Generic Inabilities and the Use of a Decision-Making Rubric for Addressing Deficits in Professional Behavior

Abstract

Background and Purpose. The difficulty of identification, remediation, and evaluation of inappropriate behaviors remains a challenge for academic and clinical faculty who are hesitant to address deficits in the affective domain. Because inappropriate behavior can potentially affect patient care and outcomes, academic and clinical faculty must be able to identify and respond to these The purpose of this article is to identify factors that foster Generic Inabilities and provide guidance to clinical and academic faculty on their fiduciary responsibilities and courses of action. Position and Rationale. The physical therapy profession has developed a variety of documents that describe physical therapists' responsibilities and obligations to professionalism; these can be considered a Therapy Code of Conduct. An examination of behaviors that are contrary to expected conduct, termed can open the conversation regarding generally unacceptable behaviors and may assist academic and clinical faculty to address unprofessional and negative behaviors when observed. Factors that contribute to the development or continuance of Generic Inabilities are silence, a misunderstanding of motivations, academic and clinical education disparities, and anti-role modeling. Numerous laws, policies, and procedures seek to protect the public from unscrupulous, incompetent, and unethical practitioners. Therefore, clinical and academic faculties have a legal and ethical responsibility to act in the face of inappropriate behaviors. Recommendations. A decision-making rubric is proposed for addressing Generic Inabilities. It includes detailed fact-finding, a consideration of the ethical principles, an assessment of the expected professional duties, an analysis of the desired outcomes, implementation of action(s), and re-assessment as needed. The adapted decision-making rubric for addressing behavioral issues takes the practitioner through a series of 7 questions that lead to implementation of a specific action. Key Words: Generic Abilities, Generic Inabilities, Professionalism, Unprofessional behaviors, Decision making. BACKGROUND AND PURPOSE Professionalism is not a spectator sport. Stefan Schulz1 Although the physical therapy-specific Generic Abilities2 have been validated,' expanded,4 and used in the profession for 10 years, the difficulty of identification, remediation, and evaluation of inappropriate behaviors, or Inabilities5 remains a challenge for academic and clinical faculty. Evidence indicates that clinical instructors (CIs) are able to recognize and address cognitive deficits6,7,8,9 but are less likely to address and remediate deficits in the affective domain.10,11,12,15 Professional growth involves changes in our knowledge, our skills and our attitudes, values and beliefs14(p55) and inappropriate behavior can potentially affect patient care and outcomes. Therefore, academic and clinical faculty must be able to identify and respond to these Generic Inabilities. For the purposes of this article, Generic Inabilities refer to behaviors in any domain of learning (cognitive, psychomotor, and/or affective) that are perceived to be the antithesis of expected professional behaviors. The purpose of this article is to identify factors that foster Generic Inabilities and to provide guidance to clinical and academic faculty on their fiduciary responsibilities and courses of action. POSITION AND RATIONALE A Physical Therapy Code of Conduct The physical therapy profession has developed documents that describe and guide the professional development of physical therapists and can be considered a physical therapy code of conduct. Similar in concept to the code of conduct of the armed forces that outlines the basic responsibility and obligation of all US service members,15 this collection of documents describes physical therapists' responsibilities and obligations to professionalism. …