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This article was migrated. The article was marked as recommended. Introduction: The escalating problem of unprofessionalism calls for teaching medical professionalism in a manner that should lead to deeper learning. Early clinical exposure (ECE) to an Intensive Care Unit (ICU) presents the issues pertaining to medical professionalism to the students in a more explicit and emotionally challenging manner. And reflection note writing evokes the critical process of thought and analysis required for learning. We conducted the present study to sensitize the pre-clinical students towards medical professionalism using these two tools, ECE and Reflection. Methods: Two hundred students of 1 st  MBBS were given an Objective Structured Clinical Examinations (OSCE). The students were then taken for ECE to an ICU. There, the students observed different ongoing activities and critical patients, a doctor discussed some cases with them, and they also interacted with the relatives of patients admitted in the ICU. Thereafter, students wrote a 'reflection' note describing what did you see? so what? and now what? Students were again given an OSCE, similar to the one given before the ECE, for assessing any change in their professional behaviour.Analysis of reflection notes was done thematically and of OSCE scores using paired t-test (p&lt;0.05). Results: The analysis of reflection notes revealed the budding of different elements of professionalism among the students. Post-visit OSCE scores also showed significant improvement. Conclusion: Incorporation of reflection note writing along with ECE is helpful in laying the foundation of medical professionalism among pre-clinical students.

Laying the Foundation of Medical Professionalism among Pre-clinical Students: Importance of Reflection