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P o essionalism in medical educa ion: An e olu iona y concep
analysis
Nas in Hani i1, Seyede Fa emeh Gheiasi2*
1Depa men o Eme gency and C i ical Ca e Nu sing, School o Nu sing and Midwi e y, Zanjan Uni e si y o Medical Sciences, Zanjan, I an.
2Depa men o Ope a ing Room and Anes hesiology, School o Nu sing and Midwi e y, Zanjan Uni e si y o Medical Sciences, Zanjan, I an.
A icle in o Abs ac
In oduc ion
P o essional de elopmen in medical educa ion is buil
upon he ounda ion o p o essionalism.
(1, 2). P o essionalism in he medical ield in ol es
alues, beha io s, and ela ionships ha es ablish us ,
including e hics, empa hy, communica ion, and
collabo a ion, which s uden s and p ac i ione s mus
consis en ly demons a e (3). Uni e si ies o medical
sciences ha e a long his o y o educa ing specialized
aspec s o medicine. Howe e , he eaching and
de elopmen o p o essionalism in he educa ion o
medical s uden s is s ill in i s in ancy (4). In medical
educa ion, in addi ion o eaching clinical knowledge and
skills in any p o ession, a en ion should be paid o
de eloping and s eng hening alues, a i udes, mo al
no ms, and social skills (1, 2, 4). The e o e, one o he
missions o medical uni e si ies is o educa e
p o essional s uden s (2, 4-6). P o essionalism is one o
he main compe encies s uden s should acqui e du ing
Hani i e al. J Med Edu De . 2024; 17(56): 138-150 Jou nal o Medical Educa ion De elopmen
Backg ound & Objec i e: Teaching p o essionalism is one o he ounda ions o p o essional
de elopmen o medical s uden s. The p esen s udy aimed o explain he an eceden s,
a ibu es, and consequences o p o essionalism in medical educa ion.
Ma e ial & Me hods: In his s udy, Rodge s' e olu iona y concep analysis app oach was used.
The sea ch was pe o med using he keywo ds "p o essionalism", "medical educa ion" and
simila wo ds in PubMed, Scopus, Scien i ic In o ma ion Da abase (SID), and Magi an
da abases and sea ch engine Google Schola . Li e a u e published in English and Pe sian was
included in he s udy. 59 a icles we e analyzed using he con en analysis app oach and
a ibu es, an eceden s, and consequences o p o essionalism in medical educa ion we e
iden i ied.
Resul s: The a ibu es o p o essionalism in medical educa ion we e iden i ied in " he
eme gence o he p o essional ole models" and " he ins i u ionaliza ion o he cul u e o
p o essionalism in educa ion". The "manne " and "compe ence" o p o esso s and "uni e si y
policy in achie ing p o essionalism" we e de e mined as an an eceden , and he consequences
o heal h s akeholde s in "communi y" and "s uden " dimensions we e de ined as he
consequences o p o essionalism in medical educa ion.
Conclusion: P o essionalism in medical educa ion in ol es he p esence o p o essional ole
models and he es ablishmen o a cul u e o p o essionalism wi hin educa ional en i onmen s.
This includes p o essional cha ac e and compe encies and mo al quali ies such as ole ance,
ai ness, and espec o human alues. The an eceden s o p o essionalism include he manne
and compe ence o p o esso s and he uni e si y's plans o achie e p o essionalism. The
consequences o p o essionalism in medical educa ion include imp o ed heal h ou comes o
he communi y, enhanced pa ien sa is ac ion, and he de elopmen o posi i e a i udes and
beha io s in s uden s. P o essionalism in medical educa ion aims o ain p o essional s uden s
and p o ide high-quali y se ices o ensu e socie y's heal h.
Keywo ds: p o essionalism, medical p o essionalism, e hics, medical educa ion, p o essional
e hic
*Co esponding au ho :
Seyede Fa emeh Gheiasi, RN, MSc,
PhD, Assis an p o esso , School o
Nu sing and Midwi e y, Zanjan
Uni e si y o Medical Sciences,
Zanjan, I an.
Email: a [email protected]
Re iew A icle
A icle his o y:
Recei ed 20 Dec. 2023
Accep ed 9 Jul. 2024
Published 14 Dec. 2024
How o ci e his a icle:
Hani i N, Gheiasi S. P o essionalism
in medical educa ion: An e olu iona y
concep analysis. J Med Edu De .
2024;17(56):138-150.
