Impact of group work on the hidden curriculum that induces students' unprofessional behavior toward faculty.

BACKGROUND: Hidden curriculum (HC) can limit the effects of professionalism education. However, the research on how HC triggers unprofessional behavior among medical students is scant. Furthermore, there is no established approach for how faculty members may create a context, such as an educational environment and education system, that prevents students' unprofessional behavior. This study aimed to develop an educational approach to prevent unprofessional behavior and clarify how faculty members consider HC that triggers students' unprofessional behavior. METHODS: The study sample comprised 44 faculty members and eight medical students from the Chiba University School of Medicine. The participants were divided into groups and asked the following question: "What attitudes, statements, and behaviors of senior students, physicians, and faculty members trigger medical students' unprofessional behavior?" The responses were collected using the affinity diagram method. The group members discussed the causes and countermeasures for the selected attitudes, statements, and behaviors of senior students, physicians, and faculty members based on the affinity diagram. The impact of the group work on the faculty members was surveyed using questionnaires immediately after its completion and six months later. Furthermore, the cards in the group work were analyzed using content analysis. RESULTS: The responses to the questionnaire on group work indicated that some faculty members (43.8%) improved HC, while others suggested conducting group work with more participants. The content analysis revealed six categories - inappropriate attitude/behavior, behavior encouraging unprofessional behavior, lack of compliance with regulations, harassment of other medical staff, inappropriate educational environment/supervisor, and inappropriate self-control - and 46 subcategories. CONCLUSIONS: The HC that triggers students' unprofessional behavior includes the words and actions of the educator, organizational culture, and educational environment. Group work makes faculty members aware of the HC that triggers unprofessional behavior, and induces behavioral change for HC improvement in the educational activities. Educators should refrain from using words and actions that encourage unprofessional behavior, such as personal anecdotes, as they reduce students' learning motivation.

Principles of digital professionalism for the metaverse in healthcare.

BACKGROUND: Experts are currently investigating the potential applications of the metaverse in healthcare. The metaverse, a groundbreaking concept that arose in the early 21st century through the fusion of virtual reality and augmented reality technologies, holds promise for transforming healthcare delivery. Alongside its implementation, the issue of digital professionalism in healthcare must be addressed. Digital professionalism refers to the knowledge and skills required by healthcare specialists to navigate digital technologies effectively and ethically. This study aims to identify the core principles of digital professionalism for the use of metaverse in healthcare. METHOD: This study utilized a qualitative design and collected data through semi-structured online interviews with 20 medical information and health informatics specialists from various countries (USA, UK, Sweden, Netherlands, Poland, Romania, Italy, Iran). Data analysis was conducted using the open coding method, wherein concepts (codes) related to the themes of digital professionalism for the metaverse in healthcare were assigned to the data. The analysis was performed using the MAXQDA software (VER BI GmbH, Berlin, Germany). RESULTS: The study revealed ten fundamental principles of digital professionalism for the metaverse in healthcare: Privacy and Security, Informed Consent, Trust and Integrity, Accessibility and Inclusion, Professional Boundaries, Evidence-Based Practice, Continuous Education and Training, Collaboration and Interoperability, Feedback and Improvement, and Regulatory Compliance. CONCLUSION: As the metaverse continues to expand and integrate itself into various industries, including healthcare, it becomes vital to establish principles of digital professionalism to ensure ethical and responsible practices. Healthcare professionals can uphold these principles to maintain ethical standards, safeguard patient privacy, and deliver effective care within the metaverse.

Nursing peer feedback: Optimizing our relationships with human resources and collective bargaining organizations.

Nursing leaders have recognized the need for consistent mechanisms to promote and sustain nursing professionalism. Peer-to-peer feedback and peer review are widely effective for nurse professionalism and self-regulation, patient care outcomes, and retention. Unprofessional behavior has been noted as widespread in health care and the effects on patients, clinicians, and organizations have been well-documented. Approximately 10% of the registered nurses in the United States belong to a collective bargaining unit (CBU) or union. This article will describe how a peer feedback program to address unprofessional behavior was implemented in a Magnet nursing practice with CBU representation.

