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Open Access Highly Accessed Research article

‘A world of difference’: a qualitative study of medical students’ views on professionalism and the ‘good doctor’

Beatriz Cuesta-Briand1*, Kirsten Auret1, Paula Johnson2 and Denese Playford1

Author Affiliations

1 Rural Clinical School of Western Australia, The University of Western Australia (M706), 35 Stirling Highway, Crawley, Perth, WA 6009, Australia

2 School of Medicine and Pharmacology, The University of Western Australia (M704), 35 Stirling Highway, Crawley, Perth, WA 6009, Australia

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BMC Medical Education 2014, 14:77  doi:10.1186/1472-6920-14-77

Published: 12 April 2014

Abstract

Background

The importance of professional behaviour has been emphasized in medical school curricula. However, the lack of consensus on what constitutes professionalism poses a challenge to medical educators, who often resort to a negative model of assessment based on the identification of unacceptable behaviour. This paper presents results from a study exploring medical students’ views on professionalism, and reports on students’ constructs of the ‘good’ and the ‘professional’ doctor.

Methods

Data for this qualitative study were collected through focus groups conducted with medical students from one Western Australian university over a period of four years. Students were recruited through unit coordinators and invited to participate in a focus group. De-identified socio-demographic data were obtained through a brief questionnaire. Focus groups were audio-recorded, transcribed and subjected to inductive thematic analysis.

Results

A total of 49 medical students took part in 13 focus groups. Differences between students’ understandings of the ‘good’ and ‘professional’ doctor were observed. Being competent, a good communicator and a good teacher were the main characteristics of the ‘good’ doctor. Professionalism was strongly associated with the adoption of a professional persona; following a code of practice and professional guidelines, and treating others with respect were also associated with the ‘professional’ doctor.

Conclusions

Students felt more connected to the notion of the ‘good’ doctor, and perceived professionalism as an external and imposed construct. When both constructs were seen as acting in opposition, students tended to forgo professionalism in favour of becoming a ‘good’ doctor.

Results suggest that the teaching of professionalism should incorporate more formal reflection on the complexities of medical practice, allowing students and educators to openly explore and articulate any perceived tensions between what is formally taught and what is being observed in clinical practice.

Keywords:
Professionalism; Medical students’ views; Good doctor; Qualitative study