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The professionalism disconnect: do entering residents identify yet participate in unprofessional behaviors?

Nagler A, Andolsek K, Rudd M, Sloane R, Musick D, Basnight L - BMC Med Educ (2014)

Bottom Line: The study reports data analyses for gender and institution based upon survey results in 2009 and 2010.For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional.A shared understanding of what constitutes professional behavior is an important first step.

View Article: PubMed Central - HTML - PubMed

Affiliation: Duke University Hospital - Graduate Medical Education, PO Box 3951, DUMC, Durham, NC, USA. Mariah.rudd@duke.edu.

ABSTRACT

Background: Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior.

Methods: Duke University Hospital and Vidant Medical Center/East Carolina University surveyed entering PGY1 residents. Residents were queried on two issues: their perception of the professionalism of 46 specific behaviors related to training and patient care; and their own participation in those specified behaviors. The study reports data analyses for gender and institution based upon survey results in 2009 and 2010. The study received approval by the Institutional Review Boards of both institutions.

Results: 76% (375) of 495 PGY1 residents surveyed in 2009 and 2010 responded. A majority of responders rated all 46 specified behaviors as unprofessional, and a majority had either observed or participated in each behavior. For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional. Men were more likely than women to have participated in behaviors. There were several significant differences in both the perceptions of specified behaviors and in self-reported observation of and/or involvement in those behaviors between institutions.Respondents indicated the most important professionalism issues relevant to medical practice include: respect for colleagues/patients, relationships with pharmaceutical companies, balancing home/work life, and admitting mistakes. They reported that professionalism can best be assessed by peers, patients, observation of non-medical work and timeliness/detail of paperwork.

Conclusion: Defining professionalism in measurable terms is a challenge yet critical in order for it to be taught and assessed. Recognition of the differences by gender and institution should allow for tailored teaching and assessment of professionalism so that it is most meaningful. A shared understanding of what constitutes professional behavior is an important first step.

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Behaviors reported having participated in by 10% or greater of respondents.
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Figure 1: Behaviors reported having participated in by 10% or greater of respondents.

Mentions: We were especially interested in knowing in which behaviors respondents had personally participated, and yet also felt to be unprofessional. We identified the 15 behaviors with highest levels of reported personal participation. For these 15 behaviors, the data indicate that 10% to 55% reported having participated personally in those behaviors, yet 38% to 92% rated them as unprofessional. These data are displayed in FigureĀ 1.


The professionalism disconnect: do entering residents identify yet participate in unprofessional behaviors?

Nagler A, Andolsek K, Rudd M, Sloane R, Musick D, Basnight L - BMC Med Educ (2014)

Behaviors reported having participated in by 10% or greater of respondents.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3974201&req=5

Figure 1: Behaviors reported having participated in by 10% or greater of respondents.
Mentions: We were especially interested in knowing in which behaviors respondents had personally participated, and yet also felt to be unprofessional. We identified the 15 behaviors with highest levels of reported personal participation. For these 15 behaviors, the data indicate that 10% to 55% reported having participated personally in those behaviors, yet 38% to 92% rated them as unprofessional. These data are displayed in FigureĀ 1.

Bottom Line: The study reports data analyses for gender and institution based upon survey results in 2009 and 2010.For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional.A shared understanding of what constitutes professional behavior is an important first step.

View Article: PubMed Central - HTML - PubMed

Affiliation: Duke University Hospital - Graduate Medical Education, PO Box 3951, DUMC, Durham, NC, USA. Mariah.rudd@duke.edu.

ABSTRACT

Background: Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior.

Methods: Duke University Hospital and Vidant Medical Center/East Carolina University surveyed entering PGY1 residents. Residents were queried on two issues: their perception of the professionalism of 46 specific behaviors related to training and patient care; and their own participation in those specified behaviors. The study reports data analyses for gender and institution based upon survey results in 2009 and 2010. The study received approval by the Institutional Review Boards of both institutions.

Results: 76% (375) of 495 PGY1 residents surveyed in 2009 and 2010 responded. A majority of responders rated all 46 specified behaviors as unprofessional, and a majority had either observed or participated in each behavior. For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional. Men were more likely than women to have participated in behaviors. There were several significant differences in both the perceptions of specified behaviors and in self-reported observation of and/or involvement in those behaviors between institutions.Respondents indicated the most important professionalism issues relevant to medical practice include: respect for colleagues/patients, relationships with pharmaceutical companies, balancing home/work life, and admitting mistakes. They reported that professionalism can best be assessed by peers, patients, observation of non-medical work and timeliness/detail of paperwork.

Conclusion: Defining professionalism in measurable terms is a challenge yet critical in order for it to be taught and assessed. Recognition of the differences by gender and institution should allow for tailored teaching and assessment of professionalism so that it is most meaningful. A shared understanding of what constitutes professional behavior is an important first step.

Show MeSH