Professional Pharmacy Fraternities as a Mechanism for Co-Curricular Learning: A Qualitative Analysis of Two Organizations.

OBJECTIVE: Professional pharmacy fraternal organizations are among the most common student organizations in schools and colleges of pharmacy, present on 98% of campuses. However, sparse literature explores the educational value these organizations offer. The purpose of this review is to explore the alignment of national requirements of two major pharmacy fraternities with co-curricular learning objectives. METHODS: All four fraternal pharmacy organizations recognized by the Professional Fraternal Association were invited to collaborate on this project. Ultimately, two fraternities participated by gathering national office requirements for reports and activities for collegiate chapters. Qualitative review of fraternity requirements was conducted via manifest content analysis by two independent reviewers, and items were coded to the relevant co-curricular domain(s) from the Accreditation Council for Pharmacy Education Standards 2016; disagreements were resolved by a third author. RESULTS: A total of 50 fraternity requirements were identified and mapped to one or more co-curricular domains, for a total of 63 codings. All six co-curricular domains were coded at least once. The most common codings were professionalism and leadership. Significant overlap existed in requirements that encompassed professionalism plus cultural sensitivity, professionalism plus self-awareness, and self-awareness plus leadership. Some activities benefited the school or community, while others solely contributed to individual member professional development. CONCLUSION: Professional pharmacy fraternities provide ample co-curricular learning opportunities among the breadth of affective domains. The mission and vision of these organizations foster affective domain skill development in both school- and community-facing events as well as dedicated individual professional development.

Learning professionalism using creativity and diversity concepts.

CLINICAL RELEVANCE: Professionalism is a multidimensional sociocultural construct that is abstract, evolving and context-dependent in nature. This has made the teaching and assessment of professionalism in healthcare complex and challenging. A lack of professionalism can increase patient risk and litigation. BACKGROUND: This article examines group creativity and diversity across healthcare and non-healthcare disciplines and how they can assist students in constructing their own understandings and knowledge of professionalism. It is proposed that linking professionalism to creativity will improve understanding on how to help students studying healthcare learn about professionalism better. METHODS: A total of 30 students from different tertiary levels and across disciplines participated in the study. They explored either a gallery or museum and examined an artefact relating to professionalism. Learning experiences were evaluated via survey results and thematic analyses of their reflective essays and semi-structured interviews. RESULTS: Participants reported increased understanding of professionalism and appreciation of perspectives and skills of others. The creative aspect of the task was fun and engaging, and group diversity enabled different opinions and perspectives to be heard and shared. This is analogous to a professional working environment. Themes generated from the essays were: (a) intrinsic motivation, (b) diversity, (c) learnings of professionalism, and (d) challenge encountered. CONCLUSION: The results of this research make a meaningful contribution to existing literature by empirically demonstrating that students from different disciplines could better construct their own understandings of professionalism when their learning activities were performed in an authentically creative and diverse setting. This educational concept is underpinned by diverse types of creativities that are not mutually exclusive. It is hoped that this first piece of evidence will stimulate more studies on utilising group creativity and diversity in healthcare education.

Medical School Characteristics Associated with Matched Otolaryngology Residency Applicants.

