Multisource feedback in professionalism for anesthesia residents

Riveros, Ricardo; Kimatian, Stephen J.; Castro, Pilar; Dhumak, Vipul; Honar, Hooman; Mascha, Edward J.; Sessler, Daniel I.

doi:10.1016/j.jclinane.2016.03.038

Cited by 28 publications

(40 citation statements)

References 15 publications

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“…The 16 studies examined 10 instruments: the Amsterdam Attitude and Communication Scale (AACS), 22 the Emergency Medicine Humanism Scale (EM-HS), 23 the Education Outcome Service (EOS) group questionnaire, [24][25][26][27] the Evaluation of Professional Behavior in General Practice (EPRO-GP), 28 the German Professionalism Scale (Pro-D), 29 the modified Physician Achievement Review (PAR), 30 the multisource feedback (MSF) questionnaire, 31 the Nijmegen Professionalism Scale, 32 the Professionalism Assessment Instrument (PAI), 33 and the Professionalism Mini-Evaluation Exercise (P-MEX). [34][35][36][37] Four instruments assessed residents and medical students (the EPRO-GP, Pro-D, Nijmegen Professionalism Scale, and P-MEX).…”

Section: Search Resultsmentioning

confidence: 99%

A Systematic Review of the Quality and Utility of Observer-Based Instruments for Assessing Medical Professionalism

Kwan¹,

Png²,

Phang³

et al. 2018

Journal of Graduate Medical Education

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Background Professionalism, which encompasses behavioral, ethical, and related domains, is a core competency of medical practice. While observer-based instruments to assess medical professionalism are available, information on their psychometric properties and utility is limited.Objective We systematically reviewed the psychometric properties and utility of existing observer-based instruments for assessing professionalism in medical trainees.Methods After selecting eligible studies, we employed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria to score study methodological quality. We identified eligible instruments and performed quality assessment of psychometric properties for each selected instrument. We scored the utility of each instrument based on the ability to distinguish performance levels over time, availability of objective scoring criteria, validity evidence in medical students and residents, and instrument length. ResultsTen instruments from 16 studies met criteria for consideration, with studies having acceptable methodological quality. Psychometric properties were variably assessed. Among 10 instruments, the Education Outcomes Service (EOS) group questionnaire and Professionalism Mini-Evaluation Exercise (P-MEX) possessed the best psychometric properties, with the P-MEX scoring higher on utility than the EOS group questionnaire. ConclusionsWe identified 2 instruments with best psychometric properties, with 1 also showing acceptable utility for assessing professionalism in trainees. The P-MEX may be an option for program directors to adopt as an observer-based instrument for formative assessment of medical professionalism. Further studies of the 2 instruments to aggregate additional validity evidence is recommended, particularly in the domain of content validity before they are used in specific cultural settings and in summative assessments.

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Section: Search Resultsmentioning

confidence: 99%

A Systematic Review of the Quality and Utility of Observer-Based Instruments for Assessing Medical Professionalism

Kwan¹,

Png²,

Phang³

et al. 2018

Journal of Graduate Medical Education

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“…Although it is accepted that professionalism lapses are more difficult to remediate and to measure than those pertaining to knowledge and skills, there is evidence that professionalism can be measured through feedback tools in the workplace . Indeed, the increasing use of multi‐source feedback in the workplace is driven in large part by the recognition of its effectiveness in completing this task . This suggests that, given the recognised importance of professionalism lapses to more general performance levels, as well to potential ethical violations, there is room for more robust measurements of professionalism to evaluate the success or otherwise of remediation interventions.…”

Section: Discussionmentioning

confidence: 99%

“…52 Indeed, the increasing use of multi-source feedback in the workplace is driven in large part by the recognition of its effectiveness in completing this task. 53,54 This suggests that, given the recognised importance of professionalism lapses to more general performance levels, as well to potential ethical violations, there is room for more robust measurements of professionalism to evaluate the success or otherwise of remediation interventions. There is also room to examine in more detail, and in a way that is informed by a theoretically rich understanding of behaviour change, how professionalism is remediated.…”

