Before the white coat: perceptions of professional lapses in the pre-clerkship
Article first published online: 21 DEC 2004
Volume 39, Issue 1, pages 12–19, January 2005
How to Cite
Ginsburg, S., Kachan, N. and Lingard, L. (2005), Before the white coat: perceptions of professional lapses in the pre-clerkship. Medical Education, 39: 12–19. doi: 10.1111/j.1365-2929.2004.02028.x
- Issue published online: 21 DEC 2004
- Article first published online: 21 DEC 2004
- Received 12 June 2003; editorial comments to authors 15 September 2003; accepted for publication 4 November 2003
- professional competence/standards;
- clinical clerkships/ standards;
- data collection;
- Toronto/ epidemiology
Background It has been shown that the professional development of clinical clerks is influenced by their experiences of unprofessional behaviour, but the perceptions of pre-clerkship students have received relatively little attention. Our purpose was to develop a greater contextual understanding of the situations in which pre-clerkship students encounter professional challenges, and to investigate what pre-clerkship students consider to be professional lapses in these situations.
Methods We conducted 4 focus groups (n = 22 students); transcripts were analysed by 3 researchers using grounded theory.
Results Pre-clerkship students reported lapses in the areas of communicative violation, role resistance, objectification, accountability and harm, validating our previous clerkship-based framework. However, they also reported numerous lapses committed by fellow students and many instances of lack of accountability to students, which were not reported by clerks. Many of their reports involved non-health care professionals.
Conclusions The willingness of pre-clerkship students to report on fellow students was associated with a tendency to blame their colleagues, at the expense of a more reflective analysis, and their views on professionalism appeared to be generic rather than medicine-specific. We should reinforce students' appreciation of these generic values and add on medicine-specific values as the students progress, in order to better cultivate professionalism without entitlement.