title: To participate or not participate in unprofessional behavior - Is that the question?
abstract: BACKGROUND
  Medical education provides students with abundant learning opportunities, each of which is embodied with messages concerning what is expected from students. This paper analyses students? exposure to instances of unprofessional behavior, investigating whether they judge such behavior to be unprofessional and whether they also participate in unprofessional behavior.
  
  
  METHODS
  The survey developed in the Pritzker School of Medicine at the University of Chicago was the basis of this questionnaire that was answered by 276 students from two medical schools in Brazil and Portugal.
  
  
  RESULTS
  Unprofessional behavior was observed frequently by students in both universities, and the mean participation rates were similar (26% and 27%). Forty-five percent of students? participation in unprofessional behavior was explained by academic year, prior observation, and judgment.
  
  
  CONCLUSIONS
  The results indicate that once students have observed, participated in or misjudged unprofessional behavior, they tend to participate in and misjudge such behavior. The frequency with which students judged behaviors they had observed or participated in as ?borderline? or unprofessional could mean that they are experiencing moral distress.
  
  
  CONCLUSIONS
  Proper discussion of unprofessional behavior should foster a broad debate to encourage empowered students, faculties, and physicians to co-create a more professional environment for patient care.
authors.affiliation: a Medicine School, Pontifical Catholic University of Paraná , Curitiba , Brazil.|b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal.
authors.forename: Renato Soleiman
authors.initials: RS
authors.lastname: Franco
authors.affiliation: a Medicine School, Pontifical Catholic University of Paraná , Curitiba , Brazil.|b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal.
authors.forename: Camila Ament Giuliani
authors.initials: CA
authors.lastname: Franco
authors.affiliation: a Medicine School, Pontifical Catholic University of Paraná , Curitiba , Brazil.
authors.forename: Solena Ziemer
authors.initials: SZ
authors.lastname: Kusma
authors.affiliation: b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal.
authors.forename: Milton
authors.initials: M
authors.lastname: Severo
authors.affiliation: b Department of Medical Education and Simulation, Faculty of Medicine , University of Porto , Porto , Portugal.|c Faculty of Medicine , University of Porto , Porto , Portugal.
authors.forename: Maria Amélia
authors.initials: MA
authors.lastname: Ferreira
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D001938:Brazil; D004501:Education, Medical / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal; D028743:Professional Misconduct / Q000523:psychology*; D057566:Self Report; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult