Developing Professionalism of Osteopathic Trainees Through Mentorship: KCOM's "Societies" Model
http://www.100md.com
《美国整骨期刊》
Kirksville College of Osteopathic Medicine of A.T. Still University of Health Sciences Kirksville, Missouri
There has been an ongoing effort by both the American Osteopathic Association (AOA) and the American Medical Association (AMA) to fulfill their obligations to society by preparing medical students to act professionally. Professionalism has been identified as a missing component in the unspoken contract among physician, patient, and the public.1 The challenge facing medical education, then, is to identify methods that better address physician professionalism in the curriculum.
In 1999, Swick et al1 reported that the majority of medical schools surveyed had little formal instruction related to professionalism and no explicit method for assessing professional behavior. Most undergraduate medical education curricula are based on structured cognitive objectives. Addressing developmental behavior issues in such a curricular model has been a major challenge to medical educators, who often find it difficult to provide students with behavioral training experiences that allow them to develop their skills as professionals in a traditional classroom setting.
The long-accepted Flexnerian paradigm of medicine, which assumes that physicians can be adequately trained by the development of only cognitive skills, is increasingly being recognized as antiquated.2,3 Experimental training of physicians, including role-playing, standardized patient experiences, and case study exercises, are beginning to improve skill development in professional behavior.4 The Kirksville (Mo) College of Osteopathic Medicine (KCOM) of A.T. Still University of Health Sciences has chosen an additional mechanism to address this need—the development of a mentorship program called the Societies.
In 2002, KCOM began its mentorship activities by developing the Societies as a cocurricular program consisting of multiple, randomly selected small groups.5 This program was designed to address many of the problems and challenges revealed by mentorship programs at other schools of medicine. By selecting highly respected faculty and staff members as mentors—in particular physicians—KCOM created the Societies as an avenue of support in which students can seek refuge during their challenging medical school years. The Societies also give students expanded opportunities to receive advice and accept constructive criticism in their professional and psychosocial development.
The KCOM students are assigned to the individual Societies randomly when they first arrive on campus during freshman orientation. Many of the Societies have activities during this time, such as discussions on health policy, medical ethics, professionalism, residencies, peer reviews, and development of student portfolios, as well as social events. When the next class arrives the following year, the new students are also randomly assigned to the Societies. Thus, the Societies provide not only the opportunity for faculty and staff in the clinical and basic sciences to serve as mentors, they also give upperclassmen the opportunities to mentor their fellow students.
The KCOM program is designed so that students remain in the same Society throughout their undergraduate and postgraduate years, and even as alumni. We expect that the program will also promote increased alumni involvement in the development of the undergraduate medical curriculum, as well as with the institution as a whole.
Ten Societies were created in the fall of 2002, each consisting of approximately 15 students from the freshman class. In 2003, the membership in each society increased from 30 to 35 students. In the fall of 2005, we added an additional six Societies. With the addition of these new Societies, the active Societies on campus each consist of only about 20 to 30 members, because, after the second year, the students are off campus on clinical rotations. When the students return to campus for various activities, such as the third-year performance assessment testing or graduation ceremonies, they may choose to meet with their Societies again. In addition, third- and fourth-year students can easily remain connected with their Societies via e-mail or other electronic forms of communication, even when they are off campus.
With the Societies serving as a "new classroom," the KCOM program has a sound educational pedagogy to address various professional-development issues and many other components of medical education. The program also gives mentors the opportunity to identify improper professional behavior and resolve any issues before there is an ethical or legal obligation to confront trainees with more formal mechanisms, such as promotions boards or disciplinary actions on or off campus.
The administration and faculty of KCOM anticipate that the Societies will help preserve the outstanding academic record of KCOM while assisting students in the development of the psychosocial skills needed to become leaders in the osteopathic medical profession. We plan to incorporate the program into KCOM's curriculum in the future.
Footnotes
As the premier scholarly publication of the osteopathic medical profession, JAOA—The Journal of the American Osteopathic Association encourages osteopathic physicians, faculty members and students at osteopathic medical colleges, and others within the healthcare professions to submit comments related to articles published in the JAOA and the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research.
Letters to the editor are considered for publication in JAOA with the understanding that they have not been published elsewhere and that they are not simultaneously under consideration by any other publication.
All accepted letters to the editor are subject to copyediting. Letter writers may be asked to provide JAOA staff with photocopies of referenced material so that the references themselves and statements cited may be verified.
Readers are encouraged to prepare letters electronically in Microsoft Word (.doc) or in plain (.txt) or rich text (.rtf) format. The JAOA prefers that letters be e-mailed to jaoa@osteopathic.org. Mailed letters should also be sent electronically, in one of the aforementioned electronic formats on an IBM-compatible CD or a 3 -inch disk, and addressed to Gilbert E. D'Alonzo, Jr, DO, Editor in Chief, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864.
Letter writers must include their full professional titles and affiliations, complete preferred mailing addresses, day and evening telephone numbers, fax numbers, and preferred e-mail addresses. Authors are responsible for disclosing financial associations and other conflicts of interest.
Although the JAOA cannot acknowledge the receipt of letters, a JAOA staff member will notify writers whose letters have been accepted for publication. Mailed submissions and supporting materials will not be returned unless authors provide self-addressed, stamped envelopes with their submissions.
All osteopathic physicians who have letters published in JAOA receive continuing medical education (CME) credit for their contributions. Writers of original letters receive 5 hours of AOA Category 1-B CME credit. Authors of published articles who respond to letters about their research receive 3 hours of Category 1-B CME credit for their responses.
Although JAOA welcomes letters to the editor, readers should be aware that these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows.
References
1. Swick HM, Szenas P, Danoff D, Whitcomb ME. Teaching professionalism in undergraduate medical education. JAMA.1999; 282:830 -832.
2. Khushf G. A radical rupture in the paradigm of modern medicine: conflicts of interest, fiduciary obligations, and the scientific ideal. J Med Philos.1998; 23:98 -122.
4. Norman GR, Muzzin LJ, Williams RG, Swanson DB. Simulation in health sciences education. J Instructional Dev.1985; 8:11 -17.
5. Laird SD. The Societies: a mentoring project to develop professionalism and leadership with student physicians [American Association of Colleges of Osteopathic Medicine Web site]. August 6,2004 . Available at: http://www.aacom.org/education/innovation/aspBoard-Detail.aspId=58. Accessed November 18, 2005.(Stephen D. Laird, DO, Ass)
There has been an ongoing effort by both the American Osteopathic Association (AOA) and the American Medical Association (AMA) to fulfill their obligations to society by preparing medical students to act professionally. Professionalism has been identified as a missing component in the unspoken contract among physician, patient, and the public.1 The challenge facing medical education, then, is to identify methods that better address physician professionalism in the curriculum.
In 1999, Swick et al1 reported that the majority of medical schools surveyed had little formal instruction related to professionalism and no explicit method for assessing professional behavior. Most undergraduate medical education curricula are based on structured cognitive objectives. Addressing developmental behavior issues in such a curricular model has been a major challenge to medical educators, who often find it difficult to provide students with behavioral training experiences that allow them to develop their skills as professionals in a traditional classroom setting.
The long-accepted Flexnerian paradigm of medicine, which assumes that physicians can be adequately trained by the development of only cognitive skills, is increasingly being recognized as antiquated.2,3 Experimental training of physicians, including role-playing, standardized patient experiences, and case study exercises, are beginning to improve skill development in professional behavior.4 The Kirksville (Mo) College of Osteopathic Medicine (KCOM) of A.T. Still University of Health Sciences has chosen an additional mechanism to address this need—the development of a mentorship program called the Societies.
In 2002, KCOM began its mentorship activities by developing the Societies as a cocurricular program consisting of multiple, randomly selected small groups.5 This program was designed to address many of the problems and challenges revealed by mentorship programs at other schools of medicine. By selecting highly respected faculty and staff members as mentors—in particular physicians—KCOM created the Societies as an avenue of support in which students can seek refuge during their challenging medical school years. The Societies also give students expanded opportunities to receive advice and accept constructive criticism in their professional and psychosocial development.
The KCOM students are assigned to the individual Societies randomly when they first arrive on campus during freshman orientation. Many of the Societies have activities during this time, such as discussions on health policy, medical ethics, professionalism, residencies, peer reviews, and development of student portfolios, as well as social events. When the next class arrives the following year, the new students are also randomly assigned to the Societies. Thus, the Societies provide not only the opportunity for faculty and staff in the clinical and basic sciences to serve as mentors, they also give upperclassmen the opportunities to mentor their fellow students.
