Using the American Board of Internal Medicine's "Elements of Professionalism" for undergraduate ethics education.
OBJECTIVE
To examine the feasibility of using the taxonomy of professional and unprofessional behaviors presented in the American Board of Internal Medicine's (ABIM's) Project Professionalism to categorize ethical issues that undergraduate medical students perceive to be salient.


METHODS
Beginning second-year medical students at the University of Washington School of Medicine (n = 120) were asked to respond to three open-ended questions about professional standards of conduct and peer evaluation. Two of the authors read and coded the students' responses according to the ABIM's elements of professionalism (altruism, accountability, excellence, duty, honor and integrity, and respect for others) and the challenges to those elements (abuse of power, arrogance, greed, misrepresentation, impairment, lack of conscientiousness, and conflict of interest). Coding disagreements were solved using review and revision of the category definitions. New categories were created for students' responses that described behaviors or issues that were not captured in the ABIM's categories.


RESULTS
A total of 114 students responded. The ABIM's professional code was adapted for students and teachers, making it context- and learning-stage-specific. One new category of challenges, conflicts of conscience, was added, and one category (abuse of power) was expanded to include abuse of power/negotiating power asymmetries.


CONCLUSIONS
Using the ABIM's taxonomy to name professional and unprofessional behaviors was particularly useful for examining undergraduate medical students' perceptions of the ethical climate for learning during the first year of medical school, and it holds promise for research into changes in students' perceptions as they move into clinical experiences. Using the framework, students can build a unified professional knowledge-and-skills base.
Robins
Lynne S
LS
University of Washington School of Medicine, Department of Medical Education, Seattle 98195-7240, USA. lynner@u.washington.edu
Braddock
Clarence H
CH
Fryer-Edwards
Kelly A
KA
D001519:Behavior / Q000145:classification; D002965:Classification / Q000379:methods; D004504:Education, Medical, Undergraduate / Q000379:methods*; D026690:Ethics, Clinical / Q000193:education*; D006801:Humans; D007388:Internal Medicine; D010819:Physician's Role; D011361:Professional Competence / Q000592:standards*; D028743:Professional Misconduct; D012938:Social Perception; D012945:Social Values; D013044:Specialty Boards; D013337:Students, Medical / Q000523:psychology; D014481:United States