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Setting Expectations on Professionalism in Residency: Orientation Workshop on Common Professionalism Issues

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Title: Setting Expectations on Professionalism in Residency: Orientation Workshop on Common Professionalism Issues


1
Setting Expectations on
Professionalism in ResidencyOrientation
Workshop on Common Professionalism Issues
  • Jayne M. Peterson, MD
  • Banner Good Samaritan Medical Center

2
Professionalism in Residency
  • One of 6 Core Competencies required for board
    certification by the ABIM
  • Traditionally difficult to define, to measure
    and to teach
  • Unwritten rules only discovered when you make
    a mistake
  • References
  • Medical Professionalism. Chicago ACGME, 2006
    (Accessed Jan. 8, 2007 at http//www.acgme.org/out
    come/implement/Profm_resource.pdf)
  • Stern, D, Papadakis, M. The Developing Physician
    Becoming a Professional. NEJM 20063551794-9.

3
Setting Expectations in Our Residency
  • Resident Manual
  • Orientation for PGY 1 prior to starting residency
  • Workshop for PGY 2s prior to moving to
    supervisory role with follow up workshop in early
    PGY 3 year
  • Monthly orientation to each new rotation
  • Advisor Meetings twice per year

4
Definitions of Professionalism
  • Prokos Trust
  • Respect - for patients families, peers, other
    healthcare team members
  • Appropriate behavior polite, dedicated,
    compassionate, hardworking, timely, well groomed,
    honest, maintain confidentiality

5
Unprofessional Behavior Examples Observed by
Attendings
  • Not taking responsibility for errors,
    communicating with patients family members
  • Not following pay back rules, leaving work
    undone or not insuring continuity of care during
    handoffs, not working as a team, falsely calling
    out sick
  • Discussing patients in a nonprofessional manner
    in multidisciplinary meetings
  • Being late for clinical duties without good
    reason
  • Poor communication skills in difficult situations
  • Poor appearance both in dress and
    attitude/interest
  • Criticizing other staff colleagues in public

6
Resident Observed Unprofessional Behavior
  • Gossiping about other members of healthcare team
  • Yelling at ancillary staff
  • Talking about patients in elevator
  • Residents shirking post call duties to interns,
    or not assisting in workload
  • Bad attitudes getting hits or whining
  • Asking for weekdays off so have less patients
    schedule squabbling
  • Poor checkouts leaving early
  • putting down students interns
  • Poor conference attendance
  • Calling in sick or not showing up for expected
    duties

7
Why do you think this unprofessional behavior
occurred?
  • Stress/time issues
  • No consequences
  • Fatigue/frustration
  • People are not secure in who they are just
    their personality arrogance
  • Clinical duties not well defined/uncomfortable
    with role in health team

8
Personal Professionalism Plans
  • Open your envelope from 2007
  • Did you do what you said you would do?
  • Do you have a way to measure your change?

9
Professionalism Quality Improvement
  • Identify Something you want to change
  • Plan What are your opportunities barriers to
    change? How will I know that the change was
    effective?
  • Do Try it
  • Study Measure the change
  • Act See if you can incorporate the change in
    your life. Start the cycle over again.

10
Summary of PDSA Cycle
Plan
Act
Do
Study
11
Example Jayne Peterson
  • Opportunity Time Management I waste too much
    time looking for things on my desk
  • Plan Organize my desk then deal with each
    item only once toss it, file it, or complete
    it.
  • Do schedule clean up date, get a new on-desk
    file system
  • Study In one month is my desk still clean and
    can I find what I need?
  • Act If in one month it is working I will keep
    this system and move on to my book shelf.

12
Resident Small Group Discussion
  • How can we improve professionalism in our
    residency program?
  • What do you think should be the consequence of
    unprofessional behavior?
  • Does it matter what the behavior is?
  • Share a personal professional plan for 2008-2009
    with your group and how you plan to measure it.
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