SUNY Upstate has a new course..."Foundations in Professionalism"

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theubiquinator

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The (unexpected) announcement:

Hello, all.

The College of Medicine has recently added formal content in Professionalism to the medical school curriculum. Our thinking on this has been shaped by the MLC3 cheating scandal of last year and the ethics remediation program that we delivered last spring. On reflection, we realized that there were important gaps in the curriculum on professional responsibilities (and to what extent do students already take these on, even as "just" students) and academic integrity.

So, with Dr. Scheinman's and Dr. Cleary's approval, we've developed a 6-session "thread" on professionalism which will run through your 2nd, 3rd, and 4th years of medical school. The first three sessions of "Foundations in Professionalism" will be delivered in cooperation with Practice of Medicine, thanks to Dr. Thompson's and Collette Fay's support. All three sessions are required; the first will be a large group session on Monday, October 3, 1:00-3:30 in WSK 1159.
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Course Description:

Course Summary
Foundations in Professionalism (FIP) is designed as a curricular “thread” that weaves through multiple years of your medical education. FIP’s purpose is to give students an opportunity to develop greater insight into the norms of the medical profession and greater competency in making moral decisions consistent with those norms. Sessions will include lectures, self-assessments, written assignments, and reflections on a variety of aspects of professionalism, including your experiences in the clinical years.


After engaging in assessments to determine (a) the kinds of moral arguments that the student prefers for resolving moral problems (b) current understanding of professional roles and expectations, and (c) the extent to which professional values are part of self-understanding, students will conduct self-assessments of strengths and areas for further development and prepare a learning plan for future professional ethical development.


Objectives
The objective of "Foundations in Professionalism" is to deepen students' understanding of the obligation of an individual physician to place patients' interests ahead of one's own, and the obligation of the medical profession to place society's interest ahead of the interest of the profession. In practice, we expect these obligations to be expressed in the attitudes, speech, and behaviors of students and physicians.


Homework
You will have homework to complete after each session. Each homework assignment is expected to take you at least 2-4 hours, so please plan accordingly. We expect that you do all homework assignments on your own, without collaborating with classmates.


***Note***For Session 3, please bring to class two copies of the personal statement you wrote when you applied to medical school.


Expectations and Grading
Criteria for successful completion of Foundations in Professionalism:

  1. Attend all sessions.
  2. Participate actively and meaningfully in small group
  3. Complete assigned reading.
  4. Complete all assignments successfully. For the first three sessions, these are:
    1. DIT-2 (during Session 1)
    2. Professional Identity Essay (during Session 1)
    3. Case Analysis 1 (homework for [and then revised during] Session 2)
    4. Reflection questions, Psychology of Cheating (homework pre-Session 2)
    5. Professional Expectations: Self Assessment and Reflection (during Session 3)
    6. Self-Assessment of DIT scores (after Session 3)
  5. At the end of Foundations in Professionalism, you will be asked to develop and submit a Self-Assessment/ Learning Plan (post-Session 6). This final assignment requires you to reflect on the various assignments and the presentations in FIP, in order to develop a plan for how you will continue your professional and ethical development. We will return copies of your completed assignments to you as the course proceeds; it is essential that you keep them, in order to complete the Self-Assessment/Learning Plan.
Your performance in Foundations in Professionalism will be factored into your grade for Practice of Medicine (for sessions presented in the second year) and Bioethics at the Bedside (for sessions presented during year 3). The weight of its contribution will be proportionate to the contact hours of this curricular thread. Each assignment must achieve a passing grade. Except for the taking of the DIT2 (which is scored, but not graded), assignments are graded Honors/High Pass/Pass/Fail. Successful completion of Foundations in Professionalism is required for graduation.
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discuss
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theubiquinator said:
The (unexpected) announcement:

Course Description:

discuss
Click to expand...
complete garbage that will only take time away from learning medicine. guess it's a good thing I don't go there :thumbdown:
 
theubiquinator said:
The (unexpected) announcement:

Course Description:

discuss
Click to expand...

