Purpose Despite growing recognition of the critical importance of physician leadership in delivering safe healthcare, especially in light of the 2023 medical crisis and professional resistance in Korea, existing studies on leadership education have focused predominantly on countries with long-established leadership curricula. This study aims to assess the curricular content of Korean medical schools to provide a quantitative and qualitative baseline of medical leadership training in the undergraduate curriculum.
Methods We conducted a content analysis of undergraduate medical curricula from 19 Korean medical schools using the Medical Leadership Competency Framework (MLCF) as a guiding framework. Survey questionnaires were distributed to designated faculty at each institution, and 270 courses were analyzed, yielding 504 leadership-related codes that were categorized thematically across the five MLCF domains and by academic year.
Results Our analysis revealed that 228 codes (45.2%) fell within “Demonstrating personal qualities” and 75 codes (14.8%) within “Setting direction,” with predominant emphasis on medical ethics and law. Training in systems-based practice, self-awareness, emotional intelligence, and team-based approaches was relatively limited. Substantial institutional variation existed, with only eight of 19 schools offering curricula covering all five MLCF domains. Most leadership content was delivered through isolated, single- semester courses rather than longitudinally integrated programs.
Conclusion While Korean medical schools recognize certain leadership competencies, there is a need for more comprehensive and consistent integration of leadership development, particularly in teamwork and systems-based practice. We recommend longitudinal integration of leadership education across pre-clinical and clinical years to address evolving competencies at different training stages.
The increasing use of social media among medical doctors and students has raised concerns about the issues related to professional behaviors in online environment. This study examines the current global guidelines on social media use for medical doctors to inform the development of such framework for Vietnamese medical doctors. A narrative review was conducted through manual searches of the official websites of national medical governing bodies. Thematic analysis was conducted on the documents to identify key principles and themes. As results, 10 guidelines, including one from World Medical Association and nine from governing bodies in nine countries were reviewed. Five key common themes were identified, including patient confidentiality, privacy, and dignity; information appropriateness; professional boundary, doctor-patient relationship, public trust; practitioner’s privacy; and health advocacy. These perspectives should be reflected together with Vietnamese cultural context when developing guidelines on professional use of social media for medical doctors in Vietnam. Detailed practical examples, clear expectations, potential disciplinary actions, and guidance on the beneficial use of social media should be included as essential components of the guidelines.
In recent years, professionalism education has been incorporated into medical education as an important part of the curriculum. Through receiving professionalism education, most medical students gradually acquire professionalism, including a professional attitude. However, some medical students demonstrate unprofessional behavior that raises concerns among faculty and other students. There are various stages to dealing with unprofessional behavior, as follows: definition, prevention, detection, evaluation, correction, and follow-up. However, it is often difficult to identify unprofessional behavior and respond appropriately. In this study, overview of medical students’ unprofessional behavior from previous studies on medical students’ unprofessionalism behavior, and how to identify and evaluate medical students’ unprofessional behavior, and effective education that can correct medical students’ unprofessional behavior was analyzed by reviewing 52 articles. Medical students’ unprofessional behavior is classified into the following four categories: “lack of involvement,” “lack of integrity,” “lack of interaction,” and “lack of introspection.” The occurrence of unprofessional behavior was found to be attributed to personal problems, interpersonal problems, external factors, and environmental factors. Educators analyzed unprofessional behavior and its causes from four categories. Medical students should perform reflective writing to help them reflect on their unprofessional behavior. Educators should use this reflective writing to interact with medical students, and to investigate and analyze the students’ unprofessional behavior. Furthermore, educators will need to assess unprofessional behavior using a roadmap to address unprofessionalism, and to respond appropriately to each stage of the roadmap. Individualized educational interventions should be provided to help students correct their unprofessional behavior.
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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.
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Purpose This study aimed to clarify the attitudes, behaviors, and learning experiences of first-year medical students participating in a nursing practice training aimed at enhancing their professionalism.
