical
      ab: Context: As unprofessional behaviour in physicians can compromise patient safety, all physicians should be willing and able to respond to lapses in professionalism. Although students endorse an obligation to respond to lapses, they experience difficulties in doing so. If medical educators knew how students respond and why they choose certain responses, they could support students in responding appropriately. Objectives: The aim of this study was to describe medical students' responses to professionalism lapses in peers and faculty staff, and to understand students' motivation for responding or not responding. Methods: We conducted an explorative, qualitative study using template analysis, in which three researchers independently coded transcripts of semi‐structured, face‐to‐face interviews. We purposefully sampled 18 student representatives convening at a medical education conference. Preliminary open coding of a data subset yielded an initial template, which was applied to further data and modified as necessary. All transcripts were coded using the final template. Finally, three sensitising concepts from the Expectancy–Value–Cost model were used to map participants' responses. Results: Students mentioned having observed lapses in professionalism in both faculty staff and peers. Students' responses to these lapses were avoiding, addressing, reporting or initiating policy change. Generally, students were not motivated to respond if they did not know how to respond, if they believed responding was futile and if they feared retaliation. Students were motivated to respond if they were personally affected, if they perceived the individual as approachable and if they thought that the whole group of students could benefit from their actions. Expectancy of success, value and costs each appeared to be influenced by (inter)personal and system factors. Conclusions: The Expectancy–Value–Cost model effectively explains students' motivation for responding to lapses. The (inter)personal and system factors influencing students' motivation to respond are modifiable and can be used by medical educators to enhance students' motivation to respond to lapses in professionalism observed in medical school.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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