Email updates

Keep up to date with the latest news and content from BMC Medical Education and BioMed Central.

Open Access Highly Accessed Research article

Exploring reflective 'critical incident' documentation of professionalism lapses in a medical undergraduate setting

David Hodges*, John C McLachlan and Gabrielle M Finn

Author Affiliations

School for Health, University of Durham, Thornaby, Stockton-on-Tees, UK

For all author emails, please log on.

BMC Medical Education 2009, 9:44  doi:10.1186/1472-6920-9-44

Published: 15 July 2009

Abstract

Background

Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting.

Methods

We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed.

Results

This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative), and student responses regarding future actions.

Conclusion

This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.