ORIGINAL�ARTICLE

ABSTRACT
Objective: To assess the perception of medical students about teaching professionalism in medical colleges. 

Study Design: Descriptive cross sectional study.

Place and Duration of Study: The study was conducted in the Department of Obstetrics and Gynecology, 
th th

Railway General Hospital, Rawalpindi, from 10  June, 2016 to 10 December, 2016. 

Materials and Methods: A semi structured, amended and validated questionnaire was used to collect the data. 

The questionnaire was distributed among 55 final year male and female medical students. 27 (49.1%) 

participants were male and 28 (50.9%) were female students. The questionnaire comprised of 9 items to 

determine various aspects of students' perception about teaching medical professionalism in medical school.

Results: Fifty five students participated. Only 20% of the students' responses were positive about their pre-

knowledge regarding the medical professionalism course. 30.9% students agreed for keeping professionalism 

course in medical schools. However, half of students' responses remained neutral. Majority of students (49.1%) 

disagreed with the effectiveness of lecturing to teach the professionalism. Majority of students (58.2%) 

approved the use of MCQs for the evaluation of professionalism course. The majority of males (82.1%) and 

females (70.2%) agreed with the effectiveness of course evaluation by MCQs.

Conclusion: A large majority of students were clear about the objectives of medical professionalism course and 

had opinion that the medical professionalism course should be taught with the use of technology rather than in 

the form of lectures and this course should be evaluated in the form of MCQs.  

Key Words: Medical Professionalism, Questionnaire, Student Feedback.

a continuing commitment to excellence and 
2,3

scholarship, leniency and sacrifice.

Medical professionalism characterizes the roles and 

distinctiveness of medical students and physicians. 

The significance of medical professionalism has been 

highlighted as multiple reports of misconduct and 

ethics violation have been published in the science 

literature pertaining to the medical community. 

Worldwide medical professionalism has received 

increased attention by medical educationist. Today, 

every society with various cultural backgrounds 

expects that the medical students must be real 

p r o f e s s i o n a l s  r a t h e r  t h a n  m e r e l y  a c t i n g  

professionally. Medical professionalism is one of the 

top priorities for the medical students, physicians 

and medical educators. 

During training, medical students undergo both 

p e r s o n a l  a n d  p r o f e s s i o n a l  d e v e l o p m e n t .  

Perceptions, in particular to required traits, are 

associated with the profession change, and 

impacted by encounters at their respective 

institutions. A recent study found that medical 

Introduction
Medical professionalism, according to The Royal 

College of Physicians (RCP) can be defined as: 'A set 

of values, behaviors, and relationships that 

underpins the trust the public has in doctors', which 

includes 'integrity, compassion, altruism, continuous 

improvement, excellence and working in partnership 
1

with members of the wider healthcare team.  

Various attributes of professionalism in medicine 

have been identified, including high ethical and 

moral standards, core humanistic values, role-

modeling, scrutiny of behavior, professional identity, 

Learning Professionalism in Medical College: Perspectives of 
Medical Students
Fareesa Waqar, Wajiha Shadab, Saadia Sultana, Shumaila Sharif

Correspondence:
Dr. Fareesa Waqar
Professor & HOD, Gynecology and Obstetrics 
Islamic International Medical College
Pakistan Railway Hospital, Rawalpindi
E-mail: fareesa.waqar@riphah.edu.pk

Department of Gynecology and Obstetrics
Islamic International Medical College
Pakistan Railway Hospital, Rawalpindi

Funding Source: NIL; Conflict of Interest: NIL 
Received: Aug 03, 2017; Revised: Jan 29, 2018
Accepted: Feb 06, 2018

Professionalism in Curriculum the Students' PerspectiveJIIMC 2018 Vol. 13, No.1

41



representatives on areas of importance that could be 

improved upon. 

The data was entered into the Microsoft Excel 

software and analyzed by using SPSS version 21.0 

statistical software. In descriptive analysis, means 

with standard deviation of the continuous variables 

were computed. Frequencies and percentages of the 

categorical variables such as gender and age were 

calculated. Mean values and standard deviation 

were analyzed for each individual question. 
Results
Fifty five students participated in the study. The 

response rate was 100%. 27 participants were male 

students (49.1%) and 28 participants were female 

students (50.9%). Out of 55 students, 30.9% agreed 

and 20% of the students disagreed for keeping 

current professionalism course in medical education 

while about half of the students remained neutral 

regarding the topic. The results indicate that only 

20% of the students' responses were positive when 

asked about their pre knowledge regarding the 

professionalism course, of which 50.4% were males 

and 60% were females. 