OBJECTIVE: Identify which medical schools produce the most otolaryngology residents, and associated characteristics which may contribute to this productivity. DESIGN: The medical school and residency program of each otolaryngology-matched student was identified. Various characteristics for each medical school and residency were compared in univariate and multivariate analysis after adjusting for class size. Percentage of matched students relative to class size was identified and compared for each geographic region. SETTING: Cross-sectional study of publicly available match data from otomatch.com and otolaryngology residency program websites from 2020-2023. PARTICIPANTS: 1411 students from 174 medical schools matched into 126 otolaryngology residencies were identified. RESULTS: Private medical schools (ß = 0.50, p = 0.03), larger otolaryngology departments (ß = 0.01, p = 0.04), and higher U.S. News and World Report (USNWR) ranking (ß = -0.01, p = 0.02) was associated with a greater percentage of otolaryngology-matched students while schools in the Mountain region were associated with a lower percentage of matched students (ß = -1.08, p = 0.02). A difference in percentage of matched students was observed when comparing across all regions (p < 0.01) but no significant differences were observed between any individual regions. The East North Central Region and the Middle Atlantic regions were more likely to match students from their respective regions compared to the Mountain region (OR: 4.98, 95% CI: 1.18, 21.01; OR: 8.20, 95% CI: 1.92, 34.99, respectively). Additionally, the Mountain region was less likely to match students from their own region compared to the Pacific (OR: 0.21, 95% CI: 0.05, 0.90), South Atlantic (OR: 0.20, 95% CI: 0.05, 0.85), and West South Central (OR: 0.15, 95% CI: 0.03, 0.67) regions. CONCLUSIONS: Medical school characteristics such as private vs public status, size of otolaryngology department, higher USNWR ranking, and geographic region impact the number of otolaryngology-matched students. Applicants should consider the impact of their geographic region when allocating signals during the residency application process.

The weaponization of professionalism against physicians of color.

Though we have made ample advances in the field of medicine in recent years, our idea of professionalism continues to be based on the standard of how white men dressed in the nineteenth century. Such a standard of professionalism not only perpetuates gender bias, but also aims to remove the culture, traditions, and behaviors of minority groups with the goal of molding these individuals to resemble the majority, preventing 'Afro' heritage from entering medicine. By contextualizing our own experiences in the medical setting as physicians of color in the context of a variety of supporting literature, we provide an overview of professionalism, its role in medicine, the double standard faced by women, and how it continues to be weaponized against physicians of racial, ethnic, and religious minorities. We advocate for minority physicians to embrace their authenticity and for institutions to develop policies that openly, firmly, and enthusiastically welcome physicians of all ethnicities, religions, and genders. Positionality Statement: In the editorial you are about to read, we, the authors, collectively bring a rich tapestry of backgrounds and experiences to our discussion on healthcare disparities. Our team consists of two Hispanic/Latina oncologists, one Middle Eastern oncologist, one Black/Caribbean-American hematologist, and one White pre-medical student with Middle Eastern heritage. Our diverse backgrounds inform our perspectives and enhance our understanding of the complex and multifaceted nature of healthcare. We are united by a shared commitment to justice, equity, and the belief that every patient deserves high-quality care, regardless of their background. This editorial is informed by our professional expertise, personal experiences, and the diverse communities we serve, aiming to highlight the critical need for inclusivity and representation in healthcare. By acknowledging our positionality, we hope to provide a comprehensive and empathetic analysis that not only identifies the challenges but also offers actionable solutions to improve healthcare outcomes for all. We recognize the power of diversity in fostering innovation and driving positive change, and we are dedicated to using our voices and positions to advocate for a more equitable healthcare system.

Professionalism among family medicine residents at King Abdulaziz University Hospital, Jeddah, Saudi Arabia: A cross-sectional study.

Background: The Saudi Commission for Health Specialties (SCHS) recently proposed the Saudi Meds Family Medicine (FM) 2020 program, which is based on CanMEDS-FM 2017 and includes a number of competencies. The purpose of this study is to evaluate the professionalism of FM residents who follow the modified curriculum of the SCHS. Materials and Methods: A cross-sectional study was conducted between June and August 2023 at King Abdulaziz University Hospital in Jeddah among FM residents from year 1 to year 3 and postgraduates from the FM residency program of both genders. For data collection, a structured self-administered web-based questionnaire adapted from CanMEDS was used. Results: A total of 45 FM residents responded, with the majority (73.3%) between the ages of 20 and 30 (77.8%), and 62.2% females. In terms of patient professionalism, 93.3% frequently/always demonstrated appropriate professional behavior and relationships in all aspects of practice; 62.2% frequently/always demonstrated a commitment to excellence in all aspects of practice. In terms of professionalism and societal commitment, 80% frequently/always demonstrated accountability to patients, society, and the profession by responding to societal expectations of physicians, and 86.6% frequently/always demonstrated a commitment to patient safety and quality improvement. In terms of professional commitment, 88.9% frequently/always fulfil and adhere to professional and ethical codes, standards of practice, and laws governing practice. In terms of self-commitment, it was discovered that 86.6% frequently/always demonstrated self-awareness and managed influences on personal well-being and professional performance. The majority (80%) managed personal and professional demands for a sustainable practice throughout the physician lifecycle, and 86.7% frequently/always promoted a culture that recognizes, supports, and effectively responds to colleagues in need. Conclusion: FM residents in Jeddah, Saudi Arabia, demonstrated acceptable levels of dedication to patients, society, profession, and self, indicating a high level of professionalism.

