A World Cafe for Entering Medical Students

Last week our newest class of first-year medical students arrived for week of orientation. One of the expectations placed on them is that they will make an early and formal commitment to a set of professional behaviors that they will honor throughout their education and then on into their professional lives.

The Senior Associate Dean for Academic Affairs asked if I would help her work with the group - 80 in all - to fashion an agreement. I suggested that we might not do justice to something that deep with so many in so little time - they had allotted two hours - and that we would do well to instead hold an exploratory conversation that would produce the content around which a written agreement could be drafted afterward. In that light a Cafe Conversation seemed perfect.

The session began with a presentation on the essential professional behaviors expected of physicians. These were described as Aspirations of Professionalism and I used those as a starting point on the graphic record drawing them in ahead of time.

Using a tent card, each table was designated as the site for one of the six aspirations. The students were instructed to then rotate each time to a different aspiration as well as to a different group of people. They were asked to reflect on this question with each aspiration: What commitments are we willing to make to our professional development and professional competence?

As I strolled the room during the table rounds, I began to be concerned as a couple of the sixteen tables were a little less engaged than the others. I didn't know quite how to read it, as this was only the second cafe I'd held with so many people. In many ways this particular week is a grueling boot camp for these young men and women, so I wondered if they were just running out of gas. Of course, I also had to second-guess the design.

The Harvesting, however, eliminated all doubts as the Cafe Magic kicked in. The reflections were slow to come at first, but as the outflow steadied it also grew deeper. By the time we were done the attendees not only expressed their satisfaction (and I love applause) but also took it upon themselves to designate a small group to craft the agreement that they will subsequently sign.
The graphic record moved the next morning into one of the classrooms they would be using during the day. Parents were on campus to see the "white coat ceremony" at days end, and I had the pleasure of seeing some of the students bring their family in to see the chart. the image will be included in their written agreement, and then kept around in poster form for the duration of this class's time here.