The vision statements created by the Philadelphia College of Osteopathic Medicine classes of 2003, 2004, 2005, and 2006 are shown in
Figures 1,
2,
3,
4, respectively. As a result of our initial experience with construction of a class vision statement, we made slight modifications to the process during the next 3 years. For example, the vision statement created by the class of 2003 (the first class to experience this exercise) was the longest. This was due to our desire to let all the voices that emerged be heard and a reluctance to “edit” students' thoughts. However, because of its length, the vision statement created by this class was cumbersome when read by the class during the white coat ceremony. As a result, during the construction of vision statements by representatives of subsequent classes, we suggested that students be mindful of the final statement length, to be concise, and to avoid redundancy. Subsequent statements prepared by the classes of 2004, 2005, and 2006 were shorter.
Construction of the entire statement by all 20 class representatives also proved to be cumbersome. Therefore, for construction of the vision statements for the classes of 2005 and 2006, the class representatives met initially and collated each group's summary. During these preliminary discussions, several recurring themes were identified. Once these themes were established, the group was divided into subcommittees to craft the portion of the statement corresponding to that theme. This theme-based organization of the vision statement is particularly evident in the statement constructed by the class of 2006, which was organized around attributes that the class sought to embody. Statements made by previous classes were organized around promises made to particular groups (eg, themselves, patients, faculty) as is typified by the vision statement created by the class of 2003.
Despite the fact that previous vision statements were intentionally not made available to each incoming class, there were many commonalities among the four statements created thus far. Altruism, one of the attributes identified by the Medical School Objectives Project as necessary to meet society's expectations of physicians, was a common theme. A commitment to the empathetic and compassionate treatment of patients was also a central element. Respect for the privacy and/or dignity of patients was explicitly promised in three statements. The need for honesty and integrity in all interactions was an integral part of each vision statement, as was humility, the capacity to recognize and accept one's limitations in knowledge and skills. Three statements recognized the teamwork and mutual respect that should be engendered among all members of the health care team.
All vision statements had prominent statements regarding the learning process during medical school and acknowledged the importance of active and lifelong learning in their chosen career paths. For example, the class of 2003 promised to “take responsibility for our education” and to “be active learners.” The class of 2004 promised to “establish a partnership for learning with our teachers based on mutual respect, responsibility, and understanding.” The class of 2005 committed to “strive to reflect [faculty's] commitment to teaching through our commitment to learning. We promise to be lifelong learners.” The class of 2006 vision statement promised to “give our all to our faculty, as the beneficiaries of their knowledge and willingness to lead us.”
A surprising common thread in our class vision statements was a commitment to balance personal/family and professional responsibilities. The class of 2003 vowed to “maintain a balance between our physical, emotional, spiritual, and social well-being.” The class of 2005 stated, “We owe it to ourselves and those around us to maintain a healthy mental, physical, and spiritual balance in our lives.” The vision statement for the class of 2006 promised to “...remember the support our family and friends lend to our achievements. If we respect all of these aspects during our education and professional careers, we will maintain a precious balance in and perspective on life.”
Students from the class of 2003 were asked to evaluate the exercise following completion of the orientation program. On a scale of 1 (worst) to 5 (best), students were asked to evaluate individual elements of the orientation program, including the development of the class vision statement. The value of creating a class vision statement was rated highly by responding students (average score, 4.51). The question that formed the springboard for discussion was also rated strongly (average score, 4.18). The white coat ceremony received positive marks from the students (average score, 4.7). As part of the ceremony, the presentation of the class vision statement also received high marks (average score, 4.32). Weaker elements of the vision statement exercise included the faculty introduction of the assignment (average score, 3.86) and the representative student reports to the class regarding the construction of the statement (average score, 3.78).
The impact of these exercises on the development of professional behaviors over the continuum of undergraduate medical education remains speculative. For example, it is difficult to ascertain whether the promises relating to the empathetic treatment of patients made during recitation of the vision statement translated to more positive professional interactions with patients. Whether these exercises influenced student attitudes during their undergraduate medical education, internship, and residency training may be easier to address. We plan to assess whether the vision statement impacted the development of professional attitudes for all classes at the end of the 2003–2004 academic year by a survey instrument. At this time, the class of 2006 will have completed their second didactic year and will be preparing for the Comprehensive Osteopathic Medical Licensing Examination (COMLEX–USA) Level 1 and the beginning of clinical rotations; the class of 2005 will have completed the first year of clinical rotations; the class of 2004 will be graduating; and the class of 2003 will be completing their internship year. This format will allow us to assess about 1000 students who have experienced the construction of a class vision statement during orientation at various later stages of training.