ProfessionalismLessonPlan
Designedtoberunbyanymedicaloralliedhealthprofessionalforgroupsofideallylessthan30medical
studentstoallowforwholegroupdiscussion,althoughcanbeusedforlargergroups.
Aim:
Toengagemedicalstudentsinacreativeandfunactivity,approachingprofessionalismfromasimilarly
vulnerableperspectivetothatapatientmaybein.
LearningPoints:
1.Professionalismisimportanttobeagoodmedicalstudentordoctorandallaspectsofitshouldbe
considered.
2.Whatthe4domainsusedintheGMC’s“Achievinggoodmedicalpractice:guidanceformedical
students”are,andwhateachoftheseincludes.
2.Begintohaveanawarenessofthe14subtopicsusedinthisguidance,andexploringpotentialpitfallsof
neglectinganysingleoneoftheseareas.
Overview:
Astheleaderofthislesson,youwillguideparticipantsthroughascenariowhichencouragesthemtothink
throughthequalitiesandcharacteristicstheywouldliketoseeinanytrustedprofessional,particularly
thoseinhigh-risksituations.Itiskeythatyouinitiallydonotrelatethelessontomedicalpracticeatall.
Thestudentswillbesplitintoteamsof4-6individuals,andinformedthattheyhavebeeninvitedtoa
skydivingsession.Onarrivalatthe“skydivingcentre”,theteamisrequiredtocreateanexhaustivelistof
thecharacteristicstheywouldliketheirinstructortohave,sothatjusttherightpersoncanbefound.
Theyarethenencouragedtorelatethecharacteristicstheyhavecomeupwithtotheframeworkgivenin
theGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”,andconsidertheimplication
oflackinganyspecificaspectsofprofessionalism,firstlyinthescenarioofskydiving,andsecondlyin
medicalpractice.
Thefollowingscriptcanbeusedflexibly,withadditionalactivitiestodevelopthis15-minuteactivityintoan
hour-longsessionifrequired.
Basicstructure:
1. Introduction“story”withexamplefromthe“previousskydivingteam”
2. Give15blankcardstowriterequirementsoftheirskydivinginstructor
3. Sort15whitecardsintothe4DOMAINheadings,(ifthereareanyblankwhite
cardstheycancompletethemnow).
4. Relatethisexercisetomedicine,givethe14SUBHEADINGcardsandmatch
themtothewhitecards
5. ForanyunmatchedSUBHEADINGcardsturnthemoverandaskstudentstoread
the“consequence”intheirgroup.
6. (Optional:addupa“score”basedonSUBHEADINGcardstheydid/didn’tmatch)
7. DiscusstheSUBHEADINGcardstheydidnotmatchtoanywhitecards.What
wouldbeapossibleoutcomeoflackingthisinmedicalpractice?
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
PREPARATION:
• ReadtheGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”,andensurethat
youarefamiliarwiththesummaryshownbelow.
• Preparea“pack”foreachteam,including
o 15blankwhitecards(seeAppendix1,alternativelyblankbusinesscardscanbeused)
o 1singlesidedreusableinvitationcard(seeAppendix2)
o 4singlesidedreusableDOMAINcards(seeAppendix3)
o 14doublesidedreusableSUBHEADINGcards(seeAppendix4)
• Preparetheroomwithseparatetablesforeachgroup,largeenoughtospreadthecardsouton,
andanoptional“leadershipboard”fortheteamscores.
NB:Mostoftheresourcesforthislesson(excludingtheblankwhitecards)canbelaminatedandreusedtominimizewastage.Ifre-usingthecardsisnotfeasible,anotheralternativeistoremovethe
backgroundcoloursfromAppendix3andAppendix4.
