Beth Gamulka: Can we teach professionalism?

This week, 13 final-year male dental students at Dalhousie University in Halifax, Nova Scotia, were suspended from clinical rotations pending further investigation of complaints filed by fellow students and by 4 professors. These men were members of a Facebook group called Class of DDS 2015 Gentlemen on which misogynistic comments about their fellow female classmates were posted. While the student complaints were initially filed in early December, the suspensions, announced on January 5 by the university, have now made national news.

The Facebook page comments that have been included in various articles are definitely misogynistic. These young men publicly discuss which dental anesthetics would best be used for date rape, and voted for which fellow female classmates would be best for hate sex.  What is most horrifying is that it appears the social media group was not new, and that these future dentists were just several months away from becoming full members of their profession.

I have no doubt that Dalhousie University will address the investigation of these complaints and follow through with disciplinary action in an appropriate manner. Like many universities, they have instituted policies that will direct the administration in an equitable and through manner.  It may be an arduous process (too slow for some—which prompted a complaint by 4 professors who felt that the university was slow in its response).  Given the turn of events, it will likely be a much more public process than the university had originally intended.  However, this process is still reactive and does not address the underlying problem. How can we teach professionalism to young men and women so that they will graduate not only with the clinical skills necessary to practice in their chosen health care profession but with the tools to conduct themselves as professionals in public?

Medical and dental school admissions have gotten even more competitive since I applied. There are many qualified applicants who do not get a spot and the vast majority of the current student body is superb.  However, medical and dental students are generally young and lack life experience.  They may have more scientific acumen than common sense.  Certainly, students in their 20s make mistakes.  How, then, can those of us involved in their education impart to them the necessary skills required to become excellent practitioners?

It is not just a good memory or excellent fine motor skills that are needed.  In every clinical rotation, students are evaluated for their professionalism as well as for their clinical knowledge.  Faculties of medicine and dentistry certainly value professionalism and understand that these attributes are equally important.   Health care professionals need to be reliable, to communicate well, to listen well, and to respect others, be they colleagues, patients or other health care team members.  They need to understand that they will be held to a higher standard in exchange for the privilege of interacting with patients when they are at their most vulnerable.

Can we teach professionalism by example? I hope so. I have repeatedly given students feedback about how to address families and patients when we enter rooms.  Students need to be reminded to make eye contact, to use lay language, to not speak as if the patient was not in the room and to address any questions openly and honestly.  Most appreciate the feedback and incorporate it into their patient interactions.  But there is an important part of their education that does not occur at the bedside or in the classroom.  Students need to lead by example for each other as well. They are each other’s future colleagues in a self-policing profession.  They should not lose opportunities to help each other develop those necessary skills.

The challenge of teaching professionalism will always be there. Like with school bullying, those who remain quiet when witnessing inappropriate behavior can influence the change.  Perhaps in a climate where poor judgment and immature behavior is identified early, and where fellow students can promptly and safely report inappropriate behavior, the new generation of health care professionals will hold each other to the high standards required of them.