The practice of dermatopathology faces unique quandaries regarding ethics and professionalism. While anecdotes exist and a recent quantitative survey has been reported, 1 no qualitative research has focused on ethical and professional concerns of dermatopathologists. [2][3][4][5] To address this knowledge deficit, we performed qualitative analyses on free-text case responses about ethical/professionalism issues encountered by American Society of Dermatopathology (ASDP) members using an anonymous cross-sectional survey.
| MATERIALS AND METHODSAfter IRB approval, members of ASDP were surveyed using methods described previously. 1 Participants were asked to "briefly describe (in one paragraph) a recent case or scenario you've experienced that was ethically challenging in your practice of dermatopathology," excluding all identifiers. Free-text responses were coded by three researchers (medical student, dermatology resident, and qualitative research analyst) using directed content analysis with MAXQDA software (VERBI, Berlin, Germany). A structured codebook was developed with deductive codes that included eight categories of ethical challenges presented in the quantitative survey a priori, as well as inductive codes from the qualitative data revisions. The codebook was revised iteratively to ensure reliability. The senior author reviewed the codes and resolved disagreements. Codes were organized to synthesize key themes and subthemes of challenging ethical scenarios reported by ASDP members.Frequencies of themes and subthemes were summarized.
| RESULTSAcross four survey distributions, 1497 unique respondents were sent surveys, and 172 free-text responses were submitted (free-text response rate 11.5%). From this, 284 partial quotes were isolated as units of analysis containing single subthemes. Overarching themes were generated from