[ DOI: 10.61186/edcj.17.56.138 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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Hani i e al.: P o essionalism in medical educa ion: An e olu iona y concep analysis
Jou nal o Medical Educa ion De elopmen ¦ Volume 17 ¦ Issue 56¦ 2024 139lopmen ¦
Volume 17 ¦ Issue 54¦ 2024
hei s udies (7, 8). P o essional iden i y de elopmen ,
p o essional beha io in pa ien in e ac ion, al uism, and
cul u al compe ence a e among he dimensions o
p o essionalism (9-11). The quali y o heal h se ices
depends on employees' le el o p o essional beha io
(12). P o essionalism in he medical p o ession inc eases
pa ien sa e y and sa is ac ion, educes s a occupa ional
bu nou , and communi y us in he heal h sys em, and
p omo es communi y heal h (13-16). Con e sely, non-
obse ance o p o essionalism by employees has
nega i e consequences. The esul s o a e iew s udy
showed ha pa ien dissa is ac ion and complain s a e
ela ed o employees' unp o essional beha io (17). The
esul s o some s udies indica e ha medical sciences
s uden s who had unp o essional beha io s du ing hei
s udies con inue his end in hei u u e pe o mance
(18, 19). The e o e, o imp o e he heal h sys em’s
pe o mance in p o iding quali y se ices, uni e si ies
should pay mo e a en ion o p o essional educa ion o
ain p o essional s a (20). On he o he hand, he apid
g ow h o medical knowledge and skills, inc easing
a en ion o he media o heal h ca e issues,
mul idisciplina y eamwo k in heal h ca e, changes in he
a i ude o doc o s, and he comme cial iew o heal h
a e among he ac o s ha cause pay mo e a en ion o
p o essionalism (21). In ecen yea s, heal hca e
p o essionals ha e become mo e ac i e in clinics,
o ices, and home ca e. Usually, he e a e no special
o ganiza ional goals in hese places and hey a e no
unde supe ision. The e o e, heal hca e p o essionals
mus adhe e o he p inciples o p o essionalism, and his
aining is achie ed du ing educa ion.
P o essionalism educa ion in medical sciences equi es
unde s anding his concep . P o essionalism is a complex
and mul idimensional s uc u e whose de ini ion changes
o e ime and in con ex (22, 23). A e iew o s udies
shows ha p o essionalism is speci ically de ined in
some ields and clinical en i onmen s (13, 24, 25).
Despi e he impo ance p o essionalism in medical
educa ion, his concep and bounda ies a e no explici
o medical educa ion o unde s and. Mo e cla i ica ion
o he concep o p o essionalism in medical educa ion
helps o e iew policies, s anda ds, codes o e hics, and
p o essional alues.
O igin and dic iona y de ini ion o
p o essionalism in medical science
Me iam-Webs e ’s Dic iona y de ines he wo d
p o essionalism as “ he conduc , aims, o quali ies ha
cha ac e ize o ma k a p o ession o a p o essional
pe son” (26). P o essionalism is also de ined in he
Longman Dic iona y as “ he skill and high s anda ds o
beha io expec ed o a p o essional pe son”
(27).P o essionalism is a wo d whose meaning is no
de ined by he dic iona y alone bu is in he essence o
he medical p o ession and e e s o wha a p o essional
does (28). P o essionalism is no a new concep , as i has
exis ed h oughou medical his o y in he o m o
medical oa hs (29). A Roman physician named
Sc ibonius de ined p o essionalism as “ he commi men
o compassion o clemency in he elie o su e ing”
(20). The Royal College o Physicians de ined Medical
p o essionalism as “a se o alues, beha io s, and
ela ionships ha unde pins he us he public has in
doc o s” (30). In some de ini ions, he p io i y o pa ien
well-being, espec o pa ien independence, and he
p omo ion o social jus ice in he heal h ca e sys em a e
conside ed as he h ee basic p inciples o
p o essionalism (5). Some s udies ha e ound i
necessa y o commi o en p o essional esponsibili ies
in p o essionalism o ul ill hese h ee p inciples. These
10 p o essional esponsibili ies include commi men o
p o essional compe ence, commi men o hones y wi h
pa ien s, commi men o sec ecy, commi men o
main aining p ope ela ionships wi h pa ien s,
commi men o imp o ing he quali y o ca e,
commi men o imp o ing access o ca e, commi men o
jus ice in he dis ibu ion o limi ed esou ces,
commi men o he use o scien i ic and echnological
knowledge, commi men o main aining us by
managing con lic s o in e es , commi men o
p o essional esponsibili ies (5, 20). Al hough he e a e
se e al de ini ions o p o essionalism, he e is no
comp ehensi e de ini ion o p o essionalism in medical
educa ion. The cul u al con ex o any socie y in luences
he de ini ion o p o essionalism. S udies by Lee (25),
Dehghani (13), and Ghadi ian (24) ha e p o ided
a ious de ini ions o p o essionalism in medical
science. P o essionalism is de ined as he conduc , aims,
o quali ies ha cha ac e ize a p o ession o a
p o essional pe son. I has exis ed h oughou medical
his o y, wi h de ini ions anging om he commi men o
compassion o he p omo ion o social jus ice. Some
s udies ha e iden i ied en p o essional esponsibili ies o
ul ill hese p inciples, including commi men o
p o essional compe ence, hones y, sec ecy, main aining
p ope ela ionships, imp o ing ca e quali y, access o
ca e, jus ice in esou ce dis ibu ion, and he use o
scien i ic and echnological knowledge. Howe e , he e
is no comp ehensi e de ini ion o p o essionalism in
medical educa ion, as he cul u al con ex o any socie y
in luences i s de ini ion. Dehghani e al. iden i ied
p o essionalism in nu sing wi h h ee basic elemen s:
p inciples o ca e, communica ion, and e hics (13).
