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Professional Socialization for the Ethical Role: How Military Academies and Medical Schools Socialize their Professionals into the Ethical Role and the Implications for Business Schools

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Professional Socialization for the Ethical Role: How Military Academies and Medical Schools Socialize their Professionals into the Ethical Role and the Implications for Business Schools
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Abeygunawardana, Chandi
Maurer, Virginia ( Mentor )
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journal orf in.n er,.r.3d. u.3- Re-:-earch

.. Oluilie , issue . - Jul , .' u S ui l 'u.li:



Professional Socialization for the Ethical Role:
How Military Academies and Medical Schools Socialize their Professionals
into the Ethical Role and the Implications for Business Schools

Chandi Abeygunav/ardana


ABSTRACT


This study examines how military academies and medical schools socialize their professionals into their ethical

roles respectively. The research focuses on an analysis of the United States Military Academy and the University

Of Florida College of Medicine. Based on previous studies on socialization theory, a professional socialization

model was developed; consisting of Van Maanen and Schein's six dimensions of socialization tactics as the

structural variables and Bucher and Stelling's situational variables. Interviews were conducted with faculty

and students at the United States Military Academy and the University Of Florida College of Medicine.

Professional socialization for the ethical role was analyzed according to such variables as status passages,

peer groups, conversion experiences, role models, role playing, and criticism. The findings raise useful questions

for business school faculty and administrators seeking to develop the proper ethical role orientation in

business students.



INTRODUCTION


The traditional formal responsibility of professional education is to inculcate neophytes with the attitudes, values,

and skills associated with the roles for which they are training. (Coombs, 1978, p.15) Recently, however,

professional schools have heightened their awareness of this role ("Business Schools", 2005). The corporate

world has been inundated with scandal following the 2001 disclosure of Enron Corporation's use of illegal

accounting procedures. These business scandals cost investors billions of dollars. In medicine, the rapport

between pharmaceutical companies and the physicians who prescribe their drugs for lucrative incentives

has challenged the primacy of the doctor-patient relationship. The abuse and humiliation of Iraqi prisoners of war

by an army brigadier general and her soldiers brought into question the U.S. Army's commitment to a strong

and clear code of ethics. These lapses highlight the growing importance of the ethical dimension of the

professional role and how prospective professionals are socialized into this role during formal schooling.



All three of these professions--- corporate management, medicine, and the military- -- are held to higher

ethical standards than nonprofessionals, and it is this ethical obligation that helps define these as occupations

with professional status. (LTC D. Jones, personal interview, Jul. 29, 2004) In the medical and military

disciplines, unethical conduct can have potentially fatal consequences. Accordingly, medical schools and






military academies acknowledge the professional ethical role and make strides to develop this dimension in

their students. Relative to these two fields, business has only recently acknowledged the serious nature

of unprofessional conduct. At best, some MBA programs have incorporated compulsory ethics courses into

the curriculum. Traditional management theories prevailing in all other aspects of the program, however,

often contradict the intent of these courses. ("Business Schools", 2005) Though the severity of the consequences

of unethical conduct varies, the underlying service orientation of all three professions provides a basis

for comparison. The goal of this paper is to examine how two types of professionals are socialized into their

ethical role in their formal education. It seeks to reveal both the inculcation of values and norms in the

normative dimension and the implicit ethical training that occurs in the curricular dimension of the United

States Military Academy and the University Of Florida College of Medicine. The implications of the military

academy and medical school professional socialization models will suggest a general framework for developing

a model for ethical socialization in the MBA programs.



METHODOLOGY


Professional Socialization Model


Bucher and Stelling (1977) developed a widely accepted theoretical framework for professional socialization, some

of whose elements prove relevant to the focus of this study. The model posits two sets of variables,

structural variables and situational variables. The former refers to the social structure of the organization and

the latter refers to the social situations that result from the structural variables. (p.21) Though the model used in

this study will be comprised of both elements, only the situational variables will be derived directly from Bucher

and Stelling's model and be modified slightly to encompass the ethical dimension of the professional role.



According to Tierney and Roads, training in higher education can be characterized by the six dimensions

of socialization tactics from Van Maanen and Schein's classic organizational socialization model. (Weidman,

Twale, and Stein, 2001, p.6) These socialization tactics will be the structural variables in the proposed

professional socialization model. Van Maanen and Schein assert that the methods of socialization influence

role orientation to the extent that newcomers' responses to roles differ because socialization tactics used

by organizations determine the information received by newcomers. Their model depicts a bipolar

continuum consisting of institutionalized tactics and individualized tactics. Within these two classifications are

three subcategories associated with the socialization tactics; context, content, and social aspects.





INSTITUTIONALIZED * ===================== O INDIVIDUALIZED

(CistodiWl Eldu d Role Orincatim) (iumolivue Ehicil Role Oricnaimls )
Context CollectivC -----------=------=O Individual

Foml .=----===-===-= = =.-----= O lnfonnal



Content Sequentiale ============== ----= Random

Fixed- ====--- -------===========0 Variable



Social Serial =-- ===========---- Disjunctive

Aspects Investiturel ======= =---=== Divestiture


Figure 1. Van Maanen and Schein's organizational socialization tactics (Jones, 1986, p.263)



The collective and individual tactics differ in terms of the contexts in which organizations provide information

to newcomers and thus produce divergent role orientations. A collective tactic involves common learning

experiences that produce standard responses from students. Interaction in group settings reinforces

the organization's norms, ultimately producing a custodial role orientation whereby neophytes accept the

proposed ethical role expectations. By contrast, an individual tactic involves a unique set of experiences for

each individual, producing differing responses, resulting in individuals adapting new approaches towards

their professional ethical roles. (Jones, 1986, p.264)



For the purposes of this study, I refer to Tierney and Roads' version of the formal and informal socialization

tactics, modified for the study of professional socialization in higher education. They delineate formal socialization

as those experiences designed to achieve formally established goals and informal socialization as those

experiences that are unstructured. (Weidman et al, 2001, p.6-7) It is important to note that the subjective nature

of experiences will inevitably result in informal socialization to some degree.



With regards to the content of information presented to newcomers through socialization, Van Maanen and

Schein assert that sequential and fixed tactics can be contrasted with variable and random tactics. (Jones,

1986, p.264 ) Professional schools that implement a sequential tactic are characterized by explicitly

stated information about the sequences of experiences in the institution to achieve the professional ethical

role. Similarly, those that are fixed offer precise information about the timetables regarding completion of each

stage of this sequence. By contrast, variable tactics involve lack of information about when newcomers will reach

a particular stage in the learning process and accompanying it is the random tactic where students are unaware

of any timetable for the stages of role development. (Weidman et al., 2001, p. 7)



Finally, perhaps most relevant to the development of the ethical role is the extent to which neophytes receive

social support from others in the institution. This is demonstrated in the serial versus disjunctive tactics and

the investiture versus divestiture tactics. (Jones, 1986, p.264) According to Tierney and Roads, serial






socialization occurs when there is a clearly set structure for education where students are trained by faculty.

Wheeler contributes to this definition in his assertion that it is in serial socialization that "the recruit has

been preceded by others who have been through the same process and who can teach him about

the setting." (Weidman et al., 2001, p.8 ) In disjunctive socialization, the lack of role models requires

that newcomers develop their own views of the ethical role. Tierney and Roads claim that professional schools

that implement an investiture tactic reinforce an individual's own competencies and existing qualities while those

who favor the divestiture method are more concerned with "stripping away those personal characteristics seen

as incompatible with the organization ethos." (Weidman et al., 2001, p.8)



Referring back to the model from which was first derived the idea of having structural variables to support

the situational variables, Bucher and Stelling (1977) provide a set of situational variables vital to the effectiveness

of the socialization process (p.21):



1. Status Passages- explicit transitional points which indicate where students are in their development of

the professional ethical role

2. Peer Group- is the organization of peer groups horizontal by cohort or vertical across cohorts; how long does it

exist during training; and to what extent does peer to peer learning occur.

3. Conversion Experience- the opportunities during training which provide emotionally intense experiences, impacting

students' perspectives on the ethical role; dimensions to be studied include the various forms and intensity of

these experiences

4. Role Playing (or Work)- whether there are opportunities for students to be involved in real activities

with responsibility in the professional role as opposed to simulated ones

5. Role Models- the kinds of models provided in the institution; the nature of the relationship between neophytes

and socializing agents; and actual activities involving students and their role models

6. Criticism- cues that students receive regarding their development in the ethical role, the form that they come in and

from whom they are given.



BACKGROUND: THE UNITED STATES MILITARY ACADEMY



West Point's motto Duty, Honor, Country is fully explicated in the official mission of the United States

Military Academy, "To educate, train, and inspire the Corps of Cadets so that each graduate is a commissioned

leader of character committed to the values of Duty, Honor, Country; professional growth throughout a career as

an officer in the United States Army; and a lifetime of selfless service to the Nation." (http://www.usma.edu/

mission.asp)



The success of this mission is contingent upon the types of individuals who are admitted into the academy. A

highly competitive admissions process guarantees a group of cadets that is intellectually and physically able to







be educated and socialized into a military leader of character. Though the West Point experience explicitly

involves cadet development in the academic, military, and physical, there is an implicit moral-ethical

development focus underlying each of these three areas. (LTC D. Jones, personal interview, July 29, 2004)





Clas of 2008


Class Profile
Volume of Appllia nts:::: '





Rink in IIIh NSithoo Clan





Ameriran Co:qte Tesdtng (ACiT) Ainamit P nrog Scorn

L;.. t :.. . . ...I

;1\, i - --




























Figure 2. USMA Class of 2008 Profile, Courtesy of http://www.usma.edu/Cass/2008/








The military and physical aspects begin the summer prior to the freshman year in Cadet Basic Training,

more familiarly known to cadets as Beast Barracks. The six and a half-week program is led by the
cadre (upperclassmen-juniors and seniors) who are supervised by both U.S. Army officers and non-










commissioned officers (NCOs). (Ruggero, 2001, p.20) Here, incoming cadets become fully immersed in the
the completion of Beast Barracks), sophomores are yearlings, juniors are cows, and seniors are firsties. (LTC












D. Jones, personal interview, Jul. 29, 2004) As of 1998, the establishment of the Cadet Leader Development
more familiarly known to cadets as Beast Barracks. The six and a half-week program is led by the

cadre (upperclassmen- juniors and seniors) who are supervised by both U.S. Army officers and non-

commissioned officers (NCOs). (Ruggero, 2001, p.20) Here, incoming cadets become fully immersed in the

military culture. At West Point, freshmen are plebes (though newcomers retain the status of "new cadets" until

the completion of Beast Barracks), sophomores are yearlings, juniors are cows, and seniors are firsties. (LTC

D. Jones, personal interview, Jul. 29, 2004) As of 1998, the establishment of the Cadet Leader Development






System necessitated that cadets have ranks corresponding to those in the military- plebes as privates, yearlings

as corporals, cows as sergeants, and firsties as officers. (Lipsky, 2003, p.19) Cadets are escorted in groups for

the entirety of their basic training. On that first day, they undergo their first ceremony, marching into "the Plain,"

the site where parades are often held, swearing their first oath as a soldier. (Ruggero, 2001, p.39)



According to Ruggero (2001), while squad leaders are charged with the responsibility of ten or so cadets,

platoon sergeants are responsible for conveying information from platoon leaders to squad leaders, and ensure

the provision of basic necessities. (p.42) In the midst of the demanding military and physical exercises, cadet

platoon and squad leaders must administer values education to the new recruits according to the Cadet

Basic Training Values Education Guide. (SCPME-CBT, 2003)



Table 1

Values Education Training Courses at USMA


First Semester VET Classes


First Class

1-1-P/1-2-R

The Dead Even Rule




1-3-R:

Sexual Assault in the

Military


1-4-P/1-5-PME:

The Foundations of the

Professional Military Ethic


AD-8:

How to Help a Friend with

a Drinking Problem


AD11/EO17/ADD

IC & EO Rep Meeting


Second Class

2-1-P/2-2-AV:

Understanding the Concept of

Duty


2-3-R:

Chain of Command

Responsibilities


2-4-AV:

Living What we Expouse

(Lecture)


2-5-AV:

Assessment of the Co. Climate


AD-5:

Alcohol, Violence, and Binge

Drinking


Third Class

3-1-H:

Intellectual Integrity




3-2-H:

Wherefore Non-Toleration


3-3-R:

Socialization




3-4-R:

Current Issues


3-5-H/R:

Election of the Company

Honor and Respect Reps


3-6-AV:

Assessment of the Co.

Climate


AD-3:

Street and Club Drugs


Fourth Class

4-1-R:

New Roles, New Rules




4-2-H:

Applications of Honorable

Living


4-3-H:

Honor Investigative System

& Process


4-4H:

Mock Honor Investigation

Hearing


4-5-R:

Date Rape Psychodrama


4-6-AV:

Assessment of the Company

Climate


AD-1:

Drug and Alcohol Overview






Courtesy of the Simon Center for the Professional Military Ethic


Here, new cadets are first exposed to the academy's stringent honor code, "A cadet shall not lie, cheat, steal,

nor tolerate those who do," and honor system. (http://www.usma.edu) Any breach of the honor code by a cadet

will result in an honor violation. This is followed by a full investigation and hearing before the honor board,

comprised of fellow cadet honor representatives. The severity of the violation will likewise determine the severity

of the course of action taken against the cadet. (LTC D. Jones, personal interview, Jul. 29, 2004) In various

meeting sessions, platoon and squad leaders discuss the army bedrock values, the tenets of the honor code,

and case studies regarding such issues as respect and sexual assault. (SCPME-CBT, 2003)



While new cadets are undergoing Cadet Basic Training, yearlings (sophomores) are enduring Cadet Field Training

at Camp Buckner. Already socialized into military life, they engage in tactical and combat operations. The

cadre's experience in the academy combined with the experience of officers and NCOs with ethical dilemmas in

the Army are utilized during field training to apply values education to field training in teaching the yearlings

such concepts as the laws of war. (SCPME-CFT, 2003) Simultaneously, through this instruction, yearlings prepare

for their role as team leaders charged with the ethical development of plebes in the coming year. (LTC D.

Jones, personal interview, Jul. 29, 2004) First and second class cadres who are not participating in leading CBT

and CFT are engaged in summer training sessions in active Army units worldwide where they learn to serve

as subordinates under Army officers during real missions. (Cadet K. Johnston, personal interview, Nov. 1, 2004)



Summer military training sessions often end in ceremonies commemorating the cadets' completion of yet

another stage in their West Point experience. This particular ceremony is especially poignant for second

year students. Cadets admitted to the academy are allowed to leave without any monetary or military

service obligation until the beginning of their third year; after this point, they owe five years of service to the

military upon graduation. (LTC D. Jones, personal interview, Jul. 29, 2004)



At the beginning of the academic year, all cadets are assigned to one of the thirty-two companies, supervised by

an adult tactical officer (TAC) and led by the cadre. (Ruggero, 2001, p.97) Each returning third class

student (yearling) is assigned a plebe to lead. Second class students (cows) are assigned two third class

students, two of their peers, and some seniors in their squad. Finally, firsties are often company leaders. (LTC

D. Jones, personal interview, Jul. 29, 2004) The leadership position at all levels entails such tasks as

organizing formations and parades, relaying important information to their subsequent companies, doing

intramurals, inspecting rooms, and helping with academics. (Cadet K. Johnston, personal interview, Nov. 1, 2004)



West Point has a core curriculum of 31 courses, covering a broad range of subjects from engineering to

psychology, required of all cadets.(http://admissions.usma.edu/Prospectus) On average, cadets have 22 hours

of academic coursework in addition to the requirement that all cadets participate in an intramural sport as well

as fifty hours of un-graded values education courses throughout the four years. (LTC D. Jones, personal

interview, July 29, 2004)









DISCUSSION


Application of Theoretical Socialization Model


Structural Variables. West Point is structured to produce a custodial role orientation in cadet socialization.

New cadets arrive and are organized into horizontal cohorts by class: plebe, yearling, cow, and firstie. From

their initial encounter with the academy during Cadet Basic Training through graduation, cadets are exposed

to similar experiences, demonstrating the collective nature of the socialization process. Those who attempt to

practice individual socialization are often reprimanded for failure to behave in unity with the group and

such continued behavior inevitably will lead to dismissal from the academy.



With regards to Tierney and Roads' definition of the formal and informal socialization tactics, though West

Point exhibits elements of both, formal socialization dominates. Every encounter at the Academy is structured

with formally established goals. There is little unstructured teaching and thus, little room for informal

socialization; however, the subjective nature of experiences allows for cadets to interpret experiences differently.



The hierarchical structure of the military academy delineates the sequential and fixed tactics whereby

leadership positions are earned. Cadets are aware at all times of the military, physical, and academic

requirements necessary to advance to a higher rank.



The leader-development focus of the academy necessitates a serial tactic whereby according to Wheeler's

definition those who have experienced the same process (cadre) train those who are new to the

environment. Furthermore, Tierney and Roads assertion that the serial tactic requires training by faculty is also

met in that army officers and non commissioned officers are often the professors and coaches that train the

cadets. These role models and the professional ethic demonstrated by them is clearly evident to new recruits as

well as the cadre who are training to be company leaders. There is no place for newcomers to develop their

own views on the ethical role as with disjunctive socialization.



West Point uses both investiture and divestiture tactics. As evidenced in the class of 2008 profile, new

cadets admitted into the academy are biased in the sense that USMA admits those who already possess

values comparable to their own. Thus, the investiture tactic whereby an individual's competencies are reinforced

is often the case. Simultaneously, through its honor code and punishments for violations, West Point uses

the divestiture tactic to identify character flaws and instill the military organization ethos, further reinforcing

the professional ethical role.



Thus, the structural variables of USMA exist to ensure that cadets will become leaders of character according to

the academy's vision. They are in place to support the effectiveness of the subsequent situational variables.







Situational Variables


Status Passages. The Values Education Guide administered by the Simon Center for the Professional Military

Ethic prescribes a passage whereby cadets internalize the cadet honor code "A cadet shall not lie, cheat, steal

nor tolerate those who do"- know, adhere, believe, and lead. (SCPME-CBT, 2003) For example, the first year

(plebe year) is focused on self and integrating as part of a team. Essentially, they are learning the subordinate

role. (LTC D. Jones, personal interview, July 29, 2004) Each subsequent year, cadets are granted more authority

and responsibility to develop leadership while still maintaining the subordinate role.



Peer Groups. The use of the second situational variable, the peer group, is important. Each year, cadets enter

in horizontal cohorts, cohering together for the duration of their time at the Academy. They learn to "cooperate

and graduate" whenever a cadet needs help, whether in academics, military, or physical. The professional ethical

role is reinforced through peer to peer learning not only through leading by example but also in such instances

as honor violations, where cadets learn the ramifications of unethical conduct.



Conversion Experiences. Cadets are exposed to emotionally intense experiences designed to influence

their perspectives of the ethical role. The honor court serves as a conversion experience for many cadets.

The experience reveals the significance of ethics for a military officer for both the cadet under investigation and

the rest of the corps of cadets.



Role Models. Cadets learn how to be a leader while being subordinates to those in the leadership role. Role

models include cadets in higher ranks, army officers (TAC), and noncommissioned officers (NCOs) in the

many aspects of the academy. They serve as professors of academic courses, military training instructors,

and coaches for intramural sports. The Academy takes great effort to assure that role models provide examples

of military ethics.



Role Playing. The West Point experience entails role playing from R-day (beginning of Cadet Basic Training)

to graduation with the role of leadership increasing with higher ranks. Furthermore, under the Cadet

Leader Development System, cadet ranks correspond to those in the military.



Criticism. Criticism assists in the development of the professional ethical role. It can be given by anyone -

army officers, professors, coaches, and primarily, peers - at any stage. The moral-ethical development

evaluation occurs through the enforcement of the honor code. The non-toleration clause of the cadet honor

code ensures that an ethical breach by a cadet will be addressed by anyone aware of it.



BACKGROUND: THE UNIVERSITY OF FLORIDA College of Medicine



In its balance between the scientific and the humanistic, the University Of Florida College of Medicine's






primary mission is, "to educate students and physicians in the humanistic, scientific and technical principles

of medicine; to provide the environment and faculty to make important biomedical discoveries; and to deliver

the highest quality health care to the patients we serve." (http://www.med.ufl.edu/oea/)



Every year, the University Of Florida College of Medicine receives more than 2000 applications for the 115

available spaces, making admission highly competitive. (http://www.med.ufl.edu/oea/admiss/brochures/

COMInfo.pdf) The medical school relies on subjective measures including letters of recommendation,

personal statements, and the interview process to select those candidates who demonstrate the potential for

ethical role development. (W. Allen, personal interview, October 30, 2004)



In the College of Medicine, certain courses during the first two years are established to bridge the gap between

the basic sciences and clinical application. The ethical dimension is also developed in such courses that employ

a more clinical aspect. First year medical students are welcomed to the College of Medicine in an

orientation conducted by class officers in the preceding class.(D. Hegland, personal interview, March 18,

2005) During this session, the incoming class delegates a small group to formulate their own statement of

ethical ideals. (W. Allen, personal interview, October 30, 2004)



Table 2.

Course Curriculum for first two years of medical school; http://www.med.ufl.edu


Fall

-Clinical Human Anatomy

-Diagnostic Imaging

-Essentials of Patient Care 1

-Basic Clinical Skills

-Interdisciplinary Family Health

-Medical Cell and Tissue Biology

-Introduction to Clinical Practice


Spring

-Medical Neuroscience

-Biochemistry & Molecular Biology

-Essentials of Patient Care II

-Human Behavior

-Priciples of Physiology

-Medical Aspects of Human Genetics


Second Year -Essentials of Patient Care 3

-Ethical and Legal Issues

-General and Systematic Pathology

-Geriatric Cases

-Hematology - Coagulation

-Immunology - POPS

-Medical Microbiology & Infectious

Diseases


-Evidence Based Medicine

-Intro to Clinical Radiology

-Oncology


-Intro to Clinical Neurology

-Medical Pharmacology

-Essentials of Patient Care 4


During the first semester, first year students engage in a semester long cadaver dissection in their Clinical


Year

First Year


Summer





Human Anatomy course. The cadaver dissection incorporates many ceremonies. The most formal and elaborate of

the rituals occurs at the end of the semester. In a funeral-type atmosphere, students are given the opportunity

to express their feelings on the experience through poetry, songs, and statements. (D. Hegland, personal

interview, March 18, 2005)



In the Interdisciplinary Family Health course, medical students are assigned to interdisciplinary teams of three

(from the Colleges of Health Professions, Pharmacy, Dentistry and Medicine) and a community volunteer to

develop their skills in interviewing patients and taking medical histories. The course also involves group

discussions involving 12-15 students and two faculty members. (IDFH Goals, 2004, Project Participants &

Structure, para. 1-2)



Each semester for the first two years, students are enrolled in Essentials of Patient Care. The EPC courses

incorporate lectures, small group sessions, physical examination practice sessions and standardized

patient simulations in the Harrell Assessment Center. (W. Allen, personal interview, October 30, 2004) Here,

student interactions with simulated patients are recorded to allow evaluation and feedback. The EPC courses are

also on a small group level (8-10 students) supervised by two faculty members. (Pauly R, 2004, p.2)



The development of the professional ethical role is further fostered in medical students during a one

month preceptorship in December where students are assigned to clinics throughout North Central Florida. They

are exposed to the primary care clinical experience and observe the primacy of the doctor-patient relationship

first hand on a daily basis. (D. Hegland, personal interview, March 18, 2005)



In addition to the EPC III and IV courses, the second year curriculum also involves the Ethical and Legal

issues course which addresses potential ethical dilemmas that students may face when they begin their rotations

in hospital clerkships in the subsequent year. (W. Allen, personal interview, Oct. 20, 2004)



At the UF College of Medicine, medical students receive their white coats at the end of the second year when it

is presumed they are prepared to understand the implications of being identified as a physician. The white

coat ceremony mirrors graduation in that it is held in the same auditorium as graduation, families are invited,

and students walk across the stage and are adorned in the long white coat.



During the third and fourth years, the primary training facilities for medical students at the UF College of Medicine

are Shands University Hospital, the VA hospital, and 11 weeks at the Jacksonville campus, providing exposure to

a diverse patient population. (D. Hegland, personal interview, March 18, 2005) In the next two years,

medical students are fully immersed in their prospective discipline. They assess information received from

staff, conduct medical duties for residents and interns, serve patients, and are tested by instructors. (Coombs,

May, and Small, 1986, p.7) One sixth of the class (approximately 20 students) is placed in each clerkship -

family medicine, neurology, pediatrics, surgery, and psychiatry - which rotate about every six weeks. Third

year students are involved in three clerkships, after which they are required to present an ethical issue that






they have faced. (W. Allen, personal interview, Oct. 30, 2004)


With fewer requirements, fourth year students engage in their one required rotation in Emergency Medicine and

their choice of a sub-internship in a specialty area where they assume a greater level of responsibility on an

intern level. (D. Hegland, personal interview, March 18, 2005) Simultaneously, they prepare for the "The Match" -

a national program where residency programs rank students and students in turn rank the residency programs

that most interest them. (W. Allen, personal interview, October. 30, 2004)



In medicine, Alpha Omega Alpha (AOA) is a national medical honor society recognizing those students

who demonstrate the highest academic achievement in their class. The University of Florida has a chapter of

the Gold's Humanism Society which has developed an AOA for character and leadership. Recognition is determined

by peer evaluations and faculty-student evaluations that occur at the end of each of the four years. The College

of Medicine underscores the AOA for character in its letter to the residency programs. (D. Hegland,

personal interview, March 18, 2004)



DISCUSSION



Application of Theoretical Socialization Model


Structural Variables. The professional ethical role of the physician is essentially achieving a balance

between objectivity in dealing with the human body and playing the role of the compassionate physician. (Coe,

1970, p.207)



As students are admitted and pass through medical school in horizontal cohorts, the College of Medicine employs

a collective socialization tactic. The demanding and intense experience of medical school provides a common bond

for those in each cohort that lasts for the duration of their training.



The medical school experience has aspects of both formal and informal socialization. The academic courses

are structured to establish set goals, but the subjective nature of experiences result in some informal

socialization. For instance, the cadaver dissection which is formally meant to impart knowledge of the

human anatomy during the first year often results in desensitization to working with the human body.



The manner in which content is delivered in medical school has the underlying sequential and fixed tactics

employed. Students are aware of the stages they must proceed through in order to become physicians. First

and second year students must gain a thorough knowledge of the basic sciences and pass the Unit I

examination. Similarly, fourth year students must pass the Unit II examinations and apply for residency programs.



By Tierney and Roads' definition, the medical school employs serial socialization as students are trained by

more experienced faculty. Even as they receive more autonomy each year, student progress is evaluated







by physicians. The medical school does not meet Wheeler's criteria in that students in the higher cohorts are

not often given the task of training incoming students. Students' exposure to physicians in preceptorships

during their first year and their exposure to physicians, interns, and residents during the third and fourth

years assure that they have role models - an element that is lacking in disjunctive socialization.




As previously noted, the highly competitive nature of the selection process for medical school ensures that

the candidates that are admitted possess the proper ethical orientation. In the medical college, it is far easier

to admit morally ethical individuals and develop the ethical dimension (investiture) than to admit those who

demand frequent corrective action for character flaws (divestiture). (D. Hegland, personal interview, March 18, 2004)




The UF College of Medicine offers a regimented four year experience and possesses structural variables that

produce a custodial role orientation whereby students achieve the professional ethical role prescribed by the college.




Situational Variables



Status Passages. First year students are informed of their ethical roles during their orientation when their

class must develop its code of ethics. The significance of this exercise lies less in the content of the ethical ideals

and more in students' recognition that they have ethical responsibilities distinguishable from other professions.

(W. Allen, personal interview, October 20, 2004) The most striking status passage in medical school occurs

following the white coat ceremony. The expectations of competency and professionalism from this uniform are

most influential in the ethical role development.





