Professional Development Of Physicians Research Articles

Teaching the Teachers With Milestones: Using the ACGME Milestones Model for Professional Development.

Teaching the Teachers With Milestones: Using the ACGME Milestones Model for Professional Development.

A Medical School Dean's Guide to Orienting Educational Leaders on Roles, Responsibilities, and Resources.

Continuing professional development of physicians often revolves around clinical activities. Accordingly, there is a lack of intentional development and support of medical education leaders despite such individuals having critical influence over key organizational functions. Unequivocally, educational leaders have complex and dynamic jobs that require clear delineation of roles, responsibilities, and resources available to successfully train the next generation of health professionals. Although there is guidance on how to longitudinally onboard medical education leaders, there is little information on how to effectively orient such leaders on the functional nature of their jobs. Baylor College of Medicine's medical school dean developed and delivered a 2-day orientation program to educational leaders to clarify roles, responsibilities, and resources. Postevaluation surveys aimed to identify key session content that would be frequently used by educational leaders to oversee key aspects of medical education. The purpose of this article is to outline the structure and content of an orientation program designed for medical education leaders, and share postevaluation data to identify which sessions were most used in practice. Other deans are encouraged to take ownership over the professional development of their educational leaders and delivering similar programming.

Plagiarised letters of recommendation submitted for the National Resident Matching Program.

Residency is a critical step in the professional development of physicians. Given the high stakes of the process, it is not surprising, although nonetheless troubling, that professional misconduct may occur: multiple studies have, rightfully, condemned applicants for plagiarising personal statements or misrepresenting publications. To date, however, no studies have examined whether faculty members may engage in similar behaviours. Software was used to evaluate 3864 unique applications containing 13 617 letters of recommendation submitted through the Electronic Residency Application Service (ERAS) to the Yale University Department of Psychiatry Residency Program in recruitment cycles from 2013-2014 to 2016-2017. The software identified pairs of letters written by different authors with at least 75 words of shared language, counting only words present in contiguous phrases of at least eight words (Shared Wording Across People, SWAP). Independent reviewers determined whether the shared language reflected acceptable forms of common usage (e.g. describing a setting of care) or was intended to convey unique attributes of an applicant, thereby representing plagiarism. We found that 5.1% of letters contained SWAP and 4.1% of letters contained plagiarism. In total, 11.8% of all applications included at least one plagiarised letter. By comparison, 2.6% of applicants' personal statements contained plagiarism. The present data demonstrate a surprising prevalence of plagiarism in letters of recommendation written for residency applicants. These data call into question both the relative weight that should be accorded to letters of recommendation and, more broadly, beg further discussion of how we conceptualise professionalism in medicine.

Not all stories of professional identity formation are equal: An analysis of formation narratives of highly humanistic physicians

ObjectiveWe sought to identify and define “highly humanistic” formation narratives, and understand how these events described, together with a reflective learning process, the professional development of physicians in a longitudinal faculty development program. MethodsQualitative analysis of twenty highly humanistic appreciative inquiry narratives selected from a total of 124 written by faculty members at the beginning and end of an eighteen month program at eight medical schools. [9,10] We employed the immersion/crystallization method of Borkan [20] to capture the rich meanings and emotional depth of the twenty narratives. ResultsHighly humanistic formation narratives described emotionally charged events in which the faculty writers provided humanistic care that went beyond what they had previously thought themselves capable of; benefited the patient, family or faculty member to a major extent; and reaffirmed or strengthened their professional values. Highly humanistic formation narratives were clustered at the end of our eighteen month curriculum. ConclusionsParticipation in faculty development for humanism may have increased the numbers of highly humanistic events by sensitizing and motivating faculty members to meet their patients’ emotional needs. Practice implicationsOur paper describes a process whereby faculty members may achieve growth in their capacities to meet patients’ needs.

Twelve tips on teaching and learning humanism in medical education

Background: The teaching of humanistic values is recognized as an essential component of medical education and continuing professional development of physicians. The application of humanistic values in medical care can benefit medical students, clinicians and patients.Aims: This article presents 12 tips on fostering humanistic values in medical education.Method: The authors reviewed the literature and present 12 practical tips that are relevant to contemporary practices.Results: The tips can be used in teaching and sustaining humanistic values in medical education.Conclusions: Humanistic values can be incorporated in formal preclinical environments, the transition into clinical settings, medical curricula and clinical clerkships. Additionally, steps can be taken so that medical educators and institutions promote and sustain humanistic values.

Interns’ Experiences of Disruptive Behavior in an Academic Medical Center

Abstract Background The first year of graduate medical education is an important period in the professional development of physicians. Disruptive behavior interferes with safe and effective clinical practice. Objective To determine the frequency and nature of disruptive behavior perceived by interns and attending physicians in a teaching hospital environment. Method All 516 interns at Partners HealthCare (Boston, MA) during the 2010 and 2011 academic years were eligible to complete an anonymous questionnaire. A convenience nonrandom sample of 40 attending physicians also participated. Results A total of 394 of 516 eligible interns (76.4%) participated. Attendings and interns each reported that their team members generally behaved professionally (87.5% versus 80.4%, respectively). A significantly greater proportion of attendings than interns felt respected at work (90.0% versus 71.5% respectively; P = .01). Disruptive behavior was experienced by 93% of interns; 54% reported that they experienced it once ...

Interns' experiences of disruptive behavior in an academic medical center.

The first year of graduate medical education is an important period in the professional development of physicians. Disruptive behavior interferes with safe and effective clinical practice. To determine the frequency and nature of disruptive behavior perceived by interns and attending physicians in a teaching hospital environment. All 516 interns at Partners HealthCare (Boston, MA) during the 2010 and 2011 academic years were eligible to complete an anonymous questionnaire. A convenience nonrandom sample of 40 attending physicians also participated. A total of 394 of 516 eligible interns (76.4%) participated. Attendings and interns each reported that their team members generally behaved professionally (87.5% versus 80.4%, respectively). A significantly greater proportion of attendings than interns felt respected at work (90.0% versus 71.5% respectively; P = .01). Disruptive behavior was experienced by 93% of interns; 54% reported that they experienced it once a month or more. Interns reported disruptive behavior significantly more frequently than attending physicians, including increased reports of condescending behavior (odds ratio [OR], 5.46 for interns compared with attendings; P < .001), exclusion from decision making (OR, 6.97; P < .001), and berating (OR, 4.84; P = .02). Inappropriate jokes, abusive language, and gender bias were also reported, and they were not significantly more frequent among interns than attending physicians. Interns most frequently identified nurses as the source of disruption, and were significantly more likely than faculty to identify nurses as the source of disruptive behavior (OR, 10.40; P < .001). Attendings reported other physicians as the most frequent source of disