We are committed to a culture that encourages the development and internalization of the attributes, applied knowledge, judgment and behaviors of the master clinician into one's concept of self.
- The personal development of a new "professional" self identity
- Creation of a new understanding of self and the world
- Occurs in stages
- Results from meaningful professional experiences, dialog and reflection
Stage 1: Early Entry
- Reflex responses derived from previous non-professional life
- Rules of the profession not clearly understood
- Immature learner "I am smart and can beat anyone at the game"
- Surprise and angst at adverse reactions to "usual behaviors"
Stage 2: Reward/Punishment
- It's all about ME
- Figuring out the "rules of the game"
- What's on the test?
- Cram and forget, get high grades
- Motivation is the "system's reward/punishment"
- Satisfaction comes from the external rewards
Stage 3: Team Membership
- Can hold multiple points of view
- Relationships are critical
- Begin to integrate and apply knowledge
- The "Profession" is a relationship
- Motivation is the "Medicine team does it this way"
- Satisfaction is from successful team and individual relationships
Stage 4: Physician Self
- Integrated the Profession (values, thinking, etc) into a knew self identity
- Professional behaviors become habitual
- Can break away from the rules and the team when appropriate
- Leads the team
- Knowledge is put into effective action
- Can be flexible and self-critical
- Motivation "I know the right thing to do"
- Satisfaction is internally derived (self-actualization)
Stage 5: Mentor
- It's all about the others
- Holds a "big picture" perspective
- Teaches the "rules" of doctoring
- Guides the team
- Art and Science of Medicine are one
- Nurtures the transformation to physician
- Motivation is to see others succeed
- Satisfaction derives from the accomplishments of others