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Hani i e al.: P o essionalism in medical educa ion: An e olu iona y concep analysis
140 Jou nal o Medical Educa ion De elopmen ¦ Volume 17 ¦ Issue 56 ¦ 2024
Acco ding o Ghadi ian e al., p o essionalism in nu sing
is de ined by h ee cogni i e, a i udinal, and
psychomo o a ibu es (24). Lee e al. iden i ied
p o essional nu sing cha ac e is ics as ad anced nu sing
knowledge, excellen skills, pa ien -based ca e, e hics,
esponsibili y, coope a ion, independence, si ua ional
judgmen , and p oblem-sol ing (25). In hese s udies, he
concep o p o essionalism has been s udied only in
nu sing, and o he ields o medical sciences ha e no
been conside ed. The e o e, a comp ehensi e concep
analysis is necessa y o explain p o essionalism in
medical educa ion.
The apid g ow h o medical knowledge and skills,
inc easing a en ion o he media o heal h ca e issues,
mul idisciplina y eamwo k in heal h ca e, changes in he
a i ude o doc o s, and he comme cial iew o heal h
a e among he ac o s ha cause mo e a en ion o
p o essionalism (21). Since he e is no ag eemen on he
de ini ion o p o essionalism in medical educa ion.
Explaining he concep o p o essionalism can p o ide a
basis o he de elopmen o his compe ence in medical
s uden s. The p esen s udy aimed o explain he
an eceden s, a ibu es, and consequences o
p o essionalism in medical educa ion.
Ma e ial & Me hods
The p esen s udy was based on Rodge s’ e olu iona y
concep analysis and aimed o cla i y he concep o
p o essionalism in medical educa ion and de e mine i s
an eceden s, a ibu es, and consequences. Rodge s’
concep analysis me hod explo es he e olu ion and
con ex ual impac o concep s. This app oach ocuses on
a concep ’s con ex , su oga e e ms, an eceden s,
a ibu es, examples, and consequences. Rodge s
in oduces a cyclic model ha can adap o he cons an ly
e ol ing na u e o ideas. The esea ch p ocess is
cha ac e ized by i s non-linea and lexible na u e, whe e
six p elimina y ac i i ies can be conduc ed
simul aneously. The ac i i ies encompass unde s anding
ocus, selec ing a con ex , collec ing da a, analyzing
in o ma ion, iden i ying an example, and o ming
hypo heses and po en ial ou comes. Rodge s ocuses on
analyzing and in e p e ing aw da a wi hin a p o ession’s
social and cul u al con ex (31). In his s udy,
p o essionalism in medical educa ion was iden i ied as
he desi ed concep . Then, a icles in p o essionalism in
medical sciences and medical educa ion we e e iewed
in a ious da abases.
Li e a u e sea ch
A e iden i ying he concep o in e es , he mos
impo an s ep is iden i ying and selec ing he
app op ia e ealm (se ing and sample) o da a
collec ion (31). A his s age, o gain a deep
unde s anding o he concep o p o essionalism in
medical educa ion, he sea ch was conduc ed in
da abases including PubMed, Scopus, Google Schola
Pe sian language da abases, Scien i ic In o ma ion
Da abase (SID), and Magi an. Based on he indices o he
a ious da abases, he sea ch o he e ms o
p o essionalism and medical educa ion was done using
OR and AND ope a o s. A icles we e sea ched in
No embe 2020 and upda ed in May 2024 in he
PubMed, Scopus da abases, and Google Schola .
Reco ds we e managed using EndNo e so wa e o
exclude duplica es (Table 1).
