Abstract:

Background:
Medical professionalism (MP) is a vital competency in undergraduate medical students as it enhances the quality and safety of patient care. The majority of medical institutions are imparting explicit and structured professionalism teaching either as a standalone module or part of other modules. However, the value of such explicit reforms and curriculum interventions has been questioned, prompting tension in developing professional identities of medical students. This study aims explore medical students' change in behaviours by exploring the process and outcome of curated series of online workshops on professional behaviour (PB).

Methods:
An international team of experts in MP and medical students were invited to participate in the design of the series of online workshop and materials delivered to undergraduate medical student in two institutions, RCSI University of Medicine and Health Sciences, Ireland and Queens University Belfast, United Kingdom. The design involved:
(i) workshop development (i.e., consensus decision on themes of professionalism, resources and guidance for participants and facilitators, and scenarios for discussion and analysis during the workshops using Rolf’s approach (What, so what, now what);
(ii) timeline;
(iii) and data collection and analysis using mixed methods of quantitative and qualitative analyses conducted using surveys (pre and post workshop) and electronic focus group discussions (post workshop), respectively. The design was based on the theory of planned behaviour (TPB) and social cognitive theory.

Findings:
The study is still ongoing. Four workshops were designed and delivered to participants (n=52) on four themes of professionalism: confidentiality, cultural awareness, raising concerns and selfcare and wellbeing. Each workshop duration was 75 minutes which included four sections:
(i) 15 minutes introduction of the workshop topic to all participants;
(ii) 40 minutes scenario-based discussion and analysis (10 minutes for each scenario) in breakout rooms of 5 participants and 2 facilitators in each room;
(iii) 25 minutes case feedback and discussion of all participants; and
(iv) workshop wrap-up and feedback.

For each workshop topic, resources and materials were designed for participants and facilitators to knowledge on guidance, what is expected in practice, regulators and healthcare promoters. Twenty-two and 10 participants undertook surveys at pre and post workshop, respectively; t-test analysis showed significant improvement in PB (P<0.05). Twenty-four students participated in electronic focus group discussion and analysis will examine the perceived influence of workshops and explore the consistency and any variability of the intervention. Results from both analyses will then be triangulated.

Conclusion:
The intervention have facilitated discussions and collective reflections in the context cognition and profound impact on undergraduate medical students intention to execute PB. The workshop designed served as pre-sensitization of students about potential professional lapses, increasing their confidence and competency to deal with the implicit professional dilemmas which will improve professionalism in practice. Educators can apply these strategies and educational resources to implement collaborative education in MP and promote cultural understanding and professional identity formation in medical students.

Keywords:

Medical professionalism, hidden curriculum, undergraduate medical students, cultural sensitivity.