Disciplinary Action by Medical Boards and Prior Behavior in Medical School

Papadakis, Maxine A.; Teherani, Arianne; Banach, Mary; Knettler, Timothy R.; Rattner, Susan L.; Stern, David T.; Veloski, J. Jon; Hodgson, Carol S.

doi:10.1056/nejmsa052596

Cited by 739 publications

(470 citation statements)

References 23 publications

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“…Risks highlighted in previous literature are based on unprofessional patient-physician contact [12] along with f "tweets" and "posts." Our presession surveys show that many residents witness unprofessional online content as reported in previous literature as well [4,13,14]. After the reflective approach session, residents stated they had improved their awareness in protecting patient privacy on digital media and would take a more proactive approach in ensuring professional use of social media and that they may modify their activity when using digital media both professionally and personally.…”

Section: Discussionsupporting

confidence: 63%

Social Media Impact: Utility of Reflective Approach in the Practice of Surgery

2014

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Social media is rapidly being incorporated into medical education. We created a small group, reflective practice sessions by integrating specific medical cases to improve awareness about professionalism on social media. Medical scenarios were generated for reflective practice sessions on social media professionalism. Anonymous pre/post-session surveys evaluated residents' use of social media and gathered their opinions on the session. Thirty-eight of 48 (79 %) residents replied to the presession survey with 50 % (19/38) reporting daily digital media use, 76 % (29/38) witnessed unprofessional postings on social media, and 21 % (8/38) posted unprofessional content themselves. Of the 79 % (30/ 38) residents who attended the session, 74 % (28/38) completed the post-session survey. Residents reported the session added to the longevity of their professional career 4.11, 95 % CI (3.89-4.36). As a result of the session, they were more conscious of using the social media more professionally 3.47, 95 % CI (2.88-3.96) and would be proactive in protecting patient privacy and confidentiality on social media sites 3.96, 95 % CI (3.50-4.37). In summary, reflective practice-based sessions regarding the impact of social media on professionalism in surgery was well favored by the residents. The majority agreed that it had important implications for the longevity of their professional career. Participants reported having an increased awareness to protect patient privacy and utilize social media more professionally.

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Section: Discussionsupporting

confidence: 63%

Social Media Impact: Utility of Reflective Approach in the Practice of Surgery

2014

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“…Papadakis et al then identified the specific types of inappropriate behaviour in medical school that were most predictive of disciplinary action against practicing physicians with unprofessional behaviour. 6 Disciplinary action by a medical board was strongly associated with evidence of severe irresponsibility and severely diminished capacity for selfimprovement. Disciplinary action by a medical board was also associated with low scores on the Medical College Admission Test and poor grades in the first two years of medical school, but the association with these variables was less strong than that with unprofessional behaviour while in medical school.…”

Section: Predicting Problem Patterns Of Behaviour In Physiciansmentioning

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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“…Qualitative information may be more sensitive for detecting individuals likely to exhibit poor professionalism. [10][11][12] Future works will examine the qualitative information from the PGY-1 Program Director surveys.…”

Section: Limitationsmentioning

confidence: 99%

Identifying Medical Students Likely to Exhibit Poor Professionalism and Knowledge During Internship

et al. 2007

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PARTICIPANTS:One thousand sixty-nine graduates between 1993 and 2002. MAIN OUTCOME MEASURE(S):Residency program directors completed an 18-item survey assessing intern performance. Factor analysis of these items collapsed to 2 domains: knowledge and professionalism. These domains were scored and performance dichotomized at the 10th percentile. RESULTS:Many variables showed a univariate relationship with ratings in the bottom 10% of both domains. Multivariable logistic regression modeling revealed that grades earned during the third year predicted low ratings in both knowledge (odds ratio [OR]=4.9; 95%CI=2.7-9.2) and professionalism (OR= 7.3; 95%CI=4.1-13.0). USMLE step 1 scores (OR=1.03; 95%CI=1.01-1.05) predicted knowledge but not professionalism. The remaining variables were not independently predictive of performance ratings. The predictive ability for the knowledge and professionalism models was modest (respective area under ROC curves=0.735 and 0.725). CONCLUSIONS:A strong association exists between the third year GPA and internship ratings by program directors in professionalism and knowledge. In combination with third year grades, either the USMLE step 1 or step 2 scores predict poor knowledge ratings. Despite a wealth of available markers and a large data set, predicting poor performance during internship remains difficult.

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Disciplinary Action by Medical Boards and Prior Behavior in Medical School

Cited by 739 publications

References 23 publications

Social Media Impact: Utility of Reflective Approach in the Practice of Surgery

Social Media Impact: Utility of Reflective Approach in the Practice of Surgery

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

Identifying Medical Students Likely to Exhibit Poor Professionalism and Knowledge During Internship

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