Table 1. Sea ch s a egy
Da a
base
Sea ch s a egy
Language
Numbe
PubMed
(P o essionalism [MeSH Te ms] OR P o essionalism [Ti le/Abs ac ]) AND (Educa ion, Medical [MeSH
Te ms] OR medical educa ion [Ti le/Abs ac ]) AND (C oss-Sec ional S udies [MeSH Te ms] OR C oss-
Sec ional S udy [Ti le/Abs ac ] OR Quali a i e Resea ch [MeSH Te ms] OR Quali a i e [Ti le/Abs ac ]
OR Sys ema ic Re iews as Topic [MeSH Te ms] OR sys ema ic e iew [Ti le/Abs ac ] OR e iew
[Ti le/Abs ac ])
English
975
Scopus
TITLE-ABS-KEY (p o essionalism) AND TITLE-ABS-KEY (medical AND educa ion) AND TITLE-
ABS-KEY (c oss AND sec ional AND s udy) OR TITLE-ABS-KEY (quali a i e AND s udy) OR TITLE-
ABS-KEY (sys ema ic AND e iew )
English
1052
Inclusion c i e ia and da a ex ac ion
The inclusion c i e ia o a icles we e access o Full Tex
Pe sian o English a icles and ha ing a c oss-sec ional
design, quali a i e esea ch, and sys ema ic
e iew. These h ee me hods we e selec ed o ensu e
accu a e iden i ica ion o he concep while p ese ing i s
de ining a ibu es in exis ing li e a u e. Sea ching o
a icles by one esea che and e iewing s udies in e ms
o hema ic ele ance was done by bo h esea che s (NH
& FGH) and independen ly. In he ini ial sea ch, he o al
numbe o documen s ob ained was 2027. A o al o 881
a icles we e ound in he sea ch o g ay li e a u e ac oss
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Hani i e al.: P o essionalism in medical educa ion: An e olu iona y concep analysis
Jou nal o Medical Educa ion De elopmen ¦ Volume 17 ¦ Issue 56¦ 2024 141lopmen ¦
Volume 17 ¦ Issue 54¦ 2024
SID, Mag I an, and Google Schola . A e e iewing he
i les o he a icles in e ms o hema ic ele ance and
emo ing duplica es, 476 a icles emained. Bo h
esea che s eached an ag eemen by discussion and
consensus i hey had any doub in iden i ying eligible
a icles. The abs ac o hese a icles was hen e iewed.
By emo ing i ele an i ems, 183 o he a icles eached
he ull- ex e alua ion s age. A his s age, 124 a icles
we e excluded om he s udy due o lack o access o
Full-Tex a icles in Pe sian o English, ha ing clinical
ial design, g ay a icles, and low-quali y a icles.
Quali y assessmen
The quali y o c oss-sec ional a icles, sys ema ic e iew
a icles, and quali a i e a icles was assessed wi h he
STROBE (S eng hening he Repo ing o Obse a ional
S udies in Epidemiology) checklis , PRISMA (The
P e e ed Repo ing I ems o Sys ema ic Re iews and
Me a-Analysis), and CASP (C i ical App aisal Skills
P og am) checklis . These checklis s acili a e he c i ical
app aisal o s udies. Finally, he ull ex o 59 a icles
was ho oughly analyzed (Figu e 1). The quali y o he
s udies was checked by wo esea che s (NH & FGH)
independen ly. Any disag eemen s we e esol ed by
discussion and consensus.
Figu e.1. The lowcha ex ac ing a icles
Da a analysis
Acco ding o Roge s' concep analysis me hod, con en
analysis is ecommended o analysis, so selec ed s udies
we e analyzed using his app oach (32). This me hod
assis s in desc ibing and in e p e ing ex ual da a h ough
sys ema ic da a coding. In o de o enhance ou
unde s anding o he concep , we ho oughly e iewed
he s udies ha we e iden i ied (33). We ex ac ed
ele an in o ma ion abou a ibu es, an eceden s,
consequences, con ex ual basis, ela ed concep s, and
al e na i e wo ds. In each sec ion, he esea che ead he
da a mul iple imes o ex ac key poin s and labels o
clea desc ip ions o each aspec o he concep . The
concep was analyzed using induc ion, and hemes we e
disco e ed (33). To ensu e he c edibili y o componen s
in he concep analysis, NH & FGH conduc ed
PubMed
N=975
Scopus
N=1052
Google Schola
N=204
SID
N=147
Magi an
N= 530
Reco ds iden i ied h ough i e da abases sea ching
N=2908 i le
Reco ds emo ed because o duplica ion
and no ela ed o aim s udy
N=2432
Abs ac s we e excluded:
N=293
Full- ex a icles excluded, no ela ed o aim
o s udy:
N=124
Abs ac s sc een o ela edness
N=476
Full- ex a icles assessed o eligibili y and
ela edness o aim o s udy:
N=183
S udies included in analysis
N=59
Pe sian pape (N=21)
English pape (N=38)
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Hani i e al.: P o essionalism in medical educa ion: An e olu iona y concep analysis
142 Jou nal o Medical Educa ion De elopmen ¦ Volume 17 ¦ Issue 56 ¦ 2024
independen assessmen s. The au ho s discussed
inco po a ing ele an s udy analyses in o he concep
analysis, aiming o sha e indings and each a consensus
on subsequen ac ions, esol ing disag eemen s, and
achie ing consensus.
Resul
F om he analysis o 59 a icles, 572 p ima y codes we e
ex ac ed. Su oga e and ela ed e ms we e iden i ied.
The p ima y code was di ided in o se en ca ego ies
(Figu e 2). These se en ca ego ies we e assigned o
an eceden s, a ibu es, and consequences (Table 2).