Summaryof“Achievinggoodmedicalpractice:guidanceformedicalstudents”forthislesson
NB:forthepurposesofthislessonthe4mainheadingsarereferredtoasDOMAINSandthe14categories
beneaththesearereferredtoasSUBHEADINGS
Domain1:Knowledge,skillsandperformance(3)
a) Developandmaintainprofessionalperformance
b) Applyknowledgeandexperienceinpractice
c) Recordworkclearly,legiblyandaccurately
Domain2:Safetyandquality(3)
a) Contributetoandcomplywithsystemstoprotectthepatientsyouareresponsiblefor
b) Respondtoriskstosafety
c) Protectpatientsandcolleaguesfromanyriskposedbyyourhealth
Domain3:Communication,partnershipandteamwork(4plusconfidentiality)
a) Communicateeffectively
b) Workcollaborativelywithcolleagues
c) Continuityandco-ordinationofcare
d) Establishandmaintainpartnershipswithpatients
Domain4:Maintainingtrust(4)
a) Showrespectforpatients
b) Treatpatientsandcolleaguesfairlyandwithoutdiscrimination
c) Actwithhonestyandintegrity
d) Openaboutlegal/disciplinaryproceedings
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
LESSONSCRIPT
(anyboxesinpalegreyareadditionalexpansionactivitiesthatcanbeusedifmoretimeisavailable)
Sectionslabeled“T”aretobedoneasawholegroup,eggroupdiscussions.Sectionslabeled“G”arefor
thesmallgroupandshouldhaveminimalinputfromthesessionleader.
Time Items
Activity
needed
1min Assignstudentstoteamsof4-6individualsatthestartofthe
lesson.
Aimformixedteamsratherthangroupsoffriends.Directthemto
thealreadysetouttables,eachofwhichshouldhavethe“invitation”
cardonit,facedown.
Youcouldaskthewholegrouptolineupinorderofshoesize,
birthday,furthestdistancetravelledthatday,etc,perhapseven
withoutspeakingandthendivideintoteamsaccordingly.Thiswould
givearandomselectionforeachteam,andwouldalsohelpthe
groupasawholetorelaxandengagewithactivities.
(White
Itmighthelpencouragegroupcommunicationatthisstagetodiscuss
boardor
asawholegroupwhatthestudents’expectationsareofa“lessonon
flipchart)
professionalism”.Ifyouhaveawhiteboard,youcouldwritedown
somewordstheywouldusetodescribeit.Trytoencouragehonesty
ratherthanthe“rightanswer”.Forexample,theymightsay
“interesting”,“unnecessary”,“difficult”,“relevant”,“boring”or
“practical”.Ifstudentsarereluctanttospeakup,youcouldtrygiving
eachofthemapieceofpapertowritedownonewordtodescribe
theirexpectationsandhaveallofthestudentsrevealtheircards
simultaneously.Itcouldhelprapportifyoushareyourexpectations
too!
Trytoalsoelicitwhattheythinktheyknowaboutprofessionalismso
far.AretheyawareoftheGMCguidanceformedicalstudents?Have
theyreadit?
2-3
Invitation
Explainbrieflytothewholegroupthattodayyouarelookingat
min
card
professionalismandintroducethescenario.
(score
Itisimportanttotryandavoiddirectlyrelatingittomedicineatthis
board)
point,astheaimistoengagetheteamsinlateralthinkingabout
professionalism.
Forexample,youmightsay:
Asyouknow,overthenext20minuteswearegoingtobethinking
aboutwhatprofessionalismmeans.Wehavesplityouintoteamsfor
theactivitieswewillbedoing.Iwillexplainwhattodoaswego
along.Youwilleachneedapen,butIwillprovideeverythingelse.
[ifscoringpointsfortheteams,explainatthispointthattherewillbe
points(andpossiblyprizes!)basedonhowwellyourteamdoesinthe
activities]
Youmighthavenoticedthatthereisacardonyourtable.Pleaseturn
itover!
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
3-4
min
15white
cards,pens
2-3
min
4domain
cards
1-2
min
[Giveafewsecondsforeveryoneintheteamtoreadit]
IwouldliketoaddmycongratulationstothoseoftheNational
CommitteeforMedicalStudentAttire.Welldone!Eachofyourteams
haswontheopportunitytogoskydiving.Howexciting!
UnfortunatelyIhavejustspokentothereceptionistattheskydiving
centre,andshehastoldmethatalloftheirusualinstructorsare
currentlyunavailable.Sheismorethanhappytofindanew
instructorforyou,butneedsyoutospecifyEXACTLYwhatyouwant
ofthem.Sheissurethanshecanguaranteeanycharacteristicsyou
askfor,butanycharacteristicsthatyoudon’tmention,your
instructorwon’thave.Thegroupbeforeyouaskedherforan
instructorwhowas“honestandreliable”butdidn’tsay“qualified”so
sheemployedthelocalbakerandhasn’tseenthemsince.
Iamgoingtogiveyou15whitecardstowritedownyour
requirementson.Youwillhave3minutestotryandthinkofasmany
asyoucan,butdon’tworryifyouhaven’tfinishedallofthewhite
cards,therewillbeanopportunitytoaddtothemlater.
Givetheteamssometimetowritedowncharacteristics
Keepaneyeonhowmanyofthewhitecardseachteamhasfilledin.
Tryandstopthemwhentheyhavedoneroughly10,orafter3-4
minutes.
Explaintothewholegroupthatyouhavesomeheadings,which
coverdifferentareasofprofessionalismtheymightwanttothink
about.
Giveeachteamasetofthe4colouredDOMAINcards.Askthemto
dividethewhitecardsbetweenthesecategories,andgivethem
sometimetocompleteanyremainingwhitecards.
Explaintothewholegroupthatwhenpeopleareskydiving,they
havetotrusttheirinstructorwiththeirlife.Oftenwhenpeople
participateinactivitieslikeskydiving,theyhavelittleknowledgeof
thespecificprocessesthatneedtobecompleted,althoughtheymay
havesomeideasaboutwhattoexpect.Theirideasmayprovetobe
correctorincorrect,buttheyneedtotrusttheresponsibleinstructor
tobehaveinasafe,professionalmanner.
Thisissimilarinlotsofwaystomedicine,whereyouwillhave
patientspotentiallytrustingyouwiththeirlife,withoutnecessarily
knowingwhetherwhatyouaredoingissafeorcorrect.
TheGMChaveproducedadocumentcalled“Achievinggoodmedical
practice:guidanceformedicalstudents”,whichlaysouttheaspects
ofprofessionalismtheyrequirefrommedicalstudents.Theysplit
these14aspectsinto4domains;theDOMAINcardsIgaveyouinthe
lastactivity.
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
2-4
min
14attribute Nextgivetheteamsthe14SUBHEADINGcards,whichfitintothe4
cards
domains.Withoutturningtheseovertheyshouldmatchthewhite
cardstotheSUBHEADINGcardsintheirteams.
[Teamsmayneedsomehelptostartthisoff.Trytocirculatebetween
theteamstogiveextrainformationonanyofthesubheadingsif
needed.ThereissomeoverlapbetweentheSUBHEADINGcards.
Theremaybesomethingstheyhavewrittendownthatdon’tfitinto
anyofthesubheadingsordomains.Youmightwanttobringthisup
inthediscussion]
Itwilllooksomethinglikethis:
(inthisexampletheyhave3unpairedSUBHEADINGcards)
1-2
min
Askthegroup:DoyouhaveSUBHEADINGcardsleftoverthatyou
didn’tmatchanyofthewhitecardsto?
AsktheminteamstoturnoveranyoftheSUBHEADINGcardswhich
areunpairedandreadthe“consequences”oftheirinstructornot
demonstratingthataspectofprofessionalism.Iftheyhavelotsof
unpairedSUBHEADINGcards,theyshouldchoosejust2or3toread
theconsequencesfor.
Theconsequencesaredramaticexamplestomakeanimportantand
memorablepoint:thereispotentialforharmifANYaspectof
professionalismisneglected.
Score
Forscoring:
board,pens +20pointsforanyoftheSUBHEADINGcardsthatarepaired.For
exampleifateamhaswritten“complieswithsafetyprocesses”they
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
2-3
min
1min wouldget+20pointsformatchingwithSUBHEADINGCard
“Contributetoandcomplywithsystemstoprotecttheskydiversyou
areresponsiblefor”.Iftheyhadalsowritten,“helpsdevelopsafety
systems”onanotherwhitecardtheywouldnotgetanyextrapoints
asthisisalsocoveredbythesamesubheading.
PointsaredeductedforeachoftheSUBHEADINGcardsthattheydid
notmatchanythingto,accordingtothescoresontheback.
Addupatotalscoreperteam.
Together:Asktheteamstochooseoneoftheirunpaired
SUBHEADINGcards.Encouragediscussionasawholegroup(orin
teamsifshortontime)aroundthequestionsinAppendix5.Ifyouare
shortontime,focusonthequestionslistedhere(q1,q3).Aimto
keepthediscussionpracticalratherthantheoretical.
1.Whydoyouthinkyoudidn’tconsiderthisaspectof
professionalismwhenyouwerediscussingitasateam?
3.Canyouthinkofsomeimplicationsofnothavingitifyouwerea
medicalstudent?
NB:akeypointintheusefulnessofthislessonasalearning
experienceisinrelatingtheseattributesbacktomedicalpractice,
throughthelensofconsideringthemselvesan“injuredparty”.The
aimisthatstudentswillrememberindividualcharacteristicsmore
readily,particularlywiththememorable“consequences”onthe
cards.
Youcanrepeatthesequestionsforoneortwomoreoftheunpaired
SUBHEADINGcards.Ifyouaredoingthis,youmightwantto
encourageteamstochoosesubheadingsfromdifferentdomains
wherepossible.
Ifyouhavelonger,youcouldgiveteamsonefulldomainfrom
“Achievinggoodmedicalpractice:guidanceformedicalstudents”to
lookoveranddiscussthepoints.Aimtokeepthediscussionpractical-
dotheythinkthisguidanceisthingstheydoinpracticethemselves?
Ifnot,whynot?Isthereanythingtheywouldadd?
Summarisewhattheyhavelearntandclosethesession
Ifyouareshortontimeyoucanbrieflysummarise.Otherwiseyou
couldgoroundandhaveeachstudentsay1thingthattheyhave
learnt,or1thingtheyenjoyed/1thingtheywouldimprove.
Ifyouhavekeptscores,announcethewinnersatthisstageand
congratulatethem.Ifyouhaveasmallprizeitcanmakethismore
fun.
Thankthestudentsandclosethesession
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
APPENDIX1:BLANKCARDSFORCHARACTERISTICSLIST
Topreparecards-cutalongthedottedlines
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
APPENDIX2:INVITATION
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
APPENDIX3:DOMAINCARDS
Topreparecards-cutalongthedottedlines
DOMAIN1:KNOWLEDGE,
SKILLSANDPERFORMANCE
DOMAIN2:SAFETYAND
QUALITY
DOMAIN3:COMMUNICATION,
PARTNERSHIPANDTEAMWORK
DOMAIN4:MAINTAINING
TRUST
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
Domain2
SafetyandQuality
Domain1
Knowledge,Skillsand
Performance
Domain1
Knowledge,Skillsand
Performance
Domain1
Knowledge,Skillsand
Performance
APPENDIX4:SUBHEADINGCARDS
Topreparecards-cutalongthedottedlines,thenfoldalongthecentraldoublelinetocreateadouble
sidedcard.
Attribute
Consequence
Developandmaintainprofessional
Youfailtorequirethatyourinstructorisqualified
performance
orhasmaintainedtheirqualifications.Asaresult,
- Acquireknowledgeandskillsasa
thereceptionistcallsinthelocalbakerwhoonce
student(goodattendance,
wentonaskydivein1963andthinkshecanmake
respondingtofeedback,
astabatit.Unfortunatelyhedoesn’treally
reflecting)
rememberitaswellashethoughtanddoesn’t
- Maintain/improveasa
pullthecorduntiltoolate.
professional.
Applyknowledgeandexperiencein
Youfailtorequirethatyourinstructorapplies
practice
theirknowledgeandskillsinaprofessional
- Workwithintheircompetence
manner.Therefore,sheturnsup2hourslate,by
- Behaveprofessionallyegnotlate,
whichtimethepilothasleft.Shedecidestofly
professionaldress
theplaneherselfasalthoughnotqualifiedtodo
- Gainingconsent
so,sheisfriendswithapilotwhohastalkedher
throughitbefore.Itturnsoutshecantakeoff,
butnotlandtheplane.