Methods A questionnaire survey was conducted among first-year medical students after their nursing practical training to understand their learning experiences. Descriptive statistics was performed for each questionnaire item. For free-text responses, descriptions were grouped by input data with similar content and meaning, and analyzed qualitatively. Others’ evaluation and self-evaluation were analyzed quantitatively.
Results Most students were actively engaged and fulfilled in the training. The free comments generated these categories: “nursing care,” “roles of nurses,” “patient impressions,” “multidisciplinary cooperation,” “communication,” and “what is required of physicians. On the first day, all items evaluated had higher mean scores in the others’ evaluation than in the self-evaluation. On the second day, for “maintains standards of personal appearance (including uniform, hair, and name tag),” the others’ evaluation means were higher than the self-evaluation means. T-tests showed a significant difference in “maintains standards of personal appearance (including uniform, hair, and name tag)” (t=-2.103, degrees of freedom [df]=71.104, p<0.05) and “attends to patients with a polite manner” (t=-2.087, df=74, p<0.05) for both the high and low groups.
Conclusion Greeting, appearance, communication skills, and attitude were found to be the important bases of attitude education in the nursing training ideally involving multidisciplinary professionals. The medical students were able to grasp what is required of doctors and objectively view such position from the viewpoints of nurses and patients.
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Methods An online questionnaire was distributed to third year medical students at one institution whose clinical rotations re-started during the pandemic. The questions asked about the students’ satisfaction with the school’s policy and feelings of safety, and the impact of COVID-19 on clinical learning.
Results The students’ perception on the school’s response to the pandemic was mixed. Re-commencement of the clinical rotations and procurement of personal protective equipment was positive but a third of students still felt unsafe. The decreased number of hospital patients did not seem to have impacted their overall clinical education with praise on the role of the supervising physicians. Seventy-six-point seven percent of students conferred the positive educational opportunities on medical professionalism presented to them only as the clinical rotation during the ongoing pandemic.
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Purpose Empathy is an important trait in physicians and a key element in the physician-patient relationship. Accordingly, one of the goals in medical education is developing empathy in students. We attempted to practically assess medical students’ empathy through their direct verbal expressions.
Methods The medical students’ empathy was measured using the modified Pencil-and-Paper Empathy Rating Test by Winefield and Chur-Hansen (2001). The students took 15 minutes or so to complete the scale, and it was then scored by one of two trained evaluators (0 to 4 points for each item, for a total score of 40). The subjects were 605 medical students, and the data were analyzed using descriptive analysis, independent t-test, and one-way analysis of variance in SPSS version 21.0.
Results The students’ empathy scores were low (mean, 12.13; standard deviation, 2.55); their most common responses (78.6%) registered as non-empathetic. Differences in empathy were observed by gender (female students>male students; t=-5.068, p<0.001), school system (medical school>medical college; t=-1.935, p=0.053), and academic level (pre-medical 1 year < other years; t=-4.050, p<0.001).
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Methods This research was carried out in three steps. The first step was systematic review of previous studies. The second step was a need assessment of medical students. The third step was a career coaching model using the results acquired from the researched literature and the survey.
Results The career coaching stages were defined as three big phases: The career coaching stages were defined as the “crystallization” period (Pre-medical year 1 and 2), “specification” period (medical year 1 and 2), and “implementation” period (medical year 3 and 4).
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PURPOSE This study was planned to evaluate that a lecture employing medical drama could motivate students to have an interest in the professionalism of healthcare personnel, which has currently become a critical subject in the field of medical education.
METHODS We analyzed subject headings, learning objectives, and further plans developed by students and their responses after two drama modules, 'car crash' and 'refusal of instruction', which were selected based on the conditions made by our faculty members, were given through video or paper to our 121 second-grade medical and nursing students in year 2012.
RESULTS Meaningful subject headings and learning objectives developed by students were 58.2%~60.0% and 36.8%~38.0% and significantly more in the 'refusal of instruction' than the 'car crash' (p=0.000). According to the students' major, medical students developed significantly more than nursing students (p=0.000). In the analysis of responses, 91.7% of students reported as impressive to the educational modules and 55.3% of them described their ideas associated with healthcare professionalism.
