Mission Statement Day: introducing professionalism to medical students

Context and setting Mission Statement Day (MSD) is an experiential exercise for Year 1 medical students. It was designed to help students begin developing their professional values and attitudes, as well as explore the personal values they bring to medical school. The MSD was introduced in September 1994 to the graduating class of 1998 at Schulich School of Medicine, University of Western Ontario. Why the idea was necessary The development of professional values is a frequently discussed topic in the medical literature. Many authors express concern that the medical profession addresses the matter inadequately and has lost sight of its core values and ethical principles. Professionalism is often introduced to medical students through special activities such as white coat ceremonies and the swearing of oaths or other special declarations. While these are excellent exercises, they tend to be passive activities. Engaging medical students in writing their own mission statements was felt to be an ideal way to begin the process of self-reflection and the exploration of personal values. What was done The MSD is scheduled at the end of the first week for each new medical class. The morning begins with several patients speaking about their personal experiences with a major health problem. They speak freely, expressing their own positive or negative opinions and answering questions. The class is then divided into small groups with a facilitator assigned to each group. The groups spend approximately 90 mins identifying the characteristics they feel are important in a future doctor, defining the roles they feel a doctor should fulfil in the health care system, and creating a mission statement. The entire class reassembles and each group shares its mission statement with the class. Later, representatives of each group create a composite class mission statement. The mission statement is engraved on a plaque in the student lounge, a copy is presented to the dean, and it is printed in the clinical skills handbooks. Finally, each class recites their mission statement at graduation. Evaluation of results and impact Using qualitative methodology we explored the impact of MSD through focus groups and key informant interviews with students from Years 1−4. The process of creating a mission statement was more important to the students than the mission statement they created. Three themes were identified: the central role of patients; bonding and group formation, and student ownership and valuing of the mission statement. Patient involvement was critical to exploring the disease and illness experience, and to stimulating discussion about compassion and professional relationships. Mission Statement Day represented the first opportunity for students to share ideas in an academic setting. They spoke eloquently of the class diversity and differing value systems, as well as the support of peers. Faculty role-modelling highlighted the value placed on MSD by the medical school. Students had vivid and easily recalled recollections of the day. The experience was very powerful, prompting the students to reflect on their future professional role and reinforcing their decisions to enter medical school. Mission Statement Day is an excellent exercise to introduce medical students to their future professional role.

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