Figu e 2. An eceden s, a ibu es, and consequences o he concep o p o essionalism in medical educa ion
Table 2. The an eceden , a ibu e, and consequence o p o essionalism in medical educa ion
An eceden
Ca ego ies
Subca ego y
Manne
Pe sonal cha ac e is ics (7, 36, 40-46)
Communica ion skills (7, 40, 42, 47-
51)
Compe ence
Adhe ence o p o essional e hics (16,
23, 36, 40, 45, 46, 48, 50-54)
Educa ional skills (36, 42, 48, 55, 56)
Uni e si y planning o achie e p o essionalism
A en ion o o icials o he con en o
he hidden cu iculum (1, 46, 56, 57)
A ac ing e hical and p o essional
p o esso s, e aining p o esso s (58)
De eloping guidelines and e hical
codes o p o essionalism (59)
A ibu e
The eme gence o p o essional ole models in
educa ional en i onmen s
Vi ue (41, 44, 56, 61-63)
Excellence (16, 40, 41, 44)
High mo al sensi i i y (38, 45)
Ins i u ionalizing a cul u e o p o essionalism in medical educa ion (37, 45, 64-67)
Consequence
Consequences o heal h s akeholde s in he communi y dimension (2, 38, 42, 53, 64, 65)
Consequences o heal h s akeholde s in he s uden dimension (36, 38, 42, 51, 53, 57, 65, 68-70)
1- Su oga e and ela ed e ms
Rela ed e ms co e only a pa o he ela ions and
dependencies o he main concep . The e o e, i does no
ha e all he a ibu es and cha ac e is ics o he concep
unde s udy (31). The mos common e ms ela ed o
p o essionalism iden i ied in he s udy we e p o essional
e hics (34-38) and p o essional beha io s (39).
Su oga e e ms mean exp essing he concep wi h wo ds
and exp essions o he han he concep chosen o he
s udy (31). Medical p o essionalism was iden i ied as he
mos common al e na i e e m (2, 6, 40).
1-1 An eceden s
An eceden s a e he p e equisi es o he concep unde
conside a ion and a ec he occu ence o he concep
 Manne
 Compe ence
 Uni e si y planning
o achie e
p o essionalism
 The eme gence o
p o essional ole
models in
educa ional
en i onmen s
 Ins i u ionalizing a
cul u e o
p o essionalism in
medical educa ion
 Consequences o
heal h s akeholde s
in he communi y
dimension
 Consequences o
heal h s akeholde s
in he s uden
dimension
An eceden s
Consequences
A ibu es
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Hani i e al.: P o essionalism in medical educa ion: An e olu iona y concep analysis
Jou nal o Medical Educa ion De elopmen ¦ Volume 17 ¦ Issue 56¦ 2024 143lopmen
¦ Volume 17 ¦ Issue 54¦ 2024
(31). An eceden s in his s udy, he manne and
compe ency o p o esso s and uni e si y planning o
achie e p o essionalism we e iden i ied (Table 2).
1-1-1 Manne
The manne o p o esso s was iden i ied in wo
subca ego ies pe sonal cha ac e is ics and
communica ion skills.
The pe sonal cha ac e is ics o p o esso s in medical
educa ion include ha ing some pe sonali y ai s such as
compassion o s uden s and colleagues, sel -con idence
(36), eliabili y (41, 42), spon anei y (36, 40), leade ship
(40, 42), c ea i i y (42), sel -managemen (7, 41), nea
and beha io (36, 43), coope a ion wi h o he s (40, 41,
44-46) lexibili y (7, 40), and c i icism (36). The
p o esso ’s communica ion skills we e conside ed
ano he subca ego y o he p o esso ’s cha ac e .
Hones y abou s uden s, colleagues, and pa ien s (42, 47-
49), body language (40, 50) espec in in e ac ions (51),
and main aining he digni y o he s uden and he pa ien
in communica ion (7, 40, 47), we e iden i ied in he ield
o communica ion skills o he p o esso in medical
educa ion.
1-1-2 Compe ence
P o esso compe ence was ano he essen ial dimension
o es ablishing p o essionalism in medical uni e si ies,
which was cha ac e ized by wo subca ego ies adhe ence
o p o essional e hics and educa ional skills.
Findings showed ha adhe ence o p o essional e hics in
p o esso s o medical uni e si ies is cha ac e ized by
espec o au onomy (16, 50, 52-54) con iden iali y (36,
40, 50, 51), non-male icence (36, 52), and ai ness in
beha io and esou ce alloca ion (40, 52). Also, he
esul s showed signs o he p o esso ’s adhe ence o
p o essional e hics, esponsibili y o he s uden ,
colleagues, and he communi y (23, 50, 52),
accoun abili y o he communi y and p o ession (45, 46,
51) o ganiza ional commi men , and esponsibili y o he
obse ance o e hical p inciples (46, 48, 50, 52).
