Professionalism by ewghwehws


									Feeling the Pain:
  Unprofessional in a
 ?Professional World?

 Patricia Goodemote, LtCol, USAF, MC
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
Implement effective tools to teach and assess
            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?
Service (before self)
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
Cultural competence
– sensitivity and value the diversity
– recognize and respond to physician
     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
    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

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
– 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
– Clinical Performance Rating
– 360 degree – Multi-Rater - blinded
    Other residents
    Clinic and Ward Staff
– Focused observation
– Patient Satisfaction
                         Sample Assessment Tool
Clinical Performance Rating Scale

   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
GME today
Disclosing Surgical Error: Vignettes for
Discussion - Video
Your professionalism tools

     Open discussion
    Feeling the SUCCESS
                Not the pain

Professionalism needs to be concretely
defined before it can be taught and
Professionalism can be taught and
assessed but need multiple venues
Modeling professionalism IS KEY
ACGME Outcome Project – Professionalism,, 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,, 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,, 2006.
Trulock AR. In the Hands of Providence: Joshua L. Chamberlain: The
   University of North Carolina Press; 1992.

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