what is professionalism ?
DESCRIPTION
What is professionalism ?. Hallmarks of a profession. Competence in a specialized body of knowledge Acknowledgment of specific duties and responsibilities Autonomy to train, admit, monitor, and discipline its members; a privilege granted by society through licensure. - PowerPoint PPT PresentationTRANSCRIPT
Hallmarks of a professionCompetence in a specialized body of
knowledgeAcknowledgment of specific duties and
responsibilitiesAutonomy to train, admit, monitor, and
discipline its members; a privilege granted by society through licensure
Physicians must be:1. Altruistic2. Knowledgeable3. Skillful4. Dutiful
Less than 15 months after its
release, the Charter was
endorsed by more than 90 specialty
societies.
7
Clinical competence (knowledge)
Communication skills
Sound ethics
Excellence
Humanism
Accountability
Altruism
Professionalism
From: Stern D., ed. Measuring Professionalism (New York: Oxford University Press, 2006).
Patient expectionsIdeal physician behaviorsMayo Clin Proc. 2006;81:338-344.
192 patients in 14 specialty settings:Confident: engenders trustEmpathetic: “Understands my feelings”Humane: compassionate and kindPersonal: patient is a person, not a diseaseForthright: “Tells me what I need to
know”Respectful: “Takes my input seriously”Thorough: conscientious and persistent
Reasons for concernProfessionalism lapsesConflicts of interest among physicians
commonDeclining trust in the medical profession
Reasons for concernUnprofessional behavior in training
associated with later disciplinary action by licensing boards (NEJM 2005;353:2673-2682)
Nearly all physician leaders and nurses have experienced disruptive physician behavior (Phys Exec 2004;Sept-Oct:6-14, Am J Nurs 2005;105:54-64, AORN J 2001;74:317-331)
Consequences of disruptive physician behaviorhttp://cme.medscape.com/viewarticle/590319
Reduced employee satisfaction, morale and productivity and increased employee turnover
Reduced communication, teamwork, and efficiency and increased costs
Decreased learner satisfaction, burnout, depression and unprofessional behavior
Professionalism is not simply innate.
Professionalism can be taught“Advancing Education in Medical Professionalism.” ACGME Outcome Project, 2004.
Formal and informal curricula influence professional attitudes and beliefs, moral reasoning, and behaviors
Role models influence attitudes and behavior; “hidden curriculum”
Should professionalism be taught? Yes.“Advancing Education in Medical Professionalism.” ACGME Outcome Project, 2004
We are a profession AAMC, ACGME,
ABIM, and JCAHO recommendations and requirements
Expectations of patients and society
Formal and informal curricula influence professional attitudes and beliefs, moral reasoning, and behaviors
Associated with important outcomes
16
Clinical competence (knowledge)
Communication skills
Sound ethics
Excellence
Humanism
Accountability
Altruism
Professionalism
From: Stern D., ed. Measuring Professionalism (New York: Oxford University Press, 2006).
Consider the elements of
professionalism.
Teaching professionalismMethods“Advancing Education in Medical Professionalism.” ACGME Outcome Project, 2004
LecturesDiscussion groupsRole plays, simulationExperiential (eg, clinical setting)Team learningRole modelingIndependent learning
Teaching professionalismStrategiesJAMA 2001;286:1067-1074
Establish a climate of humanismBe practical and relevantRecognize and use seminal eventsRole modelEncourage self-reflectionAddress the “hidden” curriculum
Should professionalism be assessed? Yes.Professionalism can be assessed (Stern DT.
Measuring Professionalism; Oxford, 2006)Formative and summative feedback
“They don’t respect what you expect; they respect what you inspect.” (Cohen JJ. Forward. In Measuring Professionalism; Oxford, 2006)
Evaluate education programs
Failure to assess sends conflicting messages to learners, physicians, and
patients.
“Most practicing physicians observe each others’ behaviors
only in the hallways and conference rooms--rarely with patients. The solution to this
problem is to expand the number of observers and the settings in
which they observe.
Effective assessment of professionalism Stern D, ed. Measuring Professionalism; Oxford, 2006JAMA 2008;300:1326-1333
Multiple observers and instruments
Variety of settingsRealistic contextSituations that
involve conflictNot overly
stringent
Transparency; learners know purpose of assessment
Symmetry; all levels of the hierarchy are assessed
What do you do with the information?Formative feedbackSummative feedbackReward exemplarsEvaluate professionalism education programs
and generate research hypotheses
Using a “professionalism portfolio”