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Role Modeling & Professionalism. Instructor Name. Goal. Residents will learn the impact their behavior and conduct have on others as an instructor and throughout their careers. . Objectives. At the end of the session, the learner will be able to: Define professionalism & its importance - PowerPoint PPT Presentation
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Role Modeling & Professionalism
Instructor Name
GoalResidents will learn the impact their behavior and conduct have on others as an instructor and throughout their careers.
ObjectivesAt the end of the session, the learner
will be able to: Define professionalism & its
importance Describe characteristics of a good &
bad role modeling Explain how to measure
professionalism through evaluation
Reflection Have you personally observed or
benefited from working with physicians who consistently demonstrated the best qualities of patient care, clinical judgment and professionalism?
ACGME Competencies Patient Care Medical Knowledge Interpersonal and Communication
Skills Practice Based Learning &
Improvement Systems Based Practice Professionalism
Defining Professionalism: ACGMEProfessionalism is commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
Professionalism How to you demonstrate it? How do you measure it? Does it really matter? How do you teach it?
Measuring Professionalism w/ E-Value Demonstrates respect, compassion,
integrity Responsive and accountable to needs of
patients, society and the profession Committed to excellence Ethical in clinical care, patient
confidentiality, informed consent, and business practices
Sensitive to culture, age, gender, disabilities
Does it Matter?Medical School Behavior Disciplinary action by state medical
board was strongly associated with unprofessional behavior in medical school.
Strongest Associations Those described as irresponsible Those w/ diminished ability to improve
their behaviorPapadakis, et al, NEJM 353:2673-82
Does it Matter?What about Residency? Does performance during
residency predict likelihood of future disciplinary actions against practicing physicians?
Papadakis et al, Ann Intern Med 2008;148:869-76
Study Design Retrospective cohort IM residents Trained from 1990 to 2000 425 AGCME accredited programs 66, 171 residents Compared ABIM certification evaluation by
program directors (global form), 1-9 scale to future disciplinary action by state board Unprofessional behavior (83%) Incompetence (1%)
Disciplinary Actions by State Boards: Unprofessional Behavior Failure to meet CME 21% Fraud/billing (medicare/aid)* 9% Controlled substance Rx violations 8% Substance abuse (self)* 6% Sexual misconduct* 5% Professional conduct (pt safety) 4.5% Negligence 4% Convicted of a crime* 4% Records (maintain, misrepresent) 3% Fail to conform to minimal practice 2%
*most associated with loss of license
Results Only 1% of diplomates were
during the 17 year study interval
Median years to first action 11 yrs (3 – 16)
Number of disciplinary actions 4.1 (1 – 48)
Papadakis et al, Ann Intern Med 2008;148:869-76
Implications Most physicians don’t get into
trouble Most residents with “issues”
hopefully resolve them Or not egregious enough?
Patient safety issues
What Makes a Role Model?
Positive Role Models Clinical Attributes
Knowledgeable Skilled (technical and clinical reasoning)
Personal Attributes Humble Approachable/Receptive Calm Attentive to patients and to students Caring/compassionate/empathetic Passionate about work
Strategies to Improve Role Modeling
Cruess, S. R, Cruess, R. L, Steinert, Y. (2008). Role modelling--making the most of a powerful teaching strategy. BMJ 336: 718-721
Strategies Be aware of being a role model Demonstrate clinical competence Protect time for teaching Show a positive attitude for what you
do Implement a student centered
approach to teaching
Strategies con’t Facilitate reflection on clinical
experiences and what has been modeled Encourage dialogue with colleagues Engage in pertinent staff development Work to improve the institutional culture Whenever possible be explicit about
what you are modeling
What do your students think?
UAB Medical Student Clerkship Evaluations
Intern Evaluation Dr. Intern was an outstanding
mentor in facilitating my medical education. I could not have asked for a more professional, devoted individual who always seemed to place the interests of the patients and his team members above those of his own.
Intern Evaluation He is an excellent role model and
is extremely helpful and approachable. He is always available for questions about any patient on the team. He takes time to teach. He made my experience on medicine very enjoyable.
Intern Evaluation She is an excellent intern. She is very
knowledgeable, approachable, and dedicated to teaching students. She takes the time to go over assessment and plans with students, and she allows students the opportunity to write admission and daily orders. One of the best interns I have seen.
Resident Evaluation I loved working with Dr. X. She was
very constructive with us and really helped me improve my differentials, my notes, and my thought process in working up patients. She interacts well with patients and shows genuine concern for them. She is an excellent role model.
Intern Evaluation Dr. X was always available for
questions and concerns. He was a great individual to work with. He presented an image of what a medical student should strive towards.
Resident Evaluation Dr. X. does an excellent job
integrating all members of the team, including medical students, into roles that allow them to contribute to the whole. He is extremely patient with students when they express difficulty with a concept.
Things to Remember The first steps to becoming a positive role
model is recognize your behavioral habits. A moment of lost composure that
translates into snapping at a nurse or belittling a patient, reflects on you and, ultimately, may influence the practices and habits of your trainees.
Realize your habits can be habit-forming for others.
Conclusions Professionalism is a require
ACGME competency Don’t underestimate your
influence Positive role model Life long efforts to maintain our
professionalism Thank you for all you do
They may forget what you said, but they will never forget how you made them feel.
-Carol Buchner
Questions???