Professionalism: orientation exercises for incoming osteopathic medical students and developing class vision statements.

The Philadelphia College of Osteopathic Medicine has developed an exercise to introduce professional ethics and behavior at the earliest stages of medical education. During orientation, each incoming class creates a class vision statement. After small group discussions on professional ethics, honesty, and responsibilities, representatives from each group collated student input and constructed a class vision statement reflective of student consensus on these issues. Each vision statement was recited as an oath during the white coat ceremony at the conclusion of the orientation program. Despite the fact that previous vision statements were unavailable to each incoming class, there were many commonalities among the statements created. Central elements of all vision statements include commitment to altruism, compassionate treatment of patients, and honesty and integrity in all professional interactions. Humility, the capacity to recognize and accept one's limitations in knowledge and skills, was also a key element in each statement. Three of four statements specifically recognized the teamwork and mutual respect that should be engendered among all members of the health care team. Each vision statement had prominent statements regarding the learning process during osteopathic medical school and acknowledged the importance of active and lifelong learning in the students' career paths. Student evaluation of this exercise has been positive, especially the recitation of the statement during the white coat ceremony. Results suggest that the development of a class vision statement represents a powerful mechanism for addressing the importance of professional attitudes, behaviors, and ethics at the earliest stages of medical education.

Lessons learned-UME-21 project.

The Undergraduate Medical Education for the 21st Century (UME-21) project evolved from two prior projects that were aimed at studying the interface between managed care and undergraduate medical education. The project provided funding for 18 US medical schools to demonstrate how they would produce graduates who eventually could practice in a rapidly changing health care environment. Medical schools were required to provide educational opportunities in nine content areas or outline why such educational opportunities could not be provided in their individual projects. Participating schools were chosen via an involved process after careful evaluation by a panel of experienced medical educators. In a project of this type, many lessons are learned. In the UME-21 project, lessons learned were gleaned from progress reports, participant annual reports, proceedings from annual project meetings and a National Symposium, findings of a National Education Group, and published papers. A lesson must have been reported by a least two involved schools to be included. The lessons learned were divided into six categories as follows: content areas, implementation, collaboration, evaluation, governance, implications- summary. Many lessons emanated from each of these categories; however, only the 10 most important lessons in each category are presented. The implications of the lessons learned are outlined and provide direction for the future of medical education innovation and research.