CONCLUSION Our study results suggest a possibility that the educational module employing selected medical drama could motivate students' healthcare professionalism.
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PURPOSE Evaluating the professional attributes of medical students is critical, because medical professionalism is an essential quality of a good doctor. But, few studies have examined the tools for assessing such attributes. This study analyzed factors of medical professionalism in medical students to develop standards that can assess medical professional attributes.
METHODS A total of 1,508 medical students in Korean medical schools or colleges answered a self-assessment survey of medical professionalism elements from 2005 to 2012 that we developed. The survey consisted of core 31 attributes on a 5-point Likert scale. Factor analysis was performed using SPSS version 20.0 and AMOS version 20.0.
RESULTS Exploratory factor analysis revealed six factors with total variance of 59.56%. The factors were termed 'empathy and accountability,' 'self-development skills,' 'academic competence,' 'interpersonal skills,' 'high intelligence,' and 'attitude towards oneself and life.' These factors showed statistically significant correlation (0.310~0.663). From the confirmatory factor analysis a six-factor model were appropriate (CFI=0.873, TLI=0.853, RMSEA=0.065). Cronbach-alpha of six factors ranged from 0.718 to 0.864.
CONCLUSION Good doctors need to have not only appropriate standards of medical knowledge but also skills to understand and communicate well with patients, as well as self-management skills, which should not be overlooked in the medical education curriculum. By optimizing the results of this study, a more refined assessment tool of professionalism can be exploited.
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In recent years, several high-profile cases related with misconduct by doctors and medical students have led to increased media interest and public concern regarding doctors who fail to maintain the expected professional standards. In response to these concerns and the increasing awareness of the social responsibility of medicine, the importance of professionalism in medical school is receiving renewed attention in our medical society. Many studies in other countries have stressed the early detection and intervention of unprofessional behaviors in medical students using an adequate evaluation system. The authors intended to explore strategies that reinforce professionalism education and prevent misconduct in medical students. We conducted an extensive literature review to identify patterns and categorize issues of misconduct and unprofessional behavior by medical students; existing evidence to determine why early detection and intervention of are crucial to prevent future misbehavior and disciplinary action by doctors; and education and evaluation systems to enhance professionalism for medical students.
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Development of a code of professional conduct for medical students and residents Young Hee Lee, Young-Mee Lee, Hyo Jin Kwon Korean Journal of Medical Education.2014; 26(4): 321. CrossRef
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PURPOSE Medical schools and graduate medical schools should understand the personality and psychological qualities of graduate medical students, medical students, and premedical students and link them with the curriculum.
METHODS In this study, through June 2010 we analyzed medical papers that were published in Korea. The search terms were psychological terminology, including emotion, cognition, intelligence, social ability, stress, motivation, judgment, and learning style.
RESULTS In the cognitive and learning aspects, preliminary doctors were under the influence of prior knowledge; cumulative learning; self-efficacy; and visual, logical, non-self-led learning types and had external learning motivation. In the emotional adaptive aspects, they appeared to be the ISTJ (introversion, sensing, thinking, judging) personality type with regard to the Myers-Briggs indicators and perfectionists, suffering from severe academic stress.
Their motivation on matriculation was associated with their interests and aptitudes, and through community service, they adapted to the learning and living environment of medicine.
In the social and moral aspects, they did not have high moral judgment, felt devaluated about their job than before, and tended to have an open and flexible doctor-patient relationship.
CONCLUSION Medical graduate students, medical students, and premedical students have greater likelihood to cultivate their character and capacity for adaptation.
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PURPOSE To adapt to rapid and turbulent changes in the field of medicine, education, and society, medical school faculties need appropriate leadership. To develop leadership competencies through education, coaching, and mentoring, we need a leadership competency model. The purpose of this study was to develop a new leadership competency model that is suitable for medical school faculties in Korea.
