Reflecting on BCMP Students' Experiences of Professionalism during Clinical Rotations

Background: The professional standards expected of individuals who commit to the practice of medicine require that they possess character traits that are consistent with and reflect the core values; principles and competencies of the medical profession. Objective: The aim was to evaluate final year Bachelor of Clinical Medical Practice (BCMP) students' experiences of professionalism during clinical rotations.Method: Hatem's definition of professionalism was the stimulus that guided 25 final year BCMP students' reflections on their experiences of professionalism during clinical rotations. The students' responses documented as portfolio entries were distilled into quantitative core values and subjected to an ethical analysis according to the guidelines as provided by the Health Professions Council of South Africa. Results: There was a positive association between frequency of reflections and the positive nature of the experiences of professionalism for the majority of the contextual attributes (53.8%). Negative experiences of professionalism (46.2%) were context-specific and perceived by students as denying them an opportunity to attain professionally required skills.Conclusion: BCMP students reflected on their professional development as a process that was influenced by individuals and a competency that was determined by the extent to which the team pulled together for the benefit of the patients and the students. The study has highlighted some of the ethical dilemmas related to context

Developing personal attributes of professionalism during clinical rotations: views of final year bachelor of clinical medical practice students.

BACKGROUND: Medical professionalism as a set of behaviours that transcends personal values, beliefs and attitudes to incorporate ethical and moral principles is considered a covenant between society and the practice of medicine. The Bachelor of Clinical Medical Practice (BCMP) a three year professional degree was launched at the University of the Witwatersrand in January 2009 in response to a documented shortage of doctors especially in the rural areas of South Africa. The BCMP programme is unique in its offering as it requires a teaching approach that meets the needs of an integrated curriculum, providing for an accelerated transition from the classroom to the patient's bedside. METHODS: Following five week attachments in designated District Education Campuses, 25 final year BCMP students were required to reflect individually on the covenant that exists between society and the practice of medicine based on their daily interactions with health care workers and patients for three of the five rotations in a one page document. A retrospective, descriptive case study employed qualitative methods to group emerging themes from 71 portfolios. Ethical clearance was obtained from the Human Research Ethics Committee at the University of the Witwatersrand. RESULTS: As an outcome of an ethical analysis, the majority of BCMP students reflected on the determinants of accountable and responsible practice (N=54). The commitment to the Oath became significant with a personalised reference to patients 'as my patients'. Students acknowledged professional health care workers (HCWs) who demonstrated commitment to core values of good practice as they recognised the value of constantly reflecting as a skill (n=51). As the students reflected on feeling like 'guinea pigs' (n=25) migrating through periods of uncertainity to become 'teachable learners', they made ethical judgements that demonstrated the development of their moral integrity. A few students felt vulnerable in instances where they were pressured into 'pushing the line'. CONCLUSIONS: Through their portfolio narratives, BCMP students showed a willingness to shape their evolving journeys of moral growth and personal development. This study has highlighted as an ongoing challenge the need to identify a process by which professionalism is sustained by HCWs to benefit health sciences students.