Ha ing educa ional skills was ano he compe ency o
p o essional eache s. Familia i y wi h he p inciples o
eaching, class oom managemen skills, ha ing high
knowledge, expe ise, and mas e y o he subjec o
eaching, ha ing c i ical hinking, using new esou ces
and he con en equi ed by s uden s, using educa ional
me hods such as in e -p o essional educa ion (55),
in eg a ed app oach, men o ship (56) and p ac ical
expe iences (42) we e men ioned as app op ia e skills o
eaching p o essionalism in medical educa ion. The use
o e alua ion me hods ollowing he educa ional
objec i es, p o iding app op ia e eedback, and
e alua ion based on he deg ee o obse ance o
p o essional and e hical p inciples o s uden s in he
clinic (36, 48) we e iden i ied as he necessa y
educa ional skills o p o esso s.
1-1-3 Uni e si y planning o achie e
p o essionalism
Uni e si y planning o achie e p o essionalism, as an
an eceden o p o essionalism, was iden i ied wi h he
ollowing subca ego ies: a en ion o o icials o he
con en o he hidden cu iculum, a ac ing e hical and
p o essional p o esso s, con inuous educa ion
p o esso s, and de eloping guidelines and e hical codes
o p o essionalism. Many s udies ha e emphasized he
use o o mal and hidden cu iculum in eaching
p o essionalism. The hidden cu iculum a ec s he
de elopmen o s uden s’ p o essionalism mo e han he
o mal con en (46, 57, 58). A hidden cu iculum is
o med unde he in luence o s uden s’ communica ion
and in e ac ions wi h acul y and s a , which can
e ec i ely de elop p o essionalism in s uden s (46, 57).
The e o e, manage s’ a en ion o he hidden cu iculum
can play an impo an ole in achie ing p o essionalism
in educa ion by a ac ing quali ied p o esso s (1).
Teaching p o essionalism h ough he o mal and hidden
cu iculum wi h di e en educa ional me hods equi es
he empowe men o p o esso s by holding con inuous
p e-se ice and in-se ice educa ion cou ses so ha
p o esso s can g ow in he ield o p o essionalism and
each s uden s (59). The exis ence o e hical guidelines
and e hical codes o p o essional and e hical
pe o mance in all ields o medical sciences can lead o
be e cla i y o he p inciples o p o essionalism o
p o esso s, s uden s, and adminis a o s (60).
1-2 A ibu es
A ibu es a e he key cha ac e is ics o a concep ound
in ele an ex s o a icles. Iden i ying he a ibu es can
p o ide a mo e accu a e and ealis ic de ini ion o he
concep (31). Based on he p esen s udy esul s, he
a ibu es o p o essionalism in medical educa ion we e
iden i ied in wo ca ego ies: he eme gence o
p o essional ole models and he ins i u ionaliza ion o
he cul u e o p o essionalism in medical educa ion
(Table 2).
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1-2-1 The eme gence o p o essional ole
models in educa ional en i onmen s
I he an eceden s a e p o ided in he uni e si y
en i onmen , he condi ions will be p o ided o he
eme gence o model p o esso s as p o essional ole
models. Role model p o esso s ha e p o essional
cha ac e and compe encies (56, 61-63). Also, hese
p o esso s ha e good mo al quali ies such as ole ance,
humili y, poli eness, ai ness and jus ice, al uism,
espec o human alues, espec o indi idual human
igh s, and espec o human beings. Mo e impo an ly,
ha ing he cha ac e is ic o pie y is e iden in hese
p o esso s (41, 44).
Sel -pu i ica ion o pe sonal in e es s, us in God,
since i y, ela ionship wi h God, p ac ical commi men o
eligious alues, insigh and sel -awa eness, p ide in he
p o ession, and p o essional alues in socie y a e he
cha ac e is ics o i ue in model p o esso s. These
p o esso s ha e a e y high mo al sensi i i y.
P o essionals wi h high mo al sensi i i y a e conside ed
a e e ence o e hical easoning and judgmen in clinical
e hical p oblems (38). Ano he cha ac e is ic o
p o essionalism in ole-model p o esso s is he desi e o
excellence. Excellence means a commi men o
ad ancemen in he p o ession (40, 44) and a
commi men o imp o ing knowledge and skills (16, 40,
41, 44).
1-2-2 Ins i u ionalizing a cul u e o
p o essionalism in medical educa ion
Acco ding o he e iewed a icles, he cul u e o
p o essionalism in medical uni e si ies was iden i ied as
a ea u e o ins i u ionalized p o essionalism in medical
educa ion.
P o iding oppo uni ies o counseling on e hical issues
in educa ion and clinics, membe ship o p o esso s and
s uden s in p o essional g oups and associa ions (64),
c ea ing a pa ne ship and coope a ion be ween s uden s
(65), p o essional suppo o people in case o e o s (66)
p o iding a pla o m o sel -con idence (37), inc easing
he mo al sensi i i y o p o esso s and s uden s (45)
inc easing pa icipa ion o heal h wo ke s, p o esso s,
and s uden s in heal h policies, p o iding oppo uni ies
o e hinking in eaching p o esso s and s uden s (45)
de eloping a spi i o coope a ion and empa hy in
s uden s, p o esso s, and s a (37, 67), a e signs o he
ins i u ionaliza ion o he cha ac e is ics o he cul u e o
p o essionalism in he en i onmen o medical
uni e si ies.
