The teaching of professional attitudes within UK medical schools: Reported difficulties and good practice.

INTRODUCTION: The demonstration of appropriate attitudinal behaviour is crucial in the professional development of doctors. This study explores the experiences of UK medical schools in developing and assessing the behaviour associated with the attitudes of undergraduate medical students. METHODS: A qualitative in-depth interview study was based on a questionnaire survey of all UK medical schools. Six heads of medical schools or their nominated representatives were interviewed. Outcome measures were the perceptions and experiences of developing and assessing appropriate attitudes and behaviour in their undergraduate students. RESULTS: Aspects of the hidden curriculum, especially the negative role modelling encountered during clinical practice, were seen to undermine the attitudinal messages of the formal curriculum. Some participants believed that students could still qualify as doctors despite having inappropriate attitudes or behaviour. Others felt certain that this was now unlikely in their school, and this confidence seemed to be backed up with the knowledge that strategies, systems and structures were in place to detect and act upon poor behaviour. DISCUSSION: The conviction that it is right to assess students on their attitudinal behaviour does not yet appear to be held consistently across all schools and we suggest that this may reflect some fundamental tensions arising from differing views about the essential elements of good medical practice, tensions that are also shaping the hidden curriculum.

Implementing a smoking ban in an acute psychiatric admissions unit.

In contrast to general medical hospitals, psychiatric hospitals often allow patients to smoke cigarettes. In addition to obvious health concerns, smoking can also interfere with clinical assessments and therapeutic activities, Implementation of a smoking ban on an acute male admissions unit did not result in any increase in aggressive behaviors. In addition, staff attitudes following the ban improved, and most staff members believed the ban was both ethical and beneficial to patients. Our research indicates that banning smoking on an acute admissions unit is feasible and well tolerated by patients and staff, although it may require extra vigilance for smoking-related contraband.