gms | German Medical Science

13. Grazer Konferenz – Teaching Medicine – an Interprofessional Agenda

24. - 26.09.2009, Innsbruck, Österreich

Role modelling and other determinants in making professional doctors


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  • corresponding author Robert Hulsman - University of Amsterdam, Academic Medical Centre, Department of Medical Psychology, Amsterdam, Netherlands

13. Grazer Konferenz - Qualität der Lehre: Teaching Medicine – an Interprofessional Agenda. Innsbruck, Österreich, 24.-26.09.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09grako07

doi: 10.3205/09grako07, urn:nbn:de:0183-09grako073

Published: December 14, 2009

© 2009 Hulsman.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


In a medical curriculum often a discrepancy exists between the preaching and practice of good clinical behaviour. For example, whereas training of communication skills is focused nowadays on patient-centredness, this is not always observed in clinical practice on a ward or in an outpatient clinic. Since students in their desire to become professionals are very sensitive to clinical experiences and examples, this discrepancy and inconsistency in the curriculum can have a detrimental impact on their attitudes and behavior. Role models are powerful in imparting professional values, attitudes, and behaviors in medical education. Positive role-models are a very powerful means of illustrating theoretical issues in clinical practice. However, role-models can also broadcast implicit values that interfere with the explicit values in the curriculum about professional behavior. Students, who are not always able to distinguish between positive and negative examples, can easily become receptive to negative role-models as they are receptive to positive role-models. These implicit, often interfering messages about good conduct students receive in medical education are referred to as the ’hidden curriculum’. Role models will always be there and exert impact on student learning. It is a challenge for the oofficial curriculum to design learning opportunities that oppose the hidden curriculum and its leading proponents.

In this session two examples will be presented about how in the Academic Medical Centre Amsterdam the teaching and assessment of professional behavior is organized. Since 1998, all 5th year students are assessed during their first major clinical clerkship on their communication and professional behavior. This assessment is done in collaboration between a physician and a medical psychologist. In 2009 the assessment procedure has been slightly revised. In the preclinical years a teaching and assessment program for professional behavior was initiated in 2006 for the 1st to 4th year students. Starting with the new bachelor-master program in 2009, all students will be summatively assessed on their professional behavior. It will be interesting to explore how these Dutch programs compare to programs in the Austrian medical schools.