title: Preclinical medical student observations associated with later professionalism concerns.
abstract: OBJECTIVE
  Professionalism is a core physician competency and identifying students at risk for poor professional development early in their careers may allow for mentoring. This study identified indicators in the preclinical years associated with later professionalism concerns.
  
  
  METHODS
  A retrospective analysis of observable indicators in the preclinical and clinical years was conducted using two classes of students (n = 226). Relationships between five potential indicators of poor professionalism in the preclinical years and observations related to professional concerns in the clinical years were analyzed.
  
  
  RESULTS
  Fifty-three medical students were identified with at least one preclinical indicator and one professionalism concern during the clinical years. Two observable preclinical indicators were significantly correlated with unprofessional conduct during the clinical years: Three or more absences from attendance-required sessions (odds ratio 4.47; p=.006) and negative peer assessment (odds ratio 3.35; p=.049).
  
  
  CONCLUSIONS
  We identified two significant observable preclinical indicators associated with later professionalism concerns: excessive absences and negative peer assessments. Early recognition of students at risk for future professionalism struggles would provide an opportunity for proactive professional development prior to the clinical years, when students' permanent records may be affected. Peer assessment, coupled with attention to frequent absences, may be a method to provide early recognition.
authors.affiliation: a Department of Internal Medicine, Section on Endocrinology & Metabolism , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Burns
authors.affiliation: b Department of Economics , Wake Forest University , Winston-Salem , NC , USA.
authors.forename: M Ann
authors.initials: MA
authors.lastname: Lambros
authors.affiliation: c Department of Internal Medicine Section on Gerontology and Geriatric Medicine , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors.forename: Hal H
authors.initials: HH
authors.lastname: Atkinson
authors.affiliation: d Department of Biostatistical Sciences, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Russell
authors.affiliation: e Department of Emergency Medicine , Wake Forest School of Medicine , Winston-Salem , NC , USA.
authors.forename: Michael T
authors.initials: MT
authors.lastname: Fitch
mesh_terms: D000041:Absenteeism; D001291:Attitude of Health Personnel; D004504:Education, Medical, Undergraduate / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D019370:Observation; D010379:Peer Group; D000068616:Professionalism / Q000592:standards*; D012189:Retrospective Studies; D012307:Risk Factors; D013337:Students, Medical; D055815:Young Adult