1-3 Consequences
A phenomenon ha is expec ed o occu ollowing he
occu ence o a concep is called a consequence (31). In
he p esen s udy, he consequences o p o essionalism in
medical educa ion we e iden i ied in he consequences
ela ed o heal h s akeholde s in bo h socie y and s uden s
(Table 2).
2- Consequences o heal h s akeholde s
The esul s o ins i u ionalizing he p inciples o
p o essionalism in medical educa ion in he communi y
will p omo e he heal h o he communi y. This
p omo ion is done by p o iding high-quali y and sa e
se ices, imp o ing eamwo k and in e -p o essional
coope a ion (55, 64) comp ehensi e ca e o pa ien s and
imp o ing heal h consequences (2, 55), espec ing he
igh s o clien s (42, 65), clien sa is ac ion wi h he
se ices p o ided, educing he numbe o complain s
(53, 64) and enhancing he communi y’s us (2, 38) in
he heal h sys em.Adhe ence o he p inciples o
p o essionalism in medical educa ion in he ield o
s uden s will ha e he ollowing consequences:
imp o ing he ela ionship o s uden s wi h us ees o
medical educa ion (42, 53), s uden s’ sa is ac ion and
inc easing he quali y o s uden li e (53, 65), eache s’
esponse o he spi i ual needs o s uden s (50),
mo i a ing and inc easing s uden s’ en husiasm o
lea ning (36) imp o ing he quali y o educa ion,
c ea ing an e hical and p o essional lea ning
en i onmen in he uni e si y, and p omo ing in e -
p o essional ac i i ies (35, 36, 38), aining commi ed
s a and educing p o essional misbeha io (2, 57),
e hinking p o essional beha io , posi i e a i udes,
cogni i e, and beha io al changes in he ield o
p o essionalism, excellen pe o mance, and
p o essional iden i y (57, 68-70).
3- De ini ion o p o essionalism in medical
educa ion
Acco ding o his s udy, p o essionalism in medical
educa ion is he ins i u ionaliza ion o he cul u e o
p o essionalism and he eme gence o he ole o
p o essional ole models in educa ional se ings o ain
p o essional s uden s, p o ide he bes quali y o
se ices, and ensu e he heal h o socie y.
Discussion
The p esen s udy aimed o cla i y he concep o
p o essionalism in medical educa ion. In his s udy, he
a ibu es o p o essionalism in medical educa ion we e
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Jou nal o Medical Educa ion De elopmen ¦ Volume 17 ¦ Issue 56¦ 2024 145lopmen
¦ Volume 17 ¦ Issue 54¦ 2024
iden i ied in wo ca ego ies: he eme gence o model
p o esso s and he ins i u ionalized cul u e o
p o essionalism in medical educa ion. The an eceden s
o p o essionalism in medical educa ion we e
de e mined in wo ca ego ies: he manne , compe ency,
and he uni e si ies’ planning o achie e
p o essionalism. Consequences o heal h s akeholde s
we e iden i ied because o p o essionalism in medical
educa ion. In his espec , he eme gence o p o essional
ole model p o esso s is a ea u e o p o essionalism in
medical educa ion. The beha io o model p o esso s is
a c i e ion o measu ing he p o essionalism o any
beha io and pe o mance in educa ional en i onmen s.
The inc ease o model p o esso s in uni e si ies is one o
he signs o he ins i u ionaliza ion o p o essionalism in
he uni e si y. Howe e , p o iding he necessa y
condi ions o he eme gence o such pa e ns and
main aining hem in he educa ion sys em equi es he
an eceden s. One way o achie e p o essionalism in
medical educa ion is ha educa ional en i onmen s
should be model-o ien ed uni e si ies 4. The medical
sciences educa ion sys em, which is conce ned wi h
a ac ing quali ied p o esso s and guiding as many
p o esso s as possible o become ole models, will
success ully achie e p o essionalism in s uden
educa ion. Li ing in a posi i e o ganiza ional cul u e
ega ding p o essionalism can play an impo an ole in
c ea ing new models (71). The exis ence o
p o essionalism- ela ed ins uc ions and e hical codes in
medical educa ion en i onmen s will inc ease he
anspa ency o du ies and p o essional beha io o all
people p esen in educa ional en i onmen s, including
adminis a o s, p o esso s, s uden s, and s a (53). Such
an educa ion sys em will quickly lead o he de elopmen
o p o essionalism.