Recordworkclearlylegiblyand
Youfailtorequirethatyourinstructormakesa
accurately
recordofanythingclearly.Assuch,althoughshe
- Goodcontinuity,goodteamwork,
checkstheweatherreportbeforeyouleave,she
safehandoversfromone
writesitdownonascrapofpapertotakewith
professionaltoanother
her.Shortlybeforejumping,shelooksatitbutit
unsurewhethershehaswrittenNWorNEforthe
windspeed.Sheguesseswrongandyouare
blown50milesoffcourse,outtosea.
Contributetoandcomplywithsystems
Youdonotrequirethatyourinstructorisdiligent
toprotecttheskydiversyouare
incomplyingwithsafetysystems.Theinstructor
responsiblefor
cannotbebotheredfollowingallofthesafety
- complywithsystemsdiligently
checksbeforeheleavesandsoforgetstocheck
- seektoimprovesystems
theparachute.Whenitopensonthedescentitis
- openandhonestfollowing
immediatelyobviousthatithasalargeripinit,
significantevents
whichbecomesrapidlyworse.Unfortunatelyhe
alsodidn’treadtheinstructionsindicatingthat
youshouldalsohaveareserveparachute.
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
Domain3
Communication,
Partnership,Teamwork
Domain3
Communication,
Partnership,Teamwork
Domain3
Communication,
Partnership,Teamwork
Domain2
SafetyandQuality
Domain2
SafetyandQuality
Respondtoriskstosafety
- responsibilityofthewholeteam
- includesprotectingdignityand
comfort
Protectskydiversandcolleaguesfrom
anyriskposedbyyourhealth
- Seekadvicefromsuitable
colleagues
- Includesimpactofstressor
anxiety
- EngagewithOccupationalHealth
Communicateeffectively
- Clearcommunicationand
listening
- Takeintoaccountlanguageand
otherbarrierstocommunication
Youfailtorequirethatyourinstructorwill
respondtosafetyrisks.Asyoutakeoff,you
noticethattheplanedoorislooseandmention
thistotheinstructor.Sheshrugsandtellsyou
thatthisisthepilot’sresponsibility,whoyou
cannotcontactasheisinthecockpit.Therattling
becomesworseandat10,000ftthedoorfallsoff.
Youfailtorequirethatyourinstructorisdiligent
aboutprotectingyouandhiscolleaguesfrom
risksposedbyhisownhealth.Asaresult,the
receptionistemploysaninstructorwhohas
recentlyreturnedfromaskydivingexpeditionin
Tanzaniaandhasmalariawithafeverof410C.On
theascentintheplanehebecomesdeliriousand
onthefree-falllosesconsciousness.Youdonot
knowhowtoactivateorsteertheparachute.
Youdon’trequirethatyourinstructorhasgood
andclearcommunication,andsothereceptionist
employsafriendlyItalian.Unluckilyhedoesn’t
speakanyEnglishandyoucan’tspeakanyItalian.
Whenyouhaveopenedthedooroftheplaneyou
thinkhesays“go,I’mready”;hewasactually
saying“wait,Ineedtheparachute”
Workcollaborativelywithcolleagues
- Adaptbehaviorasnecessaryto
improveteamworking
- Treatallmembersoftheteam
withrespect
Yourinstructorisnotrequiredtohavegoodinterprofessionalworkingrelationships.The
receptionistcontactsanoldinstructorwhowas
askedtoleaveafterpunchingthepilot.Thepilot
hasnotforgivenhim,andtellshimtojumpwhen
theyareflyingoveranactivesurface-to-air
missiletestsite.
Continuityandco-ordinationofcare
- Safetransferbetweendifferent
professionalsandsettings
- Sharerelevantinformation
Youdon’taskforaninstructorwiththeabilityto
passoninformationwell.Theinstructororganizes
theparachutes,butaccidentallyleavesthem
behind.HecallshisslightlydeafGrantopick
themup,whocallsherslightlyblindfriend,who
picksupthewrongbag.Youdon’trealizeuntil
youhavejumpedthatitonlyholdsdirtylaundry.
