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Clinical Behavior: Evaluating A Student’s Professionalism

Many health care accreditation organizations require that programs not only foster professionalism, but also prove that graduates possess these qualities. The evaluation of values, affect, and communication skill, is significantly more difficult than the evaluation of cognition or psychomotor skill. If evaluating professionalism troubles you, here are some tips to ease your discomfort.

  • Create an evaluation form that is short enough to be used on a daily basis.
    As with any metric, the greater the sample size the more reliable the data.
  • Define the essence of professional behavior with other professionals.
    Collaborate with colleagues to create evaluation questions like:
    Does the student ...
    • Arrive in the clinical area at the assigned time to receive report and begin work?
    • Report well groomed, dressed and equipped appropriately for the specific clinical rotation?
    • Exhibit concern for patients’ needs and rights?
    • Accept responsibility for his/her actions?
    • Communicate effectively with patients, peers, physicians and other hospital personnel?
    • Demonstrate interest in the clinical rotation and show the initiative to seek out supporting activities?

    It is virtually impossible to list every behavior associated with skills like communicating effectively. Therefore, the instruction section should emphasize that any negative responses to these questions require elaboration describing the student’s behavior.
  • Incorporate a progressive remediation approach.
    Consider this example. A student’s evaluation states that she did not draw the curtain during an exam, thus neglecting the patient’s privacy. This first offence merits advice from the instructor about work habits that preserve the patient’s privacy. In the event that a second similar offence occurs, the student should be reminded of the professional expectations and be told of the consequences of another similar infraction. In this scenario, it should be no surprise to the student when her third infraction results in remediation.
  • Use multiple types of raters.
    Remember, evaluation in the affective domain is all about perception. Who can evaluate a student’s patient education skills better than their patients? Who can offer insight to the student’s teamwork skills better than the staff? In addition to greater accuracy, you will have more confidence in the objectivity of the evaluation. When a number raters note the same behavior problem, you can discount a personality conflict or a "bad day."

The evaluation of intangibles, like enthusiasm and respect, is difficult but not impossible. The next time you must counsel a student about professional behavior may seem less like "I don’t like your attitude," if you employ this more objective approach.

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