title: The influence of personal and environmental factors on professionalism in medical education.
abstract: BACKGROUND
  Professionalism is a critical quality for physicians to possess. Physician professionalism has received increased attention in recent years, with many authorities suggesting that professionalism is in decline. An understanding of the factors contributing to professionalism may allow the development of more effective approaches to promoting this quality in medical education.
  
  
  CONCLUSIONS
  We propose a model of personal and environmental factors that contribute to physician professionalism. Personal factors include distress/well-being, individual characteristics, and interpersonal qualities. Environmental factors include institutional culture, formal and informal curricula, and practice characteristics. Promotion of professionalism requires efforts directed at each of these elements.
  
  
  CONCLUSIONS
  One responsibility of medical education is to foster the development of professionalism among its learners. Both personal and environmental factors play a role in physician professionalism. Accordingly, institutions should consider these factors as efforts to promote physician professionalism evolve.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA. west.colin@mayo.edu
authors.forename: Colin P
authors.initials: CP
authors.lastname: West
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
mesh_terms: D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods / Q000592:standards*; D004645:Empathy; D004992:Ethics, Medical / Q000193:education; D006808:Humanism; D006801:Humans; D015279:Organizational Culture; D010817:Physician-Patient Relations; D011361:Professional Competence / Q000592:standards*; D011364:Professional Practice / Q000592:standards*; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological; D013337:Students, Medical / Q000523:psychology*; D014481:United States; D016526:Workload