85 The Difference of Professionalism Between Emergency Medicine Residents and Faculty Physicians: Multicenter Cross-Sectional Analysis

Abstract

Professionalism is one of the critical emergency medicine (EM) physician competencies and professional behavior affects patient satisfaction. Forty-five percent of EM program directors reported that there were two or more residents with unprofessional behavior in their programs per year. Another study reported that role model was the most influential factor. However, there is no evidence to support that there is difference of professionalism between EM residents and EM faculty physicians. Therefore, to investigate difference of professionalism between EM residents and EM faculty physicians may facilitate medical professionalism education. Thus, by using a cross-sectional multicenter survey, we aimed to analyze the responses to common challenges to medical professionalism for EM physicians and to survey the extent of education related to professionalism and satisfaction with it during the time attending medical schools. We conducted a survey of EM residents and EM faculty physicians at several teaching hospitals in Japan, using the Barry questionnaire. The Barry’s questionnaire is one of the assessment of professionalism tools widely used in the US and Japan. The questionnaire instrument contains 6 challenging cases to professionalism: acceptance of gifts; conflict of interest; confidentiality; physician impairment; sexual harassment; and honesty in the documentation. After completing all six scenarios, participants were asked, ‘Have you ever experienced formal educational courses about medical professionalism?’ on yes or no responses. We sent the Barry's questionnaire to 6 hospitals. In addition, we collected data at the Japanese biannual emergency medicine academic meeting. We analyzed the frequency of providing either the best or the second best answers to each scenario as a main outcome measure and compared those frequencies between physicians in EM residents and EM faculty physicians. The Fisher exact test and proportion comparison test with normal distribution approximation were used to analyze data, where appropriate. We collected data from 135 participants (61 EM residents and 74 EM faculty physicians). Capture rate was 87%. The most challenging scenario was the sexual harassment scenario, in which 46.7% provided the best or second best answers, followed by the confidentiality scenario with 71.1%. Table 1 compares the frequencies that the participants provided the best or second best responses between EM resident and EM faculty physician. The frequency of either the best or second best responses to the confidentiality scenario was significantly greater in EM residents than in EM faculty physicians (p= 0.01). There were higher rates of participants who received formal educational courses about medical professionalism in EM residents' group versus in EM faculty physicians' group (23.0% versus 5.4%, p=0.003). EM faculty physicians were unable to provide acceptable response to challenges to professionalism in confidentiality and few had received an education in professionalism during school curricula. The greater teaching of professionalism is needed in medical education for both EM residents and EM faculty physicians in Japan.