Ill bite.

The concept is a good one.

Medicine has self-selected the machines. We evaluate students based on their performance on a standardized multiple choice question exam for admission to the college. We evaluate students based on their performance on a standardized mutiple choice question exam for admission to medical school. We evaluate students based on their performance on a standardized multiple choice question exam for admission to a residency program. And, when you're all done with residency and ready to pracitce, how do they decide you're ready? Multiple choice exam.

You get what you pay for​

Now, you might say, "but its not JUST the score that matters." And you're right. Its not. But, much like (ready for a medicine pun?) an Elisa for HIV, we screen our applicants with numbers. Don't make the cut? Dont even get looked at. So, what we've managed to do is take the people who are good at taking multiple choice exams and frequently reward them furiously. Now, a memory machine can produce results in terms of medicine, of medical decision making, but what it leaves out is the humanism, the professionalism, the patient care, the societal obligation, the thing that makes our field great.

Even look at the modern perception of a physician. The callous diagnostician or the subordinate hottie. We do less at the bedside and more at a computer. We do more mentating and less feeling. We make fewer connections. And we've done it to ourselves.

Ok, now enter this course. It has identified a problem. It says "Im going to make a course, nay, Im going to make a RULE that will FORCE these machines into people." The idea is a good one: try to educate the Houses of our profession into being more like Nurse Jackie, just with more education. But how do you induce Practical Wisdom (Barry Schwartz) into someone who doesn't have it.

Practical wisdom is the knowledge of what is right and the willingness to do it. The ability to do the right thing for the right reason even if it is "against the rule." To do that, you have to have insight, reflection, emotional connection. You cannot write a law or employ a rule nor even teach a course that compels a student or physician to do the right thing for the right reason.

So, as the first response said, this course is a waste of time. It serves only to teach the antisocial people how to appear more normal when they need to be, detracts from study time for people who don't care, and satisfies the admission committee's need to make it look like "they are teaching professionalism, addressing the issue... 'early'..."

I have to say though, the way they have written the description, this sounds more legit than others I've seen. They don't intend simply to talk at you the way to be a good person, but attempts to integrate it into what you're doing already. More like a nudge in the right direction. I doubt when put into practice it will be as flourly.

Instead, the solution should be to reevaluate how we admit students to medical school, not try to fix the problem that has been engrained in decades of training. We need to treat the infection before the abscess sets up. This course is likened to antibiotics for an abscess. Too late. You need to drain it. Draining it is severe. We need to get to the root of the problem early. This doesn't do it.

Medicine can be taught, and learned. Being a good person... not so much​
 
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So over 100 students in the class admitted to violating the code of conduct for some blow-off class and are surprised when the administration does something about it? What would you rather have them do? Hunt down individual students?

Consider how it would look from the outside if all the administration did was a formal rebuke of its students. Instead, they decided to establish a formal program (however ineffective it may be) to at least demonstrate a concerted effort.

This, sadly, is not an uncommon occurence... hence the proverb 'the few ruin it for the many.' Since this lazy bunch slacked off on busywork for a blow-off class, they just created even more busy work for future classes. Good going.
 
Yeah while this is a very understandable response it is equally as idiotic to what we have going on at PCOM. Ethics, epidemiology, and evidence based medicine is our equivalent of that. Yeah it all sounds fine and dandy....except its P/F...nobody goes and from I hear most people take the "final" together (its online.) LOL.

Classes like these take away from classes which actually may benefit us. How about a class on changes in the healthcare system, what we can do to stop/augment these changes, how to set up shop as a private practice doc....how to make MONEY as a doc. No, instead I am forced to listen to lectures on how to find quality information in my unending quest for evidence based medicine (hilarious I know that we are being drilled in EBM while pretty much all the "evidence" we get for OMM's efficacy is anecdotal).

So yeah...ethics classes= sounds good on paper....pretty worthless in practice. Dont really know what the best solution to attack this "problem" is however, (not that I think what these guys at upstate did was even an ethical issue..dumb yes...but do I think less of any of these guys no).
 
aSagacious said:
This, sadly, is not an uncommon occurence... hence the proverb 'the few ruin it for the many.' Since this lazy bunch slacked off on busywork for a blow-off class, they just created even more busy work for future classes. Good going.
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The previous course was a new mandatory MS4 course that was a basic science EBM class that took time out of acting internships and aways. I doubt if you're working 60-80+ hours a week plus have to write an ebm paper and take online quizzes which are basic sciences on steroids, you would have a problem helping out your fellow classmates on what's on the online quiz. The class was thrown at them 2 weeks before 4th year started.

If you think they were being lazy, then I guess that's your opinion.
 
Another example of needless time wasting. You can't teach "professionalism." It's kind of one of those things that you have a common sense and decency about it or you're just a *****.

That being said, through the first 2 years and change of med school, I have been shocked at the level of unprofessional behavior seen in some in my school (ie showing up in street clothes to clinical activities, repeatedly arriving late to mandatory class sessions, spamming class list serves with needless drama, excessive drinking at events where faculty are present). No bs touchy feely class will correct this. It needs to be corrected at the admissions level.
 
Brewmeister said:
Another example of needless time wasting. You can't teach "professionalism." It's kind of one of those things that you have a common sense and decency about it or you're just a *****.

That being said, through the first 2 years and change of med school, I have been shocked at the level of unprofessional behavior seen in some in my school (ie showing up in street clothes to clinical activities, repeatedly arriving late to mandatory class sessions, spamming class list serves with needless drama, excessive drinking at events where faculty are present). No bs touchy feely class will correct this. It needs to be corrected at the admissions level.
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can't teach wat yo mama didn't!
 
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OveractiveBrain said:
So, as the first response said, this course is a waste of time. It serves only to teach the antisocial people how to appear more normal when they need to be, detracts from study time for people who don't care, and satisfies the admission committee's need to make it look like "they are teaching professionalism, addressing the issue... 'early'..."
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You really think a course like this would appeal to applicants? Seems like a huge turn-off to me.

MS2 is pretty demanding as it is. USMLE is 9 months away, and while most schools are studying pathology, this one will be writing essays on professionalism.
 
aSagacious said:
So over 100 students in the class admitted to violating the code of conduct for some blow-off class and are surprised when the administration does something about it? What would you rather have them do? Hunt down individual students?

Consider how it would look from the outside if all the administration did was a formal rebuke of its students. Instead, they decided to establish a formal program (however ineffective it may be) to at least demonstrate a concerted effort.

This, sadly, is not an uncommon occurence... hence the proverb 'the few ruin it for the many.' Since this lazy bunch slacked off on busywork for a blow-off class, they just created even more busy work for future classes. Good going.
Click to expand...

More like the many ruined it for the few in this case, since 100 students is a majority of the class size at SUNY-Upstate and it is safe to assume there were still people who denied cheating.
 
Longshanks said:
More like the many ruined it for the few in this case, since 100 students is a majority of the class size at SUNY-Upstate and it is safe to assume there were still people who denied cheating.
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Not quite what I was referring to. I meant that this cohort (though the majority of the current class) made more work for who knows how many upcoming classes (even if it were only for 5 years that'd be 750 students)
 
Longshanks said:
More like the many ruined it for the few in this case, since 100 students is a majority of the class size at SUNY-Upstate and it is safe to assume there were still people who denied cheating.
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From what I understand the cheaters were MS4s last year, they're gone. These MS2s had nothing to do with it.
 
aSagacious said:
Not quite what I was referring to. I meant that this cohort (though the majority of the current class) made more work for who knows how many upcoming classes (even if it were only for 5 years that'd be 750 students)
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This is why I shouldn't post at 2:30am after and all day pre-exam study marathon. Should be sleeping and not fudging up math lol.
 
About the only thing I got out of that story is that out of 140 students, 100 of them were honest enough to admit to cheating. No way a new class is going to address that problem - if 40 people are unwilling to admit to cheating, no class is going to change their attitude about the need to be more honest in the future. They will be lairs forever.

It is pretty funny that when confronted with evidence of widespread cheating the answer the school came up with is a new class. Yeah, that should help.
 
owlegrad said:
About the only thing I got out of that story is that out of 140 students, 100 of them were honest enough to admit to cheating. No way a new class is going to address that problem - if 40 people are unwilling to admit to cheating, no class is going to change their attitude about the need to be more honest in the future. They will be lairs forever.

It is pretty funny that when confronted with evidence of widespread cheating the answer the school came up with is a new class. Yeah, that should help.
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Because it's completely inconceivable that 40 people ... wait for it... didn't cheat?
 
Felt like a child the way we were treated today. Or a criminal. Maybe both. Juvenile delinquents?

For the curious...We had a mandatory 2.5 hour session during which we wrote paragraph responses to 9 different questions like "What does it mean to you to be part of the medical profession?" and "What would be the worst thing about failing to live up to society's expectations of you as a physician?" We had 30 mins for that and it was collected. Then we had a lecture on morality. Then we took the DIT2 "instrument of moral judgement" questionnaire, then we took it in groups, which also were all collected.
 
It definitely sucks that the class you mentioned is presented as a "punishment" rather than a helpful tool for navigating ethical gray areas. We have a very similar course, though it is Pass/Fail and all the exams are open book (Roughly a 25 page syllabus). All small group sessions moderated by MD's and overseen by a pretty prominent medical ethicist. Basically just having conversations about different ethical issues (cheating in med school, right to life, core virtues/ethical models/principles). No real homework aside from a 2-3 page reading every couple weeks.

This week we discussed a case in Britain where a medical student in the top 10% of her class was caught cheating 4th year. Ultimately the med school decided to revoke her honors, but let her graduate. The take home points were: (a) Based on utilitarianism it is better to have an unethical (cheating in med school) physician then no physician at all to help people, and; (b) By kicking her out you are not showing "respect" for the work she put in to get to the top 10%. You can't not punish her, because all the other med students would get pissed at the med school, and you can't punish everyone for HER mistake. It sounds like OP is talking about all the students being punished for the mistakes of a few
 
Rather than including new courses and study material about professionalism that may or may not stick, I wish schools would spend more time screening teaching faculty. It's reasonable to assume that students are highly influenced by the practices of their attendings. Shoot, I have basically stolen straight scripts of dialogue from attendings on how to build rapport, calm a patient, and deliver bad news. Contrastingly, when students are exposed to bitter, indifferent, attendings it's reasonable to assume that they'll think this is 'normal' and could be more likely to be bitter, indifferent, attendings themselves.

I think that if schools want to make a lasting impression on students on how to act professionally, they should focus on selecting teaching faculty that are likely to embody those traits. Where this is impossible in the short term due to lack of resources, these courses could form a decent bridge.
 
Frank Nutter said:
You really think a course like this would appeal to applicants? Seems like a huge turn-off to me.

MS2 is pretty demanding as it is. USMLE is 9 months away, and while most schools are studying pathology, this one will be writing essays on professionalism.
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Applicants frequently buy into the whole "well rounded physician" thing, including ethics, professionalism, cultural competency, etc. I know I did.

Its only once you're struggling to keep up with your main class that those other things seem like pointless wastes of time. Case in point. I loved undergrad bioethics. Our med school class was taught very well also, but when those 2 hour ethics small groups mean 2 less hours for anatomy/micro etc that you'll have to make up another time, those classes become much harder to tolerate.
 
You know what, if you think "everyone cheats" and it's NBD, I think you should be in Saturday Professionalism School indefinitely in lieu of being thrown the f8ck out. No, everyone doesn't. And I know of people doing things openly in front of professors that make it clear that however smart they are, apparently they do need remedial instruction in what constitutes lying and cheating.

It sucks for the people who didn't and wouldn't do anything unethical. But this is what 6 sessions over the course of 4 years? They will live.
 
I see the concept of mass punishment isn't too popular amongst med students.
 
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