Behaviors of Highly Professional Resident Physicians

Reed, Darcy A.; West, Colin P.; Mueller, Paul S.; Ficalora, Robert D.; Engstler, Gregory J.; Beckman, Thomas J.

doi:10.1001/jama.300.11.1326

Cited by 77 publications

(74 citation statements)

References 35 publications

(41 reference statements)

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“…21 Highly professional residents (those who scored C 80th percentile on observation-based assessments) achieved higher median scores on the in-training examinations and clinical evaluation exercises, and they completed a greater percentage of required evaluations compared with residents with lower professionalism scores. Six of the eight residents who received a warning or were placed on probation had total professionalism scores in the bottom 20% of residents.…”

Section: Physician Behaviour Patterns and Patient Complaints And Litimentioning

confidence: 99%

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Bahaziq

Crosby

2011

Can J Anesth/J Can Anesth

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Purpose In this review, we examine the association between physician professional behaviour and indicators measuring patient outcomes and satisfaction with care as well the potential for complaints, discipline, and litigation against physicians. We also review issues related to the structured teaching of professionalism to anesthesia residents, including resident evaluation. Source A search of the OVID Medline and PubMed databases was carried out using keywords relevant to the topics under consideration. Program directors of Canadian anesthesiology training programs were also surveyed to assess the current state of professionalism training and evaluation in their programs. Principal findings Unprofessional behaviour is frequently manifested in practice by medical students, residents, and physicians, and it is associated with personality characteristics that are evident early in training. There is a correlation between unprofessional physician behaviours and patient dissatisfaction, complaints, and lawsuits as well as adverse outcomes of care. Physician health and workplace relationships are negatively impacted by such behaviours. Canadian program directors recognize the need to approach the teaching of professionalism in an organized fashion during physician training. Conclusions A framework is provided for defining behavioural expectations, and mechanisms are offered for teaching and evaluating behaviours and responding to individuals with behaviours that persistently breach defined expectations. There is a need to define explicitly not only the expectations for behaviour but also the processes by which the behaviours will be assessed and documented. In addition, emphasis is placed on the nature, order, and magnitude of the responses to behaviours that do not meet expectations.

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Section: Physician Behaviour Patterns and Patient Complaints And Litimentioning

confidence: 99%

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Bahaziq

Crosby

2011

Can J Anesth/J Can Anesth

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“…33 Instead, multiple tools should be used including tests of knowledge and skills, 360-degree reviews (e.g., by faculty attendings, peers, allied healthcare staff, patients, and others), objective structured clinical examination (OSCE), review of patient complaints, and other methods can be used to assess professionalism. 4,13,18,33 "Critical incident reports" can also be used for assessment of professionalism, especially for learners at the extremes of performance. 4 1 Using multiple reliable tools ensures that professionalism assessments are valid.…”

Section: How Does One Assess Professionalism?mentioning

confidence: 99%

“…Faculty, residents and fellows, and peers complete electronic professionalism assessments of medical students during their clinical rotations. 18 Finally, professionalism and ethics teaching is woven into courses and clinical rotations throughout the four-year curriculum. For example, during the pre-clinical nephrology block, students learn about a variety of professionalism and ethics issues faced by patients with kidney failure and nephrologists (e.g., just allocation of organs for transplantation, the ethical aspects of withholding hemodialysis from dying patients, and talking to patients about death and dying).…”

Section: Teaching and Assessing Professionalism At Mayo Clinicmentioning

confidence: 99%

Incorporating Professionalism into Medical Education: The Mayo Clinic Experience

2009

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Professionalism is a core competency of physicians. In this article, the statements of professional societies (e.g., the Charter on Medical Professionalism), the expectations of patients and society regarding professionalism, and a framework for defining medical professionalism are described. The framework's foundation consists of clinical competence, communication skills, and a sound understanding of the ethical and legal aspects of medicine. Rising from this foundation are attributes of professionalism: accountability, altruism, excellence, and humanism. The capstone of the framework is professionalism, or the complete physician. Reasons for teaching professionalism to and assessing professionalism among medical students, physicians in training, and physicians in practice are also described. These reasons include patient expectations; the association between professionalism and improved clinical outcomes (and the association between unprofessional behavior and adverse outcomes); accreditation organization requirements; and observations that professionalism can be taught, learned, and assessed. In addition, methods for teaching professionalism are described (e.g., didactic lectures, discussion groups, simulation, and role-modeling). To ensure that medical students, physicians in training, and physicians in practice are competent in professionalism, they should be assessed for professionalism. Thus, approaches to assessing professionalism are also described (e.g., multiple tools and observers). Professionalism assessments can be used for formative and summative feedback, evaluation of professionalism education programs, and generating hypotheses for professionalism research. Finally, the rich history and culture of clinical excellence and professionalism and specific programs for teaching and assessing professionalism at Mayo Clinic are described throughout this article. Indeed, the Mayo Clinic experience validates professionalism as a core physician competency. (Keio J Med 58 (3) :

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“…Due to the growing interest and emphasis on professionalism, there is the suggestion that psychiatrists need to be involved directly in the education of these matters, such as definition of professionalism (Talbott and Mallott, 2006). On the counts to tackle unprofessional behaviour, the implementation of measures such as reflection, selfassessment and role model are thought to be more helpful in encouraging professional development, but it would be necessary to "ring-fence" the time allocated to the learners and release the pressure from the educators (Swick, 2000;Reed et al, 2008;Engel et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

“…So emphasis on this part may strengthen the position of the medical students. Well versed tutors can influence this in a positive way (Roberts et al, 2004;Reed et al, 2008). Mentoring is stressed by some individuals of medical student group as well as by the chiropractors as one of the criteria which will strengthen their professional understanding.…”

Section: Discussionmentioning

confidence: 99%

Definition of professionalism by different groups of health care students

Zafiropoulos¹

2017

Educ. Res. Rev.

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Professionalism is important in all service-providing professions. Professional bodies have extensive rules and regulations creating the foundations of the definition of professionalism, its meaning and these rules have to be followed. In view of this, healthcare students are given intensive training. A prospective study conducted in a District General Hospital, to establish if professionalism was clearly defined. A questionnaire with open questions was given to 75 students from different disciplines including medical, nursing and chiropractic students (25 individuals from each group). The participants were at the end of their studies. The General Medical Council (GMC) criteria for professionalism were used. They were discussed as part of their induction to the orthopaedic department and the questionnaire was given to them at the end of their placement. Their answers were grouped, categorised and the findings were then analysed. All groups demonstrated a good understanding of the definition and factors that influence professionalism. Student nurses performed overall better than the other two groups. Medical and chiropractic students scored lower on communication, working with colleagues and audit/research. All three groups scored low in the categories of problem dealing and health. Reflection and mentoring were two of the subjects that they considered as important to help them improve their cognition to become a professional subject. The inclusion of the professionalism as subject to education seems that helps the understanding of the term but contact with the clinical environment and proper mentoring by senior clinicians enhances to the understanding in some of the criteria. GMC criteria can be used for the assessment of cognition of professionalism but with the addition of reflection in the list.

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Behaviors of Highly Professional Resident Physicians

Cited by 77 publications

References 35 publications

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Incorporating Professionalism into Medical Education: The Mayo Clinic Experience

Definition of professionalism by different groups of health care students

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