Evaluation of a culture change program to reduce unprofessional behaviours by hospital co-workers in Australian hospitals.

BACKGROUND: Unprofessional behaviours between healthcare workers are highly prevalent. Evaluations of large-scale culture change programs are rare resulting in limited evidence of intervention effectiveness. We conducted a multi-method evaluation of a professional accountability and culture change program "Ethos" implemented across eight Australian hospitals. The Ethos program incorporates training for staff in speaking-up; an online system for reporting co-worker behaviours; and a tiered accountability pathway, including peer-messengers who deliver feedback to staff for 'reflection' or 'recognition'. Here we report the final evaluation component which aimed to measure changes in the prevalence of unprofessional behaviours before and after Ethos. METHODS: A survey of staff (clinical and non-clinical) experiences of 26 unprofessional behaviours across five hospitals at baseline before (2018) and 2.5-3 years after (2021/2022) Ethos implementation. Five of the 26 behaviours were classified as 'extreme' (e.g., assault) and 21 as incivility/bullying (e.g., being spoken to rudely). Our analysis assessed changes in four dimensions: work-related bullying; person-related bullying; physical bullying and sexual harassment. Change in experience of incivility/bullying was compared using multivariable ordinal logistic regression. Change in extreme behaviours was assessed using multivariable binary logistic regression. All models were adjusted for respondent characteristics. RESULTS: In total, 3975 surveys were completed. Staff reporting frequent incivility/bullying significantly declined from 41.7% (n = 1064; 95% CI 39.7,43.9) at baseline to 35.5% (n = 505; 95% CI 32.8,38.3; χ2(1) = 14.3; P < 0.001) post-Ethos. The odds of experiencing incivility/bullying declined by 24% (adjusted odds ratio [aOR] 0.76; 95% CI 0.66,0.87; P < 0.001) and odds of experiencing extreme behaviours by 32% (aOR 0.68; 95% CI 0.54,0.85; P < 0.001) following Ethos. All four dimensions showed a reduction of 32-41% in prevalence post-Ethos. Non-clinical staff reported the greatest decrease in their experience of unprofessional behaviour (aOR 0.41; 95% CI 0.29, 0.61). Staff attitudes and reported skills to speak-up were significantly more positive at follow-up. Awareness of the program was high (82.1%; 95% CI 80.0, 84.0%); 33% of respondents had sent or received an Ethos message. CONCLUSION: The Ethos program was associated with significant reductions in the prevalence of reported unprofessional behaviours and improved capacity of hospital staff to speak-up. These results add to evidence that staff will actively engage with a system that supports informal feedback to co-workers about their behaviours and is facilitated by trained peer messengers.

[Japanese Code of Ethics for Pharmacists and Professionalism].

In their role as providers of pharmaceutical products to society, pharmacists must demonstrate professionalism if they are to gain the trust of the community. The Japan Pharmaceutical Association has published the Pharmacist Platform in Japan and the Japanese Code of Ethics for Pharmacists; these resources provide clear guidelines for pharmacists and are an important component of the profession. Becoming a pharmacist involves joining a professional community and thereby pledging to accept a set of ethical standards. This concept of the pharmacy profession is shared by other countries, and the International Pharmaceutical Federation has indicated that professionalism is an issue that should be addressed in every country. This review introduces the Pharmacist Platform in Japan, the Japanese Code of Ethics for Pharmacists established by the Japan Pharmaceutical Association, and the background of each establishment.

