Feeling the Pain: Unprofessional in a ?Professional World? Patricia Goodemote, LtCol, USAF, MC Objectives Understand your own and your colleagues definition of professionalism Understand colleagues perception of its application as a physician and/or military leader Understand how professionalism improves or deteriorates unit, colleague, and patient relationships Implement effective tools to teach and assess professionalism Workshop Outline Define professionalism – Historical example – ACGME definition Discuss cases to apply professionalism – Initial case and more small case (small group) – Our own experiences (small group) – Good cases (large group) Discuss tools for teaching/assessing professionalism – My tool to start out residency – Other tools available – Your tools (open discussion) What is Professionalism? Professionalism Respectful Compassionate Integrity Service (before self) Dependable Ethical Commitment to excellence ACGME Competency Residents must demonstrate a commitment to: – carrying out professional responsibilities – adherence to ethical principles – sensitivity to a diverse patient population ACGME Competency Professional behavior – respect, compassion, and integrity Ethical principles – continuity of care, confidentiality, respect, and autonomy Cultural competence – sensitivity and value the diversity – recognize and respond to physician impairment Professionalism Cases Initial case Small groups – Discuss other cases – Share personal experience Tested your professionalism. Were you happy with how you handled the situation? Large group – 1 rep from each small group share the case or personal experience that caused most discussion or learning Teaching Professionalism Our character is what we do when we think no one is looking… H Jackson Browne Do what I say, not what I do… Many People FEELING THE PAIN You just learned your FIRST professionalism workshop!!!! Not too painful- was it!! Making Professionalism Concrete Describe in terms of specific behaviors – Make sure learners know the standards for professional behavior – Model appropriate behaviors Categorize and describe levels of professionalism – Make positive/negative professional behaviors explicit when observed Review professionalism scenarios – Use case discussion in teaching sessions When to teach? Clinical teaching Ethics Committee Case based teaching Journal Club Mentoring Interactive workshops Role modeling Lecture/ Conference/ Role plays and Seminar clinical vignettes Institutional initiatives Teaching Professionalism New Intern class – Case based exercise as above – Develop a class motto – Develop standard of professionalism they expect themselves to adhere to – Post motto/standard in resident work area Assessing Professionalism Tools: – Clinical Performance Rating – 360 degree – Multi-Rater - blinded Other residents Faculty Clinic and Ward Staff – Focused observation – Patient Satisfaction Sample Assessment Tool Clinical Performance Rating Scale Professionalism Lacks respect, compassion, Always demonstrates respect, integrity, honesty; compassion, integrity, honesty; insensitive to diversity; teaches/role models responsible shirks responsibility; behavior; total commitment to disregards need for self self-assessment; willingly assessment; places self- acknowledges errors; readily interest above patients places needs of others above and society. self-interest. Does not meet expectations or N/A or cannot evaluate failing Below expected Meets expectations Exceeds expectations Outstanding 0 1 2 3 4 5 Sample Assessment Tool 360 feedback – Sample – Created by asking residents/faculty staff what they wanted to know about themselves OR what they would want others to know – Descriptive words - helpful Other tools to teach/assess ACGME Outcome Project – Professionalism – http://www.acgme.org/outcome/implement/Profm_res ource.pdf NBME – http://professionalbehaviors.nbme.org/ GME today – http://www.gme-today.com/ Disclosing Surgical Error: Vignettes for Discussion - Video – https://web2.facs.org/timssnet464/acspub/frontpage.cf m?product_class=keepcur Your professionalism tools Open discussion Feeling the SUCCESS Not the pain Professionalism needs to be concretely defined before it can be taught and assessed Professionalism can be taught and assessed but need multiple venues Modeling professionalism IS KEY References ACGME Outcome Project – Professionalism, http://www.acgme.org/outcome/implement/Profm_resource.pdf, 2007. Barry D CE, Anderson RJ. Common issues in medical professionalism: Room to grow. Am J Med. 2000;108:136-142. Gleich G, Potts S – Powerpoint presentation on Professionalism. GME Today: General Core Competencies – Professionalism, http://www.gme-today.com, 2007. Green MJ FN, Ubel PA, Maugher DT, Aboff BM, Sosman JM, Arnold RM. Lying to each other: When internal medicine residents us deception with their colleagues. Arch Intern Med. 2000;160:2317-2323. Klein EJ, Jackson JC, Kratz L, et al. Teaching professionalism to residents. Acad Med. Jan 2003;78(1):26-34. National Board of Medical Examiners: Assessment of Professional Behaviors, http://professionalbehaviors.nbme.org, 2006. Trulock AR. In the Hands of Providence: Joshua L. Chamberlain: The University of North Carolina Press; 1992.
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