METHODS To collect behavioral episodes with regard to leadership, we interviewed 54 subjects (faculties, residents, nurses) and surveyed 41 faculties with open-ended questionnaires. We classified the behavioral episodes based on Quinn and Cameron's leadership competency model and developed a Likert scale questionnaire to perform a confirmatory factor analysis. Two hundred seven medical school faculties responded to the questionnaire.
RESULTS The competency clusters that were identified by factor analysis were professionalism, citizenship, leadership, and membership to an organization. Accordingly, each cluster was linked with a dimension: self, society, team (that he/she is leading), and organization (to which he/she belongs). The clusters of competencies were: professional ability, ethics/morality, self-management, self-development, and passion; public interest, networking, social participation, and active service; motivating, caring, promoting teamwork, nurturing, conflict management, directing, performance management, and systems thinking; organizational orientation, collaboration, voluntary participation, and cost-benefit orientation.
CONCLUSION This competency model that fits medical school faculties in Korea can be used to design and develop selection plans, education programs, feedback tools, diagnostic evaluation tools, and career plan support programs.
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PURPOSE How does professionalism develop while becoming a great doctor? This study based on the life of Avison, a great doctor, aims to identify the developmental features of an excellence and professionally ethical doctor.
METHODS We chose Oliver R. Avison, who founded the first modern hospital and medical school in Korea, now known as Severance Hospital and Yonsei University College of Medicine. Sixteen pivotal events in Avison's life were extracted, based on 2 standards: self-memory and strong feeling. Further we analyzed Avison' life using a professional development analysis model.
RESULTS Oliver Avison's medical professionalism development was divided into 4 periods: 'Motivating in Medicine period', 'Medical Training period', 'Medical Doctor period', and 'Medical Educating period'. A hallmark of Oliver Avison's medical professionalism development was the growth of motivation and social responsibility, medical knowledge, medical creativity, intra-personal intelligence, and relationship forming abilities.
CONCLUSION To excel in medicine, a medical student should be encouraged to understand his unique intellectual potentials and interest as a medical worker, and try to understand problems in the established domain and field of medicine, to develop new medical symbol systems, and climates.
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PURPOSE Today, the social requirement of medicine emphasizes the importance of medical professionalism. This forces medical educators to introduce new contents and methods into the curriculum. This study aims to offer ideas for developing the curriculum through clarifying priorities on the basic qualities of medical professionalism and evaluating the current curriculums in medical schools in South Korea. METHODS: In April 2005, 46 respondents majoring in basic medical sciences, clinical medicine, and medical humanities/social sciences completed a structured questionnaire. The questionnaire consisted of 3 categories related to: 1) the basic qualities of medical professionalism/general education courses, 2) the process of developing the qualities of humanities and social sciences in medical education, and 3) the appropriate allocation of credits for each subject to premedical and medical courses.
The analysis consisted of frequency, chi-square, and multiple responses using Korean Ed, SPSS 14.0 for Windows.
RESULTS The most important basic quality is basic medical knowledge. The credits for the general education are sufficient but it's contribution is lacking (44.44%). The most lacking element in the general education courses is socio-cultural comprehension (45.65%). The knowledge of humanities and social sciences is very important in developing the basic qualities (56.52%). The important learning experiences related to these is the introspection into human beings (32.16%). Credits for medical humanities classes in premedical and medical course are noticeably insufficient (45.65, 54.35%, respectively). The appropriate program of informal curriculum for fostering the qualities is meeting with various medical specialists (44.44%, 47.83%, respectively). There is almost no difference among the major groups under (p<.05.) CONCLUSION: To assist medical students to be equipped with the basic qualities of medical professionalism, the realm of medical humanities should be made mandatory; and the general education courses need to be reformed, especially in the premedical curriculum. In particular, continuous cooperation between faculties in medicine, liberal arts, and/or social sciences need to exist with the conglomeration of these into fewer medical humanities majors in Korea.
