Abstract
BackgroundProfessionalism is deemed as the basis of physicians’ contract with society in Japan. Our study in 2005, using a questionnaire with scenarios to professionalism, suggested that many physicians at various levels of training in Japan encounter challenges when responding to these common scenarios related to professionalism. It is unclear how medical professionalism has changed among Japanese residents in over time.MethodsWe conducted a follow-up survey about challenges to professionalism for Japanese residents using the same Barry Questionnaire after a seven-year interval from the prior survey. The survey uses six clinical scenarios with multiple choice responses. The six cases include the following challenges: acceptance of gifts; conflict of interest; confidentiality; physician impairment; sexual harassment; and honesty in documentation. Each scenario is followed by 4 or 5 possible responses, including the “best” and the “second best” responses. The survey was conducted as a part of nationwide general medicine in-training examination.ResultsWe collected data from 1,049 participants (290 women, 28%; 431 PGY-1 and 618 PGY-2 residents). Overall, the current residents performed better than their colleagues in the earlier survey for five scenarios (gifts, conflict of interest, confidentiality, impairment, and honesty) but not for the harassment scenario. PGY-2 residents were more likely to select either the best or 2nd best choices to gifts (p = 0.002) and harassment (p = 0.031) scenarios than PGY-1 residents. Residents in the current study chose either the best or 2nd best choices to the gifts (p < 0.001) and honesty (p < 0.001) scenarios than those of the previous study conducted seven years ago, but not for the harassment scenario (p = 0.004).ConclusionsOur study suggests that there is improvement of medical professionalism with respect to some ethical challenges among the Japanese residents in the current study compared to those in our previous study.Electronic supplementary materialThe online version of this article (doi:10.1186/s12909-015-0313-6) contains supplementary material, which is available to authorized users.
Highlights
Professionalism is deemed as the basis of physicians’ contract with society in Japan
Formal training in professionalism for both residents in training and their faculty may lag behind organizational expectations, and residents tend to learn about medical professionalism through interaction with patients, senior physicians, co-medicals and colleagues
We used existing nationwide general medicine intraining examination (GM-ITE) for conducting the questionnaire in these hospitals [15]. This 100-item case-based examination was conducted by the Japan Organization of Advancing Medical Education Program (JAMEP, a non-profit organization) and was held for three hours once in year 2013 in March, the last month of Japanese academic year for Postgraduate Year (PGY) 1 and 2 resident physicians
Summary
Professionalism is deemed as the basis of physicians’ contract with society in Japan. Our study in 2005, using a questionnaire with scenarios to professionalism, suggested that many physicians at various levels of training in Japan encounter challenges when responding to these common scenarios related to professionalism. It is unclear how medical professionalism has changed among Japanese residents in over time. Medical professionalism is defined as the ability to meet the ethical expectations required to practice medicine competently [1]. These expectations are based on the principles of patient welfare, autonomy and social justice. Formal training in professionalism for both residents in training and their faculty may lag behind organizational expectations, and residents tend to learn about medical professionalism through interaction with patients, senior physicians, co-medicals and colleagues
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