Factors leading to lapses in professional behaviour of Gynae residents in Pakistan: a study reflecting through the lenses of patients and family, consultants and residents.

INTRODUCTION: Professional behaviour is the first manifestation of professionalism. In teaching hospitals, the residents can be considered vulnerable to lapses in professional behaviour when they fail to meet the set standards of professionalism. Residents of some specialties are more at risk of lapses in professional behaviour due to the demanding nature of work. Research focusing on the behaviour of residents in the field of Gynae and the underlying factors contributing to such behaviour is notably lacking in the literature. Additionally, there is a gap in understanding the perspectives of patients from Pakistan on this matter, as it remains unexplored thus far, which constitutes the central focus of this study. An increase in complaints lodged against Gynae resident's professional behaviour in Pakistan Citizen Portal (PCP) was observed. Therefore, an exploratory qualitative study was conducted to investigate the factors and rationales contributing to the lapses in resident's professional behaviour. The study collected the viewpoints of three stakeholder groups: patients and their families, consultants and residents. The study was conducted in three phases. First, the document analysis of written complaints was conducted, followed by face-to-face interviews (11 per group) conducted by trained researchers from an independent 3rd party. Finally, the interview data was transcribed, coded and analysed. In total 15 themes were identified from the interviews with 3 stakeholders, which were then categorized and resulted in 6 overlapping themes. The most prevalent lapse reported by all 3 stakeholders was poor verbal behaviour of residents. CONCLUSION: The highly ranked factors contributing to triggering the situation were associated with workplace challenges, well-being of residents, limited resources, patients and family characteristics, patients' expectations, lack of administrative and paramedic support, cultural factors and challenges specific to Gynae specialty. Another intriguing and emerging theme was related to the characteristics of patients and attendants which helped in understanding the causes and implications of conflicting environments. The value of competency also emphasized that can be accomplished by training and mentoring systems. The thorough examination of these factors by key stakeholders aided in accurately analysing the issue, its causes, and possible solutions. The study's findings will assist higher authorities in implementing corrective actions and offering evidence-based guidance to policymakers to improve healthcare system.

Medical students' professionalism attributes, knowledge, practices, and attitudes toward COVID-19 and attitudes toward care provision during pandemic amidst the COVID-19 outbreak according to their demographics and mental health.

PURPOSE: This study examines various aspects related to medical professionalism in medical students during coronavirus disease 2019 (COVID-19) pandemic, focusing on their medical professionalism attributes, KPA (knowledge, practices, and attitudes) toward COVID-19 and attitudes toward provision of care in pandemic. We assessed whether these aspects related to medical professionalism were varied by their demographics and mental health level. METHODS: Six questionnaires related to medical professionalism were distributed online to medical students in six grades at a single medical school. A one-way analysis of variance was used to examine differences in scores related to medical professionalism based on their demographics, for examples, gender, grade, residence, religion, as well as their mental health levels. Pearson correlation analysis was used to examine correlations between each variable. RESULTS: Female students scored higher on medical professionalism attributes and attitudes toward duty-to-care than male students. Medical professionalism attribute scores were higher with higher relationship satisfaction and resilience levels but lower with higher anxiety levels. Furthermore, these scores were significantly associated with attitudes toward COVID-19 preparedness. However, COVID-19 knowledge and practice scores were negatively associated with attitudes toward COVID-19 preparedness and careers after graduation. Meanwhile, students who took the leave of absence related to 2020 doctors' strike had significantly lower scores on attitudes toward COVID-19 preparedness and duty to care than those who did not. CONCLUSION: Our findings suggest that mental health of medical students is strongly related to their various aspects related to medical professionalism, especially their attitudes toward COVID-19 preparedness. Good mental health was positively linked to medical professionalism attributes and attitudes toward COVID-19 preparedness. However, knowledge and practice of COVID-19 were negatively associated with willingness to participate in the pandemic response. Additionally, the experience of the 2020 leave of absence impacted the attitudes of medical students toward COVID-19 preparedness (p=0.015) and their duty to care (p=0.012) negatively.

