Emergency Medicine Resident Perceptions of Medical Professionalism

Abstract

IntroductionMedical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees’ perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism.MethodsWe performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine’s “Project Professionalism” and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions.ResultsOf the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the “respect for others” and “honor and integrity” valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the “duty and service” domain (p<0.05). Among different residencies, significant differences were found with attributes within the “altruism” and “duty and service” domains (p<0.05).ConclusionResidents perceive differences in the relative importance of traditionally defined professional attributes and this may be useful to educators. Explanations for these differences are hypothesized, as are the potential implications for professionalism education. Because teaching professional behavior is taught most effectively via behavior modeling, faculty awareness of resident values and faculty development to address potential gaps may improve professionalism education.

Critical Appraisal of Emergency Medicine Educational Research: The Best Publications of 2016

“…Similar to prior years, the most common study populations were medical students (21/75; 28%) and residents (48/75; 64%) . Interestingly, this year only one study addressing medical students was highlighted for excellence, in contrast to prior years.…”

“…Three of these studies with an experimental design were highlighted . There was a decline in the number of observational studies (35/75; 47%), compared to 2015 (36/61; 59%), but an increase in the number of studies using survey methodology (19/75; 25%) in 2016 compared to 10 of 61, 16% in 2015, and 0% in 2014. It should be noted that all survey studies in this review drew data from participants from multiple institutions per the predetermined selection criteria.…”

O profissionalismo e suas formas de avaliação em estudantes de Medicina: uma revisão integrativa

“…For the assessment of professionalism, attributes called "domains" have been created and subdivided into specific attributes, which facilitates analyses based on characteristics. Examples of domains are empathy, altruism, self-improvement, competency, punctuality, responsibility, respect, confidentiality, secrecy and fairness 1,4,10,15 . It should be emphasized that the process of teaching and assessing students must highlight the importance of displaying these behaviors 8 .…”

“…It represents a complex, dynamic and multidimensional construct that is difficult to define and encompasses multiple and varied concepts which, many times, are dissimilar. It also includes individual and behavioral factors that are learned throughout life and are influenced by sociocultural aspects 1,4 . Due to this, establishing an ideal model to teach and assess professional attitudes can be quite challenging 1,2 .…”

“…In this process, it is necessary to raise the faculty's awareness of their role as formative agents of behaviors and attitudes, and as influencers of good actions and changes in their students' way of acting 4,11 . In addition, it is important that the assessment and teaching processes enable students to reflect on the importance of displaying professional behaviors 8 .…”