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
Domain3
Communication,
Partnership,Teamwork
Domain4
MaintainingTrust
Domain4
MaintainingTrust
Domain4
MaintainingTrust
Domain4
MaintainingTrust
Establishandmaintainpartnerships
withskydivers
- Treatthemasindividuals
- Listentothemandtreatthem
fairly,withrespect
- Beclearaboutroles
Youdonotaskforaninstructorwhowantsto
workwithskydivers.Thereforewheneveryou
offertohelphesays,“Iamtheinstructor,Iknow
best.”Whenyouarereadytojump,youthinkyou
seesomestormyweathercoming,butdon’tfeel
comfortablespeakingup.Itturnsouttobea
hurricane,whichyoumeethalfwaydown.
Showrespectforskydivers
Youdonotaskforaninstructorwhoshows
- notpursuingimproperorsexual
respectforthoseintheircare.Yourinstructor
relationshipswithskydivers
behavesoddlyontheflightup,askingwhichgirls
- notexpressingpersonalbeliefsin
areinrelationships.Whenthedoorisopenedhe
distressingways
declareshimselfa“Beyonceworshipper”and
- honestyifsomethinghasgone
stateshewilloffer“singleladyhumansacrifices”.
wrong
Heforcefullyaskswhowantstogooutthedoor
first.
Treatskydiversandcolleaguesfairlyand
Youdonotrequirethatyouinstructortreatall
withoutdiscrimination
skydiversfairly.Hejokesthatthewomenshould
- donotdelayhelpbecauseyou
“stayonthegroundandmakesandwichesfor
believetheskydiverhas
whentheygetback”.Itturnsoutthepilotis
contributedtotheproblem
actuallyfemaletoo,andrefusestoflytheplane.
- awareofunconsciousbias
Thereforenobodycangoskydiving.
Actwithhonestyandintegrity
Youdonotaskforaninstructorwhobehaves
- honestinallregards.Including:
withhonestyandintegrity.Sherealizesshortly
experience,qualifications,
aftertakeoffthatsheforgottopackenough
plagiarism,yourownhealth,
parachutesforalltheparticipantsbutdoesn’t
communicationwithpatientsand
wanttoadmitthemistake,sosheputsajumper
colleagues,finances,insurance.
intheemptybagtopaditout.Oneofyoupulls
theripcordondescent,toreleaseonlyafluffy
purplefleece
Openaboutlegal/disciplinary
proceedings
- honestduringlegalproceedings
- informsemployersofany
convictionsorcautions
immediately
- Withinandoutsidework
Youdidn’taskforaninstructorwhowasopen
aboutlegalanddisciplinaryproceedings.Itturns
outthatheisontherunfromthepolice,and
whenyouaskhisnameherepeatedlysays“John
Smith”inaheavilyaccentedvoice.Theplane
seemstobetakinglongerthanyouwouldexpect,
andwhenyoulandafterthedive,thetreeslook
suspiciouslytropical;thesandsuspiciouslywhite.
BethanyLloyd,Year5,UniversityofAberdeen([email protected])
APPENDIX5:Questionsfordiscussion
1. Whydoyouthinkyoudidn’tconsiderthisaspectofprofessionalismwhenyouwerediscussingitas
ateam?
2. Canyouthinkofatimewhenyousawthisbeingneglectedinmedicalpractice,maybebyafellow
medicalstudent,aconsultant,anFY,anurseoranyoneelse?Whathappened?
3. Whatmightbetheimplicationsofdisregardingthisaspectofprofessionalismasamedicalstudent?
Orapracticingdoctor?
4. Whatcouldyoudotoensurethatyouputthisintopracticenowandinthefuture?
5. Howcomfortablewouldyoufeelchallengingsomeoneelseaboutthis?Whatiftheywere
significantlymoresenioregyourconsultantorsupervisor?Whatiftheywereanothermemberof
themulti-professionalteamegaphysiotherapist,dietician,nurse?
BethanyLloyd,Year5,UniversityofAberdeen([email protected])