AMA launches new education initiative

The new multi-school plan's first goal is "figuring out what professionalism looks like."

By Andis Robeznieks, amednews staff. Sept. 1, 2003.

Medical professionalism is being demanded by the public and state medical licensing boards, but opinions on what it is and how it should be taught vary widely.

With the launch of the AMA's Strategies for Teaching and Evaluating Professionalism (STEP) medical education initiative, efforts now are under way to refine the definition, to create "best practices" methods on how to teach it and then to measure how well those methods worked.

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"Our first goal is to figure out what professionalism looks like," said Faith Lagay, PhD, director of the AMA Ethics Resource Center. "We want to describe it in real terms and not just say, 'Here are the elements.' "

To get the program going, the AMA contacted 125 medical schools in the United States and Canada. Of those, 111 responded and 42 (about one-third) applied to become partner institutions. Ten were chosen, and each will get $15,000 for participating in a two-year program in which faculty and residents will be trained to teach and serve as models of medical conduct.

First step: Building consensus

Dr. Lagay said the first step would be to create a group consensus on what values, behaviors and attitudes constitute professionalism, then determine what courses and curriculum will help advance those values, behaviors and attitudes. The third step is to determine how to measure if the curriculum actually has worked.

According to at least one expert, the medical world will be watching to see how the program develops.

"It's an extremely important program and we're all going to be learning from what STEP does," said Patricia Surdyk, PhD, senior project manager for the Accreditation Council for Graduate Medical Education in Chicago. "The whole medical education system is going to benefit by watching what these institutions are doing."

A key to understanding professionalism, Dr. Surdyk said, is to see how it relates to other skills and characteristics such as communication and integrity. "Professionalism has to be something that is ingrained in the institution," she said. "You can't expect faculty to teach abstract concepts and then not demonstrate them."

Second step: Learn from mistakes

The idea is not just to teach medical students to be physicians, Dr. Surdyk said, but to "form them" so that learning about professionalism becomes more than just an empty exercise one does to get certified.

"My goal for the program would be that physicians and faculty come to realize that teaching professional values is just as important as teaching medical knowledge," she said. "I'm not looking for something pie in the sky. I'm looking for people with feet of clay who can learn from each other and from their mistakes and move on."

Dr. Surdyk said she also was looking to see if the program could provide insight into why professionalism exists more in some institutions than it does in others.

One of the reviewers who evaluated the applications from the medical schools was AMA Trustee Herman I. Abromowitz, MD, a Dayton, Ohio-based family physician.

"Accreditation councils for medical schools and residency programs now require proof of competency in professionalism," he said in a press release. "Yet there is no standard of definition of 'professionalism,' nor are there measurement criteria."

He also noted how this program collectively will be able to accomplish more than any of the schools could individually.

The participating schools are Indiana University School of Medicine, Bloomington; Loyola University Chicago Stritch School of Medicine, Maywood, Ill.; McGill University Faculty of Medicine, Montreal; Michigan State University College of Human Medicine, East Lansing; New York University School of Medicine; University at Buffalo School of Medicine and Biomedical Sciences; University of Minnesota Medical School, Minneapolis; University of North Dakota School of Medicine and Health Sciences, Grand Forks; University of Pennsylvania School of Medicine, Philadelphia; and the University of Texas Medical School at Houston.