Code of Ethics;
Class of 2008
We, tlie U livcrsit of Florida Collcge of Medicine Class of 20O , establish this ( odl of
Elthlct t stoPive our gmuidiLn priiwcipl it nAs we prsue n our cfallinit to praclico thlo ail of
iceldicimll. We resolve to mI ln nilill a s4tnRdalt conlullitinlild to:
R- Repecvl t t bauly. rattilii. mrud sntulcllt of life
* Ptoe id in all i ted'rs, w"Jilh h iukSiLtli, nAckit led Jasj our persolnlal lImit4dions Q and
niiCtrkes. seeking utijdnnce when needed. rnmd Irlciving eriLecmni w% itill m opcln
ingl ild.
* Embrace divcrsLly as it appliei to nil peoples aid idei.t
Earn Ihe tnlsl of our paLients and callcagues by making honcsly and inlegrity
utlmOtIE 4rinr4lithi ill ilt ko do
* Fortie from t11linPiqiC ndivi &mlitudc. mind ntklhuni rspact,
SMninintn balance in our personal andIt professionial lives in okder to cllbctivcly
nulrtun the ovemrl wncEl-bciig of both palicelts uid loved ones.
SCornmil In n lie of lanniilg 'on thnl "e mny incaprimmle novel idens m In medical
prwl.u v.
* Tecnh with cjithnstinsm those 'lwho will follow us i]i the trdi4ion of Ihose Iiwho
hIav preceded LIS.
STake titm to listoi to each pi mien and ncare fbr all %% illh an uwicondliional
compssion that semTTIS Irom our love for hnmrnilty.
'w' oo Pc a'� �<> 'fpo' f'fi J th' + fb.cfgee't . bit fi,) To 10 ^tJ r/. rt' ,. '*
-Ikmnrkih sehiplpre.�F

Figure 3. UF Med School Class of 2008 Code of Ethics; Courtesy of http://www.med.ufl.edu




Peer Group. The feedback mechanisms in place in the small group discussions typical of the clinically-

focused medical school courses allow for much peer to peer learning. Due to the very regimented and

structured nature of the medical school program, peer to peer learning occurs most often within cohorts rather




than across. (D. Hegland, personal interview, March 18, 2005) There are a few instances including orientation

and development of the code of ethics that demonstrate interaction across cohorts.



Conversion Experiences. On the whole, medical school is a mentally rigorous and emotionally intense

experience. The formal ceremonies at the end of the Clinical Anatomy course are particularly poignant as

medical students receive an opportunity to outwardly acknowledge the impact of the experience on their

lives. Another conversion experience is the white coat ceremony where medical students both externally

and internally acknowledge the physician role and the need to place the interests of the patient first.



Role Models. At the UF College of Medicine, students are exposed to role models during the preceptorship in

their first year where they observe doctor-patient interaction with the clinical physicians to which they are

assigned. (W. Allen, personal interview, Oct. 30, 2004) Most medical students accept the compassionate

physician role as a default. In their clerkships, they learn as much from positive role models as from negative

ones. For many students, the latter serve as a reminder of the kind of physician they do not hope to become and

the type of behavior they choose not to emulate. (D. Hegland, personal interview, March 18, 2004)



Role Playing. The extent to which medical students have the opportunity to role play is contingent upon the year

of medical school they are in. Some of the first and second year clinically-oriented courses call for some role

playing with simulated patients. The Interdisciplinary Family Health course requires real patient interaction

with assigned community families. The opportunities for assuming the physician role increase during the latter

two years when they are thrust into the hospital environment. Furthermore, extracurricular activities such as

the Equal Access Clinic which provides indigent care for those in the community and is run by medical students

from the UF College of Medicine especially provide opportunities to role play.



Criticism. It is often through socializing agents that students receive criticism. According to students at the

medical school, they are often evaluated on six professional competencies. During simulated patient

encounters, students receive constructive criticism from faculty members as well as the small peer group

regarding their interactions with patient. Furthermore, they are more likely to receive criticism more beneficial to

the professional ethical role during the third and fourth years from physicians, interns, and residents who

observe their behavior as clerkship evaluations are based on 30% grades and 70% subjective opinion of patients

and house staff. (D. Hegland, personal interview, March 18, 2005) The most notable role that criticism plays in

the ethical role development is the annual peer evaluation for the AOA for Character and Leadership.



Professional Ethical Socialization Model: MBA Program


American business schools appear to be in the early stages of defining how to prepare their students for the

ethical dimension of their professional role as managers. In 2003, the Association to Advance Collegiate Schools

of Business International (AACSB Int.), a 495 member organization comprised of the nation's top business

schools, established a requirement that accredited MBA programs teach students their ethical and

legal responsibilities to organizations and society. Many top business schools such as Harvard and Stanford






have included an ethics course in their MBA programs. ("Business Schools", 2005) As more business schools

design and implement ethics programs, they may find some useful lessons from the models of medical schools

and military academies. The following questions are derived from studying the professional socialization models

used in the United States Military Academy and the University Of Florida College of Medicine.



Structural Variables



1. What is the professional ethical role of the manager as determined by the MBA program? Accordingly, what are

the norms, values, and attitudes that the school aspires to instill in its students?

2. What qualifications should be established as admissions criteria to ensure that those students admitted

demonstrate the potential to assume the ethical role?