The rise of medical influencers: The pros and the cons.

In the past few years, the online influencer industry has exponentially expanded, fuelled by the COVID pandemic lockdown, increased social media platforms and lifestyle appeal of influencership. This phenomenon has likewise infiltrated the medical field, where many healthcare practitioners have taken to social media platforms for content creation and influencer marketing. There are many reasons that underlie medical influencership - some may use it to improve public health literacy and correct medical misinformation, engage in medical advocacy or use the platform simply as a means of humanistic expression of the medical career, while others may seek to advertise private practice/medical products, boost personal reputation, and gain popularity and monetary benefits. Regardless of the underlying motivations of the medical influencers, some have fallen afoul of professionally accepted practices and ethical boundaries in their use of social media platforms, leading to serious consequences such as professional sanctioning or termination of employment. In this article, we hope to provide a comprehensive review of the 'good' (positive practices), the 'bad' (practices with possible unintended negative consequences) and the outright unprofessional or unethical behaviours aspects of social media use by medical influencers and offer practical strategies to ensure responsible and meaningful use of influencer platforms at both the physician and health systems level.

Concept analysis of conscience-based nursing care: a hybrid approach of Schwartz-Barcott and Kim's hybrid model.

BACKGROUND: The nursing profession considers conscience as the foundation and cornerstone of clinical practice, which significantly influences professional decision-making and elevates the level of patient care. However, a precise definition of conscience in the nursing field is lacking, making it challenging to measure. To address this issue, this study employed the hybrid approach of Schwartz Barcott and Kim to analyze the concept of conscience-based nursing care. METHODS: This approach involves a three-phase process; theoretical, fieldwork, and analytical. A systematic literature review was conducted using electronic databases during the first phase to find relevant papers. The content of 42 articles that met the inclusion criteria was extracted to determine the attributes, antecedents, and consequences of consciousness care using thematic analysis. Based on the working definition as a product of this phase, the plan of doing the fieldwork phase was designed. During this phase, data were collected through interviews with nurses all of whom were responsible for patient care in hospitals. In this phase, 5 participants were chosen for in-depth interviewing by purposeful sampling. Data were analyzed using directed content analysis. The findings of the theoretical and fieldwork phases were integrated and the final definition was derived. RESULTS: The integration of the theoretical and fieldwork phases resulted in identifying four key characteristics of conscience-based nursing care. Firstly, it involves providing professional care with a conscientious approach. Secondly, ethics is at the core of conscience-based care. Thirdly, external spirituality plays a significant role in shaping one's conscience in this context. Finally, conscience-based nursing care is both endogenous and exogenous, with professional commitment being the central focus of care. CONCLUSION: Conscience-based nursing care is an essential component of ethical care, which elevates clinical practice to professional care. It requires the integration of individual and social values, influenced by personal beliefs and cultural backgrounds, and supported by professional competence, resources, and a conducive organizational atmosphere in the healthcare field. This approach leads to the provision of responsive care, moral integrity, and individual excellence, ultimately culminating in the development of professionalism in nursing.

The hidden professionalism curriculum: Teach it, see it, do it and repeat!

Background: Professionalism is a complex and multifaceted component of medical education. Historically, students have learned about professionalism informally and as part of the hidden curriculum. Currently, professionalism is increasingly prominent in formal curricula, but uncertainty remains regarding optimal professionalism pedagogies. In this study, the authors explored medical students' exposure to professional topics and considered factors that enabled students to correctly recognize and manage these issues. Methods: Convenience sampling was used to recruit medical students from existing clinical attachments at the authors' hospital. A semi-structured interview format was used to explore participants' awareness of professional issues within fictional vignettes created using published regulatory guidance. The interview transcripts and interview guide field notes were then analyzed. Results: The data suggest that students require a combination of didactic teaching and experiential learning to reliably recognize and manage professional issues. Didactic teaching alone enabled topic recognition, but with uncertainty about management strategies. Experiential learning alone led to erratic recognition of the subject and reliance upon role modeling to guide its management. This work stimulates faculty development to enhance teaching professionalism. Conclusions: Undergraduate medical education on professionalism must be introduced into the formal curriculum. Didactic teaching is required to scaffold experiential learning. Failure to do so renders students unable to reliably recognize or manage professional issues encountered in clinical practice. Further research questions were identified to progress this work.

Assessment of Professionalism in Pharmacists and Pharmacy Students: Scoping Review of Instruments and Validity Evidence.

OBJECTIVE: To characterize which instruments have been developed to assess professionalism in the field of pharmacy. FINDINGS: A scoping review was conducted to answer which instruments have been developed to assess professionalism in the field of Pharmacy. The databases consulted were EMBASE, ERIC, PUBMED/Medline, Scopus, and Web of Science. No restrictions on language or year of publication were made. Only studies about development or translation of instruments for professionalism assessment were included. The methodological quality of studies was verified by the Questionnaire Cross-Cultural Adaptation Guideline and the COnsensus-based Standards for the selection of health Measurement INstruments. Seven studies met the eligibility criteria and were included in this scoping review. In general, the instruments were developed from ideological elements assigned to professionalism by pharmaceutical and medical entities, in addition to theoretical references that came from social sciences. Regarding the evaluation of validation and psychometric property evidence, the studies generally adopted distinct procedures which highlights some destandardization, although the methodological quality was accepted. SUMMARY: More studies on the professionalism field should be conducted to characterize professionalism and develop pharmaceutical practices in line with societal demands and expectations.

Effects of Self-Leadership on Nursing Professionalism among Nursing Students: The Mediating Effects of Positive Psychological Capital and Consciousness of Calling.

To provide high-quality nursing care, nursing education requires the basic quality of self-leadership from professional nurses so that they can make self-directed and responsible judgments and decisions. Therefore, this study aimed to investigate relationships among self-leadership, positive psychological capital, consciousness of calling, and nursing professionalism in nursing students. A cross-sectional online survey of 202 students from two universities in South Korea was conducted between August and September 2022, using a convenience sampling method. A structured questionnaire was used to collect data. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and bootstrapping using Hayes' PROCESS macro for mediation. A significant positive correlation was found between self-leadership, positive psychological capital, consciousness of calling, and nursing professionalism. Positive psychological capital and consciousness of calling showed an indirect mediating effect on the relationship between self-leadership and nursing professionalism. To improve nursing professionalism, programs should be developed to educate nursing students, strengthen their self-leadership skills, and increase the influence of positive psychological capital and consciousness of calling for nursing. This will ultimately contribute to improving the quality of patient care by fostering competent nursing experts.

[Considering Medical Professionalism from the Standpoint of Pharmacy Education].

Worldwide interest in teaching medical professionalism has increased drastically over the past two decades and is recognized as an important core competency. It is also essential in pharmacy education. However, there is no single definition of medical professionalism owing to its multifaceted nature, leading to difficulty in understanding it. The foundational concept of professionalism are the social contract and accountability, which describe the relationship between the profession and the society which it serves. Profession must understand expectations from the society, which is trustworthy, assures competence, and devoted to the public good for the contract based on their mutual trust. In "teaching," three basic educational actions ("setting expectations," "providing experiences," and "evaluating outcomes") are required. There are two learning goals of professionalism education: the minimum goal of not doing unprofessional acts and the aspirational goal of pursuing a higher level of interiorized professionalism which leads to the professional identity formation. The true professionals are "reflective practitioners," who have the ability to manage ambiguous problems using their interiorized professionalism in complicated situations. Therefore, reflection is one of the central concepts of professionalism education. The Professionalism Mini-Evaluation Exercise (P-MEX), an observational tool to evaluate medical professionalism, has some favorable aspects; the Japanese version is available and is a guide to specific actions for professionalism through its items, although some cautions must be exercised when using it. Considering that teaching professionalism includes not only formal but informal and hidden curricula, all of the staff in the educational environments should consider professionalism education by understanding professionalism.