As far as the lectures are concerned in order to 

perceive the professionalism course 29.1% of the 

total students “agreed” and 49.1% of students 

“disagreed”. Out of the total agreed, 51% were 

males, whereas19.1% males disagreed. Of total 

agreed 44.1% were females while 20.5% females 

disagree. About the perspicuity of professionalism 

objectives total 45.5% of students agreed while 

54.5% disagreed, out of total agreed, 20% were 

males and 80% were females.

Almost 80% students agreed about the usage of 

technology during the lectures among which, 58% 

were males and 42% were females. However 20 

(36.4%) students agreed when asked about the 

interaction and support provided by the tutors and 

almost same number 23 (41.8%) of students were 

neutral of this question in which 44.4% were males 

and 29% were female. 83.6% students “disagreed” 

when queried about the inclusion of grades into final 

evaluation” and 10.9% replied as neutral. In addition, 

78.2% students remained neutral or 10.9% students 

disagreed about “the professionalism course assists 

in learning of the other subjects”. 

Regarding the participant's' reply on multiple 

students thought that society requires them to be 

professional in all their dealings and negates the 

social aspect of their lives as an individual. 

Participants felt that they were always being viewed 

with high expectations of professionalism at all times 
2

from their choice in clothing to their activities.  In this 

modern digital age of social media and networking, 

medical personnel need to be ever more careful and 

be able to demonstrate professionalism in their 
4,5

online lives.

It has now become the current emphasis of medical 

educationists that professionalism must be taught 

explicitly during undergraduate medical studies. 

With recent emphasis of medical institutions in 

inculcating professionalism and certain behavioral 

attributes into medical students, it is of interest to 

see the change in the level of professionalism as 

students' progress in their medical training and more 

importantly how they perceive the professional 

environment around them. The current study aimed 

to assess the perception of medical students about 

teaching the course on professionalism in medical 

colleges. 

Materials and Methods
This descriptive cross sectional study was conducted 

in the Department of Obstetrics and Gynecology, 
th

Railway General Hospital, Rawalpindi from 10  June, 
th

2016 to 10  December, 2016.

By using random sampling technique, fifty five final 

year medical students were invited to respond to the 

questionnaire. After explaining the purpose of the 

study, informed consent of the participant students 

was obtained and their confidentiality was ensured.

A semi structured amended questionnaire was used 

to collect the data.  Initially it was a 12 item 

questionnaire which was then converted to a 9 item 

questionnaire after validation and then used for this 

cross sectional survey. The Likert scale was employed 

throughout the questionnaire.  In Likert scale 1 and 2 

were considered as disagreed, third was considered 

neutral, 4 and 5 were considered as agreed. 

Amendments, finalization and validation of the 

questionnaire were done by involving senior faculty 

from medical education department, senior clinical 

faculty and students' representatives. The validity of 

questionnaire was ensured by getting the views of 

a b o v e  m e n t i o n e d  f a c u l t y  a n d  s t u d e n t s  

42

Professionalism in Curriculum the Students' PerspectiveJIIMC 2018 Vol. 13, No.1



course in medical school. Similar findings were 

presented in a study which demonstrated that the 

professionalism courses should be taught in colleges 

in order to cultivate more polished professional skills 

in medical students, which in turn permits 
8

concentrating on appropriate proficient conduct.  

Another study reported that medical schools in US 
9

are teaching professionalism as a separate course.  

When inquired about lectures as a method for 

teaching the professionalism course 29.1% of the 

students agreed and an overwhelming majority 

approximating to 49.1% of students disagreed. A 

Lancet review in 2001 stressed upon the necessity of 

teaching professionalism in the form of lectures to 

medical students and suggested that rigorous 
10 

research would be required in this area. Regarding 

perceptions on the assessment system, most of the 

students reported that the professionalism course 

should be evaluated by MCQs. Previous studies have 

shown that there are no strategies on the most 

operative ways of supporting medical students to 
11

develop high standards of medical professionalism.
12

According to Hendelman et al.  most of medical 

institution had a professionalism curriculum in place 

for the pre clerkship phase but lack of formal 

program in the clerkship years. The present study 

identified a lack of knowledge or interest by the 

medical students in the current professional course. 

The most obvious reasons for the lack of interest in 

professionalism course was the assessment which 

students have not considered helpful and felt 

uncomfortable for having it on a weekly basis. 

Students agreed with use of technology during the 

lectures and showed a significant positive value. 