- interviewing process

- admissions essays

- other


3. What measures would ensure that the business school environment fosters the development of the ethical role?

4. What structural variables in MBA education influence the ethical role orientation of prospective managers?

5. Which aspects of the structure could be changed to improve ethical role orientation?

6. What are the common learning experiences of the program and how could they promote an ethical role orientation?

7. Does interaction in group settings reinforce the ethical managerial role?

8. Is there an individual set of experiences that produces differing responses, resulting in individuals adopting

new approaches towards their professional ethical roles?



Situational Variables



1. What aspects of the school environment would support or conflict with students assuming the ethical role?

- curriculum (prevailing management theories)

- tolerance of cheating and plagiarism

- promotion of unprofessional values explicitly or implicitly

2. How can students initially become aware of the ethical dimension of their professional role as they progress

through the program?

- orientation

- curricular and extracurricular activities

- creating codes of ethics

- other

3. To what extent are professional ethical values reflected in the evaluation of students in various academic activities?





4. How should the program handle individual deviation from the proposed ethical managerial role?

5. What transitional points or status passages could be used or created to represent a growing ethical role orientation?

6. How much of what is learned in the MBA program occurs in peer to peer learning experiences?

7. What opportunities might serve as conversion experiences, providing emotionally intense episodes to instill

and reinforce the professional ethical role orientation?

- challenging speakers

- case studies

- poignant literature

8. Are students exposed to both positive and negative role models? How could the program assist students

in distinguishing the two?

9. Are there opportunities for role playing and practicing the managerial role?

10. How can students receive criticism constructive to the development of their ethical role by faculty and staff and peers?

11. Will the faculty support a systematic program for instilling professional ethical values among MBA students?



CONCLUSION



The ethical and legal responsibilities of corporate management to shareholders and others are numerous and

often conflicting. Thus the professional ethical role of the manager is not easily defined and socialization to fulfill

this role can be a challenging process. Nevertheless, business schools are charged with the responsibility of

preparing qualified professionals that can meet the ethical and legal obligations of a managerial position.

Socialization for the ethical role in higher education involves inculcation of values and norms in the

normative dimension and implicit ethical training in the curricular dimension. (Weidman et al., 2001, p.2 )

The military academy and medical school models suggest relevant structural and situational considerations

for business school faculty and administrators seeking to foster ethical role development in these two dimensions.






REFERENCES



1. Bucher, R. & Stelling, J. (1977). Becoming Professional. Beverly Hills, CA: Sage Publications.

2. Business schools stand accused of being responsible for much that is wrong with corporate management

today. [Electronic Version]. (2005, February 19). The Economist.

3. Coe, R. (1970). Sociology of Medicine. New York: McGraw Hill.

4. Coombs, R. (1978). Mastering Medicine: Professional Socialization in Medical School. New York: The Free Press.

5. Coombs, R., May, S., & Small, G. (1986). Inside Doctoring: Stages and Outcomes in the Professional Development





of Physicians. New York: Praeger.

6. Interdisciplinary Family Health Goals and Objectives. (2004). Retrieved November 18, 2004, from University

of Florida, College of Medicine Web Site: http://families.health.ufl.edu/GoalsandObjectives.htm

7. Jones, G. (1986). Socialization Tactics, Self Efficacy, and Newcomers' Adjustments to Organizations. The Academy

of Management Journal, 29 (2), 262+. Retrieved July 15, 2004, from JSTOR database.

8. Lipsky, D. (2003). Absolutely American: Four Years at West Point. Boston: Houghton Mifflin

9. Pauly, Rebecca. (2004). Essentials of Patient Care Syllabus. Retrieved November 18, 2004, from University

Of Florida, College of Medicine Web Site: http://medinfo.ufl.edu/yearl/epc/epc_lfall 2004_syllabus.pdf

10. Ruggero, E. (2001). Duty First: A Year in the Life of West Point and the Making of American Leaders. New

York: Harper Collins.

11. Simon Center for the Professional Military Ethic. (2003). Cadet Basic Training Values Education Guide. West

Point: Author.

12. Simon Center for the Professional Military Ethic. (2003). Cadet Field Training Values Education Guide. West

Point: Author.

13. UF College of Medicine Admissions Brochure. (n.d.). Retrieved December 14, 2005, from the University of

Florida, College of Medicine Web Site: http://www.med.ufl.edu/oea/admiss/brochures/AdmissionsPolicy.pdf

14. USMA Prospectus. (n.d.). Retrieved February 17, 2005, from United States Military Academy, Admissions

Department Web Site: http://admissions.usma.edu/Prospectus

15. Weidman, J., Twale, D., & Stein, E. (2001). Socialization of Graduate and Professional Students in Higher

Education (Report Vol. 28 No.3). Washington, D.C.: Association for the Study of Higher Education. (ERIC

Document Reproduction Service No. ED457710)





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