The KCOM program is designed so that students remain in the same Society throughout their undergraduate and postgraduate years, and even as alumni. We expect that the program will also promote increased alumni involvement in the development of the undergraduate medical curriculum, as well as with the institution as a whole.
Ten Societies were created in the fall of 2002, each consisting of approximately 15 students from the freshman class. In 2003, the membership in each society increased from 30 to 35 students. In the fall of 2005, we added an additional six Societies. With the addition of these new Societies, the active Societies on campus each consist of only about 20 to 30 members, because, after the second year, the students are off campus on clinical rotations. When the students return to campus for various activities, such as the third-year performance assessment testing or graduation ceremonies, they may choose to meet with their Societies again. In addition, third- and fourth-year students can easily remain connected with their Societies via e-mail or other electronic forms of communication, even when they are off campus.
With the Societies serving as a "new classroom," the KCOM program has a sound educational pedagogy to address various professional-development issues and many other components of medical education. The program also gives mentors the opportunity to identify improper professional behavior and resolve any issues before there is an ethical or legal obligation to confront trainees with more formal mechanisms, such as promotions boards or disciplinary actions on or off campus.
The administration and faculty of KCOM anticipate that the Societies will help preserve the outstanding academic record of KCOM while assisting students in the development of the psychosocial skills needed to become leaders in the osteopathic medical profession. We plan to incorporate the program into KCOM's curriculum in the future.
Footnotes
As the premier scholarly publication of the osteopathic medical profession, JAOA—The Journal of the American Osteopathic Association encourages osteopathic physicians, faculty members and students at osteopathic medical colleges, and others within the healthcare professions to submit comments related to articles published in the JAOA and the mission of the osteopathic medical profession. The JAOA's editors are particularly interested in letters that discuss recently published original research.
Letters to the editor are considered for publication in JAOA with the understanding that they have not been published elsewhere and that they are not simultaneously under consideration by any other publication.
All accepted letters to the editor are subject to copyediting. Letter writers may be asked to provide JAOA staff with photocopies of referenced material so that the references themselves and statements cited may be verified.
Readers are encouraged to prepare letters electronically in Microsoft Word (.doc) or in plain (.txt) or rich text (.rtf) format. The JAOA prefers that letters be e-mailed to jaoa@osteopathic.org. Mailed letters should also be sent electronically, in one of the aforementioned electronic formats on an IBM-compatible CD or a 3 -inch disk, and addressed to Gilbert E. D'Alonzo, Jr, DO, Editor in Chief, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864.
Letter writers must include their full professional titles and affiliations, complete preferred mailing addresses, day and evening telephone numbers, fax numbers, and preferred e-mail addresses. Authors are responsible for disclosing financial associations and other conflicts of interest.
Although the JAOA cannot acknowledge the receipt of letters, a JAOA staff member will notify writers whose letters have been accepted for publication. Mailed submissions and supporting materials will not be returned unless authors provide self-addressed, stamped envelopes with their submissions.
All osteopathic physicians who have letters published in JAOA receive continuing medical education (CME) credit for their contributions. Writers of original letters receive 5 hours of AOA Category 1-B CME credit. Authors of published articles who respond to letters about their research receive 3 hours of Category 1-B CME credit for their responses.
Although JAOA welcomes letters to the editor, readers should be aware that these contributions have a lower publication priority than other submissions. As a consequence, letters are published only when space allows.
References
1. Swick HM, Szenas P, Danoff D, Whitcomb ME. Teaching professionalism in undergraduate medical education. JAMA.1999; 282:830 -832.
2. Khushf G. A radical rupture in the paradigm of modern medicine: conflicts of interest, fiduciary obligations, and the scientific ideal. J Med Philos.1998; 23:98 -122.
4. Norman GR, Muzzin LJ, Williams RG, Swanson DB. Simulation in health sciences education. J Instructional Dev.1985; 8:11 -17.
5. Laird SD. The Societies: a mentoring project to develop professionalism and leadership with student physicians [American Association of Colleges of Osteopathic Medicine Web site]. August 6,2004 . Available at: http://www.aacom.org/education/innovation/aspBoard-Detail.aspId=58. Accessed November 18, 2005.(Stephen D. Laird, DO, Ass)