This month’s Journal Club post was written by Alex Fiorentino, MD, Maine Track ’17, based on the following article:  Basing the Evaluation of Professionalism on Observable Behavior: A Cautionary Tale by Ginsburg, Regehr, and Lingard1.

Though an estimated 90% of U.S. medical schools offer some type of formal instruction in professionalism2, it is difficult for medical educators to agree upon what constitutes professionalism, much less apply a consistent standard of professionalism to trainees3.  In the setting of increasing efforts to evaluate trainees via direct observation of competencies, the authors of the above study set out to assess whether observation of student behaviors can serve as the basis for consistent and legitimate evaluation of professionalism.

Discussion Questions:

  1. How would you define professional behavior – and unprofessional behavior – among medical trainees?
  2. Which is more useful for determining whether a lapse in professionalism has occurred: an account of exactly what a trainee did, or an explanation of why they did it?
  3. Are there situations in medicine in which truthfulness represents an unprofessional course of action, or is lying always unprofessional?
  4. Can professionalism be taught? If so, what would be your ideal method for teaching it?



  1. Ginsburg S, Regehr G, Lingard L. Basing the evaluation of professionalism on observable behaviors: a cautionary tale. Academic Medicine, 2004 Oct;79(10 Suppl):S1-4.
  1. Swick HM, Szenas P, Danoff D, Whitcomb ME. Teaching professionalism in undergraduate medical education. JAMA, 1999 Sep 1;282(9):830-2.
  1. DeAngelis CD. Medical professionalism. JAMA, 2015 May 12;313(18):1837-8. doi: 10.1001/jama.2015.3597.


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