Abstract
BackgroundProfessionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior.MethodsDuke University Hospital and Vidant Medical Center/East Carolina University surveyed entering PGY1 residents. Residents were queried on two issues: their perception of the professionalism of 46 specific behaviors related to training and patient care; and their own participation in those specified behaviors. The study reports data analyses for gender and institution based upon survey results in 2009 and 2010. The study received approval by the Institutional Review Boards of both institutions.Results76% (375) of 495 PGY1 residents surveyed in 2009 and 2010 responded. A majority of responders rated all 46 specified behaviors as unprofessional, and a majority had either observed or participated in each behavior. For all 46 behaviors, a greater percentage of women rated the behaviors as unprofessional. Men were more likely than women to have participated in behaviors. There were several significant differences in both the perceptions of specified behaviors and in self-reported observation of and/or involvement in those behaviors between institutions.Respondents indicated the most important professionalism issues relevant to medical practice include: respect for colleagues/patients, relationships with pharmaceutical companies, balancing home/work life, and admitting mistakes. They reported that professionalism can best be assessed by peers, patients, observation of non-medical work and timeliness/detail of paperwork.ConclusionDefining professionalism in measurable terms is a challenge yet critical in order for it to be taught and assessed. Recognition of the differences by gender and institution should allow for tailored teaching and assessment of professionalism so that it is most meaningful. A shared understanding of what constitutes professional behavior is an important first step.
Highlights
Professionalism has been an important tenet of medical education, yet defining it is a challenge
Professionalism has been an important tenet of medical education at least since the time of Hippocrates [1]
The overall response rate across the board at both institutions was somewhat higher for year two (78% Duke University Hospital (DUH), 94% Vidant Medical Center/East Carolina University (VMC/ECU)) than year one. (68% DUH, 75% VMC/ECU)
Summary
Professionalism has been an important tenet of medical education, yet defining it is a challenge. Perceptions of professional behavior may vary by individual, medical specialty, demographic group and institution. Understanding these differences should help institutions better clarify professionalism expectations and provide standards with which to evaluate resident behavior. Professionalism has been an important tenet of medical education at least since the time of Hippocrates [1]. Professionalism lapses lead to more state licensing board actions than a lack of medical knowledge [6,7]. Unprofessional behavior in medical school predicts poor performance in residency [8] and later adverse actions by a licensing board [9,10,11]. Residents with higher scores on professionalism demonstrate higher in -service training examination and mini-CEX (clinical evaluation exercise) scores, are more likely to complete administrative tasks and are less likely to receive official “warnings” or “probationary status” during their formal training [13]
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