Section: Statement Of Principal Findings and Comparison With Existimentioning

confidence: 99%

Remediating professionalism lapses in medical students and doctors: A systematic review

et al. 2019

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Context A remediation intervention aims to facilitate the improvement of an individual whose competence in a particular skill has dropped below the level expected. Little is known regarding the effectiveness of remediation, especially in the area of professionalism. This review sought to identify and assess the effectiveness of interventions to remediate professionalism lapses in medical students and doctors. Methods Databases Embase, MEDLINE, Education Resources Information Center and the British Education Index were searched in September 2017 and October 2018. Studies reporting interventions to remediate professionalism lapses in medical students and doctors were included. A standardised data extraction form incorporating a previously described behaviour change technique taxonomy was utilised. A narrative synthesis approach was adopted. Quality was assessed using the Critical Appraisal Skills Programme checklist. Results A total of 19 studies on remediation interventions reported in 23 articles were identified. Of these, 13 were case studies, five were cohort studies and one was a qualitative study; 37% targeted doctors, 26% medical students, 16% residents and 21% involved mixed populations. Most interventions were multifaceted and addressed professionalism issues concomitantly with clinical skills, but some focused on specific areas (eg sexual boundaries and disruptive behaviours). Most used three or more behaviour change techniques. The included studies were predominantly of low quality as 13 of the 19 were case studies. It was difficult to assess the effectiveness of the interventions as the majority of studies did not carry out any evaluation. Conclusions The review identifies a paucity of evidence to guide best practice in the remediation of professionalism lapses in medical students and doctors. The literature tentatively suggests that remediating lapses in professionalism, as part of a wider programme of remediation, can facilitate participants to graduate from a programme of study, and pass medical licensing and mock oral board examinations. However, it is not clear from this literature whether these interventions are successful in remediating lapses in professionalism specifically. Further research is required to improve the design and evaluation of interventions to remediate professionalism lapses.

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“…In relation to the concepts, eight articles mentioned their own definitions (8,14,(16)(17)(18)(19)20,23).…”

Section: Professionalism: Multidimensional Constructmentioning

confidence: 99%

“…The literature review demonstrated that most the studies develop the teaching of professionalism also through formative feedback, multiple source or 360 0 feedback, case studies, readings on the theme, workshops, discussion sessions about clinical cases, elements of the hidden and informal curriculum, discussions in small groups, interactive workshops, discussion of clinical cases, videos with cases that give rise to ethical and professional discussion (8)(9)(10)(11)(12)14,16,19,20,21,26,27). The teaching of professionalism through observation of professional or unprofessional behaviours in case studies has been a potential tool in the training of the future professiona (27).…”

Section: Teaching Of Professionalism: Role Models and The Curriculummentioning

confidence: 99%

Profissionalismo na Formação do Especialista Médico: Revisão Integrativa da Literatura

Feitosa

Brilhante

Cunha

et al. 2019

Rev. bras. educ. med.

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Introduction The construct professionalism is increasingly being recognized as an important component of medical education; fundamental to the physician’s role in society Objective: To group in a concise and systemized way the information available in scientific productions on the concept of medical professionalism and its applications in medical residency programs. Methods A total of 85 articles were found in 2018, of which 13 were excluded for duplication using the Mendeley platform. Of the 72 remaining articles, 35 were excluded for not answering the research question. Of the 37 articles selected for reading of the abstract, eight were not available, leaving 29 articles. After reading all articles for the final selection, 11 articles were excluded. Six papers did not fulfill the goals of the research, and five were opinion articles. Results The production included 18 articles, from which analysis emerged three thematic categories: (a) professionalism: multidimensional construct; (b) teaching of professionalism: role modeling and the curriculum; (c) evaluation of professionalism: multiple strategies in the curriculum. The most frequently cited domains were: altruism, responsibility, care, teamwork, self-control, ethical principles and clinic excellence. Ten articles highlighted the importance of role modeling by preceptors and members of the health team in the Medical Residency Program for teaching professionalism. Regarding the most commonly used strategies for the selection, feedback practices and the OSCE were highlighted in scenarios to evaluate the domains of professionalism. Conclusion Professionalism is a dynamic construct that is worked on in the form of teaching and assessment in Medical Residency Programs. There is no consensus on the professionalism concept, and thus, multiple strategies are used for the teaching, among which role modeling can be highlighted. The teaching of medical professionalism, as a construct, in the training of specialists can reduce lapses and foster assistance based on respect for the autonomy of people and social responsibility.

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Multisource feedback in professionalism for anesthesia residents

Cited by 28 publications

References 15 publications

A Systematic Review of the Quality and Utility of Observer-Based Instruments for Assessing Medical Professionalism

A Systematic Review of the Quality and Utility of Observer-Based Instruments for Assessing Medical Professionalism

Remediating professionalism lapses in medical students and doctors: A systematic review

Profissionalismo na Formação do Especialista Médico: Revisão Integrativa da Literatura

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