Instituting a Culture of Professionalism: The Establishment of a Center for Professionalism and Peer Support

Shapiro, Jo; Whittemore, Anthony D.; Tsen, Lawrence C.

doi:10.1016/s1553-7250(14)40022-9

Cited by 67 publications

(86 citation statements)

References 22 publications

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“…[38,39] In Brigham and Women's Hospital, a Center for Professionalism and Peer Support was set up. [40][41][42] In Johns Hopkins Hospital, a support program called RISE (Resilience in Stressful Events) has been implemented. [19,39,43] The University of Missouri Health Care has its forYOU Team.…”

Section: Introductionmentioning

confidence: 99%

The need and availability of support systems for physicians involved in a serious adverse event

Leferink

Bos²,

Heringa

et al. 2018

JHA

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Objective: Serious adverse events occur in healthcare, and do not solely have consequences for patients (first victims), but also affect physicians involved (second victims). These second victims experience diminished emotional well-being and less professional performance. An increasing number of hospitals organize support for second victims, although scientific evidence on the kind of support that is expected and needed is poor. This study therefore investigates support needs after serious adverse events from both personal (physicians) and organizational (quality and safety staff members) perspectives. Methods: We conducted semi-structured interviews in a Dutch university medical center. Physicians (N = 19) who had been directly involved in a serious adverse event participated. In addition, quality and safety staff members (N = 3) reflected on the support needs as expressed by physicians. Verbatim transcripts were three-fold coded, which led to several themes for our inductive thematic analysis. Results: Contrary to recent developments in healthcare organizations, participants did not plea for a hospital-wide support team. Acceptance of the emotional and professional impact of an adverse event by direct colleagues and supervisors is more important. Where such a cultural context is provided, physicians prefer support of a close and reliable colleague to cope with emotions and doubts, a supervisor who monitors recovery, and a healthcare organization that provides information about required procedures to learn from the events. However, this ideal was seldom found in the competitive working environment. This underlines the need for a shift from a competitive professional culture into a more supportive one. Conclusions: Ideally, direct colleagues support each other after an adverse event. This form of collegial support can only be successful if there is general acceptance of healthcare professionals' vulnerability and their support needs within the direct working environment. To create the right circumstances to meet these support needs, both healthcare professionals and hospital organizations have to recognize and take their responsibilities.

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Section: Introductionmentioning

confidence: 99%

The need and availability of support systems for physicians involved in a serious adverse event

Leferink

Bos²,

Heringa

et al. 2018

JHA

View full text Add to dashboard Cite

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“…If we add the rising demands for "efficiency,"-seeing a larger number of patients with fewer resources, and the increase in the workload and responsibilities of health care providers in general, -we will find fertile ground not only for disruptive behaviors but also for the identity crisis of modern medical practice as exemplified by the rise of commercialism against values such as altruism and compassion. 2,31 Philip Zimbardo, in his book The Lucifer Effect: Understanding How Good People Turn Evil, states that situational forces can induce good people to depart from ethical paths via mechanisms such as obedience to authority, deindividuation, self-justification, and rationalization, all of which are remarkably common in the learning of medicine. 32 He argues that leaders must share the responsibility for the occurrence of unethical behaviors (and their consequences) within their institutions.…”

Section: Discussionmentioning

confidence: 99%

“…14 Institutions that have created anonymous reporting mechanisms against unprofessional behavior commit to not only improving their learning/practicing environment but also to enhancing patient safety. 2,15,16 We believe that most deans, directors, and chiefs do not want to look for unethical and unprofessional behavior in their colleagues. These are sensitive matters about which some may feel uncomfortable or unknowledgeable.…”

Section: Reasons Whymentioning

confidence: 99%

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Why Medical Schools Are Tolerant of Unethical Behavior

Vidal

Silva

Santos

et al. 2015

The Annals of Family Medicine

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The exposure to unethical and unprofessional behavior is thought to play a major role in the declining empathy experienced by medical students during their training. We reflect on the reasons why medical schools are tolerant of unethical behavior of faculty. First, there are barriers to reporting unprofessional behavior within medical schools including fear of retaliation and lack of mechanisms to ensure anonymity. Second, deans and directors do not want to look for unethical behavior in their colleagues. Third, most of us have learned to take disrespectful circumstances in health care institutions for granted. Fourth, the accreditation of medical schools around the world does not usually cover the processes or outcomes associated with fostering ethical behavior in students. Several initiatives promise to change that picture. THE ORATOR'S SPEECHR ecently, we attended the graduation ceremony of medical graduates at our medical school. It is satisfying to see the glowing faces of our students and their families, as these young men and women perform this last ritual towards becoming physicians. As the orator gave her speech, she thanked the professors and health care professionals who had taught her and fellow graduates important lessons of competent and humane care of sick patients, and also faculty who had provided them with examples of "pure unethical behavior." She justified her "gratitude" by saying that they had learned 2 eloquent lessons: how to behave professionally and how not to behave toward patients, their families, and colleagues.In the next few days after the ceremony, we asked other faculty members and other professionals who had attended the graduation ceremony about their thoughts on the speech. Surprisingly, no one seemed uneasy about the not-so-subtle allegation of unethical behavior of faculty in our medical school. In fact, no one had approached the orator or her fellow graduates to verify the claims of disrespectful and unethical behavior.We wondered what would have happened if that speech had been presented at another type of institution. Would the CEO respond by reaffirming the organization's commitment to ethical behavior? Would the orator and her fellow graduates be asked to substantiate the claims and assist with investigations to protect not only the organization's customers and employees, but also the organization's mission and reputation? We hope that the answer to those questions would be yes.Why then is unethical behavior tolerated in medical schools? This is not a local problem and unfortunately there are several examples in the medical literature describing how common such unprofessional situations are around the world.3-8 Most, if not all, medical schools confront harassment and discrimination as described by a recent systematic review. 9For the purposes of this essay we will define unethical behaviors as those that infringe any aspect of the medical code of ethics. We will also consider professionalism as a subset of health care ethics as proposed by Brody and Doukas 1 a...

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“…In cases where disruptive behaviors or other types of unprofessional behaviors occur it is important to have a consistent process for event reporting, incident review, and appropriate follow up intervention conducted by individuals skilled in facilitation and conflict mediation [7,8].…”

Section: Recommendationsmentioning

confidence: 99%

Understanding the Psychology behind Physician Attitudes, Behaviors, and Engagement as the Pathway to Physician Well- Being

Rosenstein¹

2016

JPCPY

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Instituting a Culture of Professionalism: The Establishment of a Center for Professionalism and Peer Support

Cited by 67 publications

References 22 publications

The need and availability of support systems for physicians involved in a serious adverse event

The need and availability of support systems for physicians involved in a serious adverse event

Why Medical Schools Are Tolerant of Unethical Behavior

Understanding the Psychology behind Physician Attitudes, Behaviors, and Engagement as the Pathway to Physician Well- Being

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