Medics riled by tests of professional behaviour

Efforts to assess students on their 'fitness to practise' causes concern. Hannah Fearn writes

July 9, 2009

New techniques designed to measure the "professionalism" of budding doctors before they graduate have caused disquiet among medics.

Students are angry about what they call "professionalism creep" - new methods introduced by universities to monitor their personal progress outside academic examinations and practical training.

Andrew Kinmond, welfare chair of the British Medical Association's Medical Students Committee, said there was an unhealthy obsession with fitness to practise that had become "unnecessarily intrusive" within higher education.

"It's an oxymoron to suggest that we have to learn professionalism and then measure the way we behave from the beginning," he said.

Recent research at Durham University proposed a new method of measuring students' fitness to practise called the Conscientiousness Index.

The study, published in the journal Academic Medicine, outlines criteria against which students are scored to indicate their level of professionalism.

The index, which was tested on 200 medical students at Durham, allowed students to pick up points for activities such as following instructions at registration, submitting Criminal Records Bureau checks to the university on time and attending classes.

Points were lost for handing in assignments late and reading but failing to respond promptly to emails from academic staff.

The index was developed after research in the US found that poor behaviour by medical students was linked to subsequent failings later in their careers.

John McLachlan, associate dean in Phase One medicine at Durham and leader of the research, defended attempts to evaluate students' professionalism alongside their academic performance.

"A doctor's behaviour is as important as their knowledge. In fact, most complaints to the General Medical Council are about behaviour, not lack of knowledge."

He said that "measuring professionalism is problematic and difficult to define", a difficulty that the index seeks to overcome.

If it proves successful, it could be rolled out across universities in health-related courses and other disciplines, including teaching.

But Mr Kinmond, a medical student at Keele University, insisted that methods of assessment such as the index were problematic.

"Behavioural studies are only projections. They are not determinable," he said. "The majority of students meet the high standards set by medical schools, but how can a set of bad answers on a questionnaire constitute a bad doctor?"

He added that there was no clear definition of "professionalism", and said students were worried about how their scores would be used. He speculated that they could be utilised to hold academically successful students back for a year.

Despite the concerns, Professor McLachlan insisted that students were not being "spied on", and said the index's focus was on areas that were "simple to measure".

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