Teaching, learning and assessment of professionalism in medical education: A citation-based systematic review of literature

Background: Professionalism is an important competence in medical practice, yet a complex area. We describe the landscape of published articles on teaching, learning and assessment of professionalism in medical schools. This study aims to review the temporal trend of literature published and cited on the subject, and includes frequently publishing authors, journals, and network analysis. The study further aims to present the themes of the most commonly cited articles. Methods: A systematic review of peer-reviewed literature was carried out to describe the current patterns of research in professionalism using the terms “professionalism” AND "medical education" OR "medical college" OR "medical school". The title and abstract of the selected documents were skimmed to include only relevant articles. ‘Relevant’ articles were defined as articles describing teaching, learning or assessment of professionalism in undergraduate medical curricula. Articles describing professionalism, but not directly related to teaching, learning and assessment were excluded. Results: Over the study period spanning from 1973 to 2020, a total of 1053 articles were identified as relevant. A surge in the number of publications was observed from the year 2000. Over 400 articles were published in 5 leading journals in medical education. Of the 50 top-cited papers, 18 (36%) articles explored opinions of stake holders through questionnaires and surveys about different aspects of professionalism, there were 13 (26%) ‘Commentary’ and 7 (14%) review articles. The primary objectives of more than 50% of the top-cited articles were assessment methods (14%), teaching by humiliation (14%), personal identity formation (8%), barriers to professionalism (8%), and teaching ethics (8%) and empathy (8%). Conclusions: We describe the landscape of published articles on teaching, learning and assessment of professionalism in undergraduate medical schools. The surge in publications since 2000, top publishing journals and frequently publishing authors were identified. Of the most cited articles, assessment methods, personal identity formation, and teaching empathy and ethics predominate as the main themes.