Medical professionalism as developmental transformation.

摘要

In the past decade, designing educational environments to support medical professionalism and the development of a professional identity have become prominent issues among medical educators. This dissertation argues that medical professionalism and the construction of a professional identity is a development process. In order for students to acquire this professional identity, educators must understand the tasks associated with this development, the interaction of multiple developmental domains and the role of educational learning environments in shaping the development of professionalism.;This case study describes the journey of thirty two medical students as they moved through one year of their medical education. Data for this study were collected over a one year period. Each participant engaged in two interviews that occurred over one year of his/her medical education. Collectively, the experiences documented in these interviews represent all four years of medical education.;The interviews were based on the self-authorship interview (Baxter Magolda & King, 2007). Observations and engagement with students in a variety of settings were used to refine and expand insights gained from interviews and to more fully understand participants' actions and intentions in a variety of contexts. The data from interviews and observations were analyzed using the constant comparative method (Glaser & Straus, 1967).;Three phases in the journey toward medical professionalism and the construction of a professional identity emerged from the participants' descriptions of their experiences. During this journey, the domains of knowledge, self and others played an important role in students' development. As students moved through the phases of their journey, each of these domains underwent qualitative changes that contributed to the development of medical professionalism and the construction of a professional identity. Throughout this journey, institutional, extra-curricular and personal contexts exposed students to a variety of forces that served to propel students forward in their development.;Implications of this study suggest the investigation and documentation of the developmental nature of medical professionalism is an area worthy of continued study. In addition, a careful examination of the learning environment of the first two years is necessary in order to better support and guide students on this educational journey.