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The Medical Student Objectives Project of the American Association of Medical Colleges states that physicians must demonstrate "a commitment to advocate at all times the interests of one's patients over one's own interests," as well as "an understanding of the threats to medical professionalism posed by the conflicts of interest inherent in various financial and organizational arrangements for the practice of medicine." Due to these concerns, for the last some 30 years, there have been many attempts to improve medical professionalism curriculum in medical education such as altruistic attitudes and professional behaviors that those pursuing careers in medicine should possess. However, physicians today are not infrequently confronting conflicts of interest, such as those arising between the health system that employs them and the individual patient seeking care.
This paper briefly reviews current status of teaching medical professionalism in Korean medical schools, and discusses tasks to be coped with to further improve the medical professionalism curriculum in Korea including development of effective teaching and evaluation methods.
This paper also emphasizes the importance of the role of the medical education systems such as National Licensing Medical Examination and the Medical School Accreditation System in improving the teaching of medical professionalism in Korean medical schools.
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PURPOSE Medical professionalism has become a very popular theme in medical education since 2000. Despite the high interest, not alot of variety of studies have been done. In particular, it is very difficult to find a study focusing on the professionalism level of medical students; and none exists in Korea. The purpose of this study is to examine the level of medical professionalism in medical students and the differences between the academic years. METHODS: Of the 41 medical schools in Korea, eight were sampled randomly. From these, 2,590 medical students were finally chosen for the survey. Independent t-test and one-way Anova were used to analyse the differences between the academic years. RESULTS: The level of medical professionalism (medical knowledge, skills and attitude) of premedical students and medical students all appeared to be below average or average. For premedical students, differences were seen in 'professional knowledge' but still at a below average level. By graduation, medical students showed an overall increase in all three domains of medical professionalism, especially in 'professional attitude'. Their scores, however, did not reach more than average. CONCLUSION: There are specific areas of weaknesses in medical professionalism in students; and as their level of professionalism was not satisfactory even by the time of graduation, medical educators need to reconsider the present medical professionalism curriculum and investigate ways to improve the level of medical professionalism in medical students.
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Current Status of ‘Professional Identity Formation’ Education in the Medical Professionalism Curriculum in Korea Young-Hee Lee Korean Medical Education Review.2021; 23(2): 90. CrossRef
Students’ self-assessment of achievement of terminal competency and 4-year trend of student evaluation on outcome-based education Sanghee Yeo, Bong Hyun Chang Korean Journal of Medical Education.2019; 31(1): 39. CrossRef
Relationships among Cultural Disposition, Morality, and Psychological Health of Medical Students in a Province of Korea Sunyoung Lee, Byungduck An Korean Medical Education Review.2016; 18(1): 26. CrossRef
Development of an inventory assessing medical students' attitudes towards academic misconduct Hyo Jin Kwon, Young-Mee Lee, Young Hee Lee Korean Journal of Medical Education.2013; 25(3): 211. CrossRef
A Review of the Patterns of Unprofessional Behavior and Evaluation Programs to Prevent Misconduct by Medical Students Young Hee Lee, Young-Mee Lee Korean Journal of Medical Education.2012; 24(2): 93. CrossRef
Korean Medical Students' Cognitive, Emotional, and Social Characteristics Sook Hee Ryue, Hae Bum Lee Korean Journal of Medical Education.2012; 24(2): 103. CrossRef
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Are Medical Students Satisfied with Their Medical Professionalism Education? Yera Hur, Ji-Ha Kim, Chang-Jin Choi Korean Journal of Medical Education.2010; 22(1): 65. CrossRef
Are There Gaps between Medical Students and Professors in the Perception of Students' Professionalism Level? - Secondary Publication Yera Hur Yonsei Medical Journal.2009; 50(6): 751. CrossRef
Are There Gaps in the Perception of Medical Students' Professionalism Between Medical Students and Professors? Yera Hur Korean Journal of Medical Education.2008; 20(3): 209. CrossRef
PURPOSE The primary concern of this study was to identify the core elements of medical professionalism [in] medical school applicants.
METHODS 250 medical school professors were chosen to participate in a Delphi study and 250 medical students were asked to complete questionnaires. 106 responses from the Delphi survey and 230 completed questionnaires were finally used for analysis. The Delphi survey was repeated four times and from this result, the medical students' questionnaires were made. The questionnaire for pre-medical students included 27 medical professionalism statements.
RESULTS Responses from the Delphi survey and questionnaires revealed the following: 1) of the 27 medical professionalism elements examined, the most important core element was thought to be 'life-long learning skills', 2) the level of professionalism in Korean medical students was mostly assessed to be below 3.0 mean score by the professors, and 3) there were significant differences between the professors' and the premedical students' assessments of the level of medical professionalism inpremedical students.
Premedical students tended to rate themselves higher than the professors.
CONCLUSION Medical professionalism includes the areas of professional knowledge, skills, and attitude and their designated domains and elements. These areas should be considered when selecting people into medical schools.
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Medical students’ self-evaluation of character, and method of character education Yera Hur, Sanghee Yeo, Keumho Lee BMC Medical Education.2022;[Epub] CrossRef
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Are Medical Students Satisfied with Their Medical Professionalism Education? Yera Hur, Ji-Ha Kim, Chang-Jin Choi Korean Journal of Medical Education.2010; 22(1): 65. CrossRef
Medical Professionalism Development of Oliver R. Avison Sook-hee Ryue, Eun Bae Yang Korean Journal of Medical Education.2009; 21(2): 185. CrossRef
Are There Gaps between Medical Students and Professors in the Perception of Students' Professionalism Level? - Secondary Publication Yera Hur Yonsei Medical Journal.2009; 50(6): 751. CrossRef
Are There Gaps in the Perception of Medical Students' Professionalism Between Medical Students and Professors? Yera Hur Korean Journal of Medical Education.2008; 20(3): 209. CrossRef
Medical Students' Self Assessment on Medical Professionalism Yera Hur, Sungho H Lee, Sun Kim Korean Journal of Medical Education.2008; 20(1): 23. CrossRef
Development and Evaluation of the ‘Doctor and Leadership’ Curriculum Sangsook Lee, Minho Seo, Joonsik Kim, Jaeryong Kim, Woo-Hyun Park, Kyunghee Chun, Youngsoon Park Korean Journal of Medical Education.2007; 19(4): 279. CrossRef
PURPOSE As the importance of teaching professionalism has become more emphasized in medical education, Korean medical educators are trying to introduce and revise new learning materials concerning professionalism. The purpose of this study is to analyze the transition of curricula subjects related to medical professionalism in Korean medical schools. METHODS: A search for the learning subjects was done by reviewing the' Korean Medical Education Guide'from 1998 to present. Subject titles relating to medical professionalism and the time allocation of these subjects in lectures and laboratories in the 41 Korean Medical Schools were identified. The annual increasing rate of related subjects, as well as some characteristic differences between medical schools were analyzed. RESULTS: There were 28 subjects with content on medical professionalism in 1998/99.
There was a rapid increase in the introduction of professionalism to the curriculum annually. Although private medical schools outnumber the public system, there was no significant difference between them in the number of established subjects. But schools with fewer students had more programs relating to professionalism. This may be seen as a reflection of the relatively newly established schools with fewer students being more ready to adopt curriculum reform than older, larger medical schools. CONCLUSION: The results show that there has been a rapid growth in the number of subjects relating to medical professionalism in the curriculua at Korean medical schools. This study focused mainly on analyzing the current subject constellation in the curricula. A further study on the specifics of curriculum content and its teaching method is required.
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Exploratory and Confirmatory Factor Analysis of Medical Professionalism Core Attributes Scale Keumho Lee, Yera Hur Korean Journal of Medical Education.2012; 24(4): 339. CrossRef
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