However, these attributes develop over time and are 

inculcated at all levels of medical training. The 

findings of this study demonstrate that 45.5% 

students agree that the objectives of the 

professionalism course were easy to understand 

throughout the course. An overwhelming majority of 

students (83.6%) disagree when asked about 

including their professionalism grade in their final 

a s s e s s m e nt  a s  t h i s  affe c te d  t h e i r  o ve ra l l  

performance in the course and shows that they are 
13

not ready to take it up full time. Feudtner et al.  

found that 62% of medical students believed that 

during the course of their clerkship, their ethical 

options question, overall 58.2% students replied by 

selecting the option that the course should be 

evaluated by MCQs while 30.9% students reported 

that the professionalism course should not be 

evaluated by MCQs, Also it was concluded that the 

majority of males (82.1%) and females (70.2%) were 

in favor of course evaluation being based on the 

MCQs. However, 90% students did not agree for the 

course evaluation to be in the form of essays 

f u r t h e r m o r e  7 2 . 8 %  d i d  n o t  w a n t  g r o u p  

presentations to be a method of course evaluation.

Table I: Percep�on of Medical Students about 
Professionalism Course

Discussion
Medical professionalism is generally depicted as 

attributes of expert brilliance, honesty and 
6,7

benevolence.  This study planned to investigate the 

students' perception towards the professionalism 

course in medical schools. It was found that, only a 

few student responses were positive about their pre-

knowledge regarding the medical professionalism 

course (20%) and approximately 30.9% medical 

students agreed for keeping the professionalism 

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Professionalism in Curriculum the Students' PerspectiveJIIMC 2018 Vol. 13, No.1



principles have been eroded.

Medical schools place the foundation for fostering 

the medical professionalism to practice the issues 
14

among practicing clinicians.  It is thus imperative 

that professionalism is incorporated into the 
1 5 , 1 6 1 7

undergraduate curriculum.  Cruess et al.  

emphasized that a profession requires specialist 

knowledge and skills acquired through training and 

education and the professional is expected to use 

these attributes to serve the humanity. 
Conclusion
The medical professionalism course needs to be 

included in medical education in order to make the 

students understand the goals and importance of the 

medical professionalism course in academic and 

clinical practice. A large majority of students were 

c l e a r  a b o u t  t h e  o b j e c t i v e s  o f  m e d i c a l  

professionalism course and had opinion that the 

medical professionalism course should be taught 

with the use of technology rather than in the form of 

lectures and this course should be evaluated in the 

form of MCQs. 

REFERENCES
1. Simoni AD. Teaching medical professionalism: a lesson in 

perspective from Plato's ProtagorasBr J Gen Pract. 2017; 
67: 123.

2. Finn G, Garner J, Sawdon M. 'You're judged all the time!' 
Students' views on professionalism: a multicentre study. 
Med Educ 2010; 44: 814-25.

3. Trimble M. The Profession of Medicine and its Rivals. The 
Ulster Medical Journal. 2016; 85:76-9.

4. Ross S, Lai K, Walton JM, Kirwan P, White JS. “I have the right 
to a private life”: Medical students' views about 
professionalism in a digital world. Medical Teacher. 2013; 

35: 826–31. 
5. Jawaid M, Khan MH, Bhutto SN. Social network utilization 

(Facebook) & e-Professionalism among medical 
students. Pakistan Journal of Medical Sciences. 2015; 31: 
209–13. 

6. ABIM Foundation, ACP-ASIM Foundation, European 
Federation of Internal Medicine. Medical professionalism 
in the new millennium: a physician charter. Ann Intern Med 
2002; 136: 243-6.

7. Kassirer JP. Managing care - should we adopt a new ethic? N 
Engl J Med. 1998; 339: 397-8.

8. Steneck NH. Fostering professionalism and integrity in 
research. University of St. Thomas Law J. 2008; 5: 522-43.

9. Swick HM, Szenas P, Danoff D, Whitcomb ME. Teaching 
professionalism in undergraduate medical education. 
JAMA. 1999; 282: 830-2.

10. Stephenson A, Higgs R, Sugarman J. Teaching professional 
development in medical schools. Lancet. 2001; 35: 867-70.

11. Vimmi P. Developing medical professionalism in future 
doctors: a systematic review International Journal of 
Medical Education 2010; 1: 19-29.

12. Hendelman W, Byszewski A. A National Survey: Medical 
Professionalism in Canadian Undergraduate Programs 
2007.

13. Feudtner C, Christakis DA, Christakis NA. Do clinical clerks 
suffer ethical erosion? Students' perceptions of their 
ethical environment and personal development. Acad Med 
1994; 69: 670-9.

14. Papadakis MA, Loeser H, Healy K. Early detection and 
evaluation of professionalism deficiencies in medical 
students: one school's approach. Acad Med. 2001; 76: 
1100-6.

15. Irvine D. The Doctor's Tale. Oxford: Radcliffe Medical Press, 
2003.

16. Hilton SR, Slotnik HB. Proto-professionalism: how 
professionalization occurs across the continuum of medical 
education. Med Educ. 2005; 39: 58-65.

17. Cruess RL, Cruess SR. Steinert Y. Teaching medical 
professionalism. Cambridge: Cambridge University Press, 
London 2009.

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