. The indings o ou s udy show ha ano he
p econdi ion o aining p o essionals in he medical
sciences is ha p o esso s ha e he app op ia e cha ac e
and compe ence. P o essional p o esso s ha e an
impo an ole in o ming p o essionalism in medical
educa ion by using o mal and hidden educa ional
con en and applying app op ia e eaching and e alua ion
me hods (44, 48, 51, 72). P o essionalism in medical
educa ion means he abili y o p o esso s o
communica e p o essionally wi h colleagues, s uden s,
s a , and pa ien s. This a ibu e can each
p o essionalism o s uden s and e en o he s a in
educa ional en i onmen s as hidden con en . S uden s
o en lea n wha hey see, no wha hey hea (5, 73). I
hese p econdi ions a e me , posi i e consequences can
be expec ed o socie y, he heal h sys em, and i s
s akeholde s.
Medical uni e si ies should s i e o ain e hic-based
and p o essional medical s uden s by p o iding o mal
con en h ough he educa ion sys em and paying special
a en ion o hidden con en h ough models (46, 74).
Achie ing p o essionalism in medical educa ion will
lead o aining mo i a ed people and people in e es ed
in lea ning mo e and inc easing knowledge, skills, and
e hics in in e ac ion wi h clien s (36). Finally, educa ing
p o essional and e hic-based s uden s will ensu e he
communi y’s heal h by p o iding he bes quali y o
se ice. The esul o p o essional s uden s’ wo k in he
u u e will be he communi y’s sa is ac ion, us , and
posi i e a i ude owa d medical s a (38).
This s udy adds o he exis ing li e a u e by p o iding a
concep analysis o p o essionalism in medical educa ion
om an I anian pe spec i e, which may di e om o he
cul u al con ex s. The s udy also iden i ies some o he
ac o s ha a ec he de elopmen and assessmen o
p o essionalism in medical educa ion, such as he ole o
p o esso s, he hidden cu iculum, and he e hical
guidelines. The s udy may help medical educa o s and
policymake s o design and implemen e ec i e
s a egies o os e p o essionalism in medical s uden s
and acul y.
One o he limi a ions o he p esen s udy is ha only
English and Pe sian a icles we e included in his s udy,
and s udies in o he languages we e igno ed. Ano he
limi a ion o he p esen s udy was ha he sea ch was
conduc ed in only a ew da abases and he numbe o
a icles in his ield was la ge. I is possible ha some
s udies we e missed. I has he po en ial o weaken a
mo e comp ehensi e g asp o his concep ’s scope.
Despi e his limi a ion, using p ecise keywo ds and
sea ching in e na ional da abases helped minimize i s
impac on he esul s. Roge s’s e olu iona y concep
analysis me hod ollows a linea analysis s a egy,
sepa a ing da a collec ion om analysis, which could
comp omise da a eliabili y and alidi y when
conside ing su oga e and ela ed e ms as excep ions.
The e o e, he possibili y o b oadening concep ual
bounda ies is diminished, esul ing in he deple ion o
essen ial esou ces and obs uc ing he e ec i e
explana ion o he concep .
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146 Jou nal o Medical Educa ion De elopmen ¦ Volume 17 ¦ Issue 56 ¦ 2024
Conclusion
P o essionalism in medical educa ion is c ucial o he
de elopmen o compe en and e hical heal hca e
p o essionals. I in ol es he p esence o p o essional
ole models and he es ablishmen o a cul u e o
p o essionalism wi hin educa ional en i onmen s.
P o esso s' beha io and compe ence, as well as he
uni e si y's plans o achie e p o essionalism, a e
impo an an eceden s o p o essionalism in medical
educa ion. The consequences o p o essionalism include
imp o ed heal h ou comes, enhanced pa ien
sa is ac ion, and he de elopmen o posi i e a i udes
and beha io s in s uden s. Medical uni e si ies should
s i e o ain e hical and p o essional s uden s by
p o iding o mal and hidden con en h ough he
educa ion sys em. This s udy p o ides aluable insigh s
in o he concep o p o essionalism in medical educa ion
and can guide medical educa o s and policymake s in
os e ing p o essionalism in s uden s and acul y.
E hical conside a ions
This s udy was app o ed by he e hics commi ee o
Zanjan Uni e si y o Medical Sciences wi h code
(IR.ZUMS.REC.1397.257).
A i icial in elligence u iliza ion o a icle
w i ing
The au ho s claim ha no a i i ial in elligence was
u ilized o w i ing a icle.
Acknowledgmen s
This s udy was ex ac ed om a esea ch p ojec in line
wi h he mission o he e hics, spi i ual heal h, and
p o essional commi men wo king g oup in medical
science educa ion wi h code A-11-148-18.
Con lic o in e es s a emen
The au ho s decla e ha hey ha e no con lic o in e es .
Au ho con ibu ions
The au ho s con ibu ed equally. All au ho s ead and
app o ed he inal manusc ip .
Funding
The suppo esou ces o his s udy we e he Resea ch
Vice-Chancello o Zanjan Uni e si y o Medical
Sciences and he Cen e o S udies and De elopmen o
Medical Educa ion wi h he code o (A-11-148-18)
Da a a ailabili y s a emen
The da ase s a e a ailable om he co esponding au ho
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