Turning unprofessional behaviors around using Holmes' reflection approach: a randomized controlled study

  • Leila Naeimi ORCID Researcher, Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Medical Education Development Center, Zanjan University of Medical Sciences, Zanjan, Iran.
  • Fariba Asghari ORCID Associate Professor, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Saharnaz Nedjat ORCID Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Azim Mirzazadeh ORCID Associate Professor, Department of Internal Medicine, Department of Medical Education, Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Mahsa Abbaszadeh ORCID Assistant Professor, Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Ali Reza Sima ORCID Assistant Professor, Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
  • Sara Mortaz Hejri ORCID Mail Assistant Professor, Department of Medical Education, Educational Development Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Professionalism; Holmes' approach; Unprofessional behavior; Medical students; Reflection.

Abstract

Many medical schools around the world have included professionalism training in their formal curriculum. However, these efforts may not be adequate; given the exposure of students to unprofessional behaviors in the clinical settings. In the present study, we aimed to design, implement, and evaluate a longitudinal program to improve professionalism among medical students upon their transition to clinical settings. A total of 75 medical students were enrolled in the study and randomly assigned to two groups. The control group did not receive any training, while for the intervention group; a 10-hour program through 16 weeks was organized based on the Holmes' reflection approach. The effectiveness of the program was evaluated by measuring three outcomes in both groups. Data analysis was performed using paired t-test and Multiple Linear Regression. Scores of judgment of professionalism increased in the intervention group (from 7.56 to 10.17; P< 0.001), while there was no significant improvement in the control group’s scores. Students' attitudes towards professionalism and their professional behaviors did not change significantly.Based on our findings, the Holmes reflection approach helps students improve their cognitive base of professionalism. Long-term follow-up and further qualitative studies will help us better understand the effects of this approach on other desirable outcomes. 

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Published
2020-09-16
How to Cite
1.
Naeimi L, Asghari F, Nedjat S, Mirzazadeh A, Abbaszadeh M, Sima AR, Mortaz Hejri S. Turning unprofessional behaviors around using Holmes’ reflection approach: a randomized controlled study. J Med Ethics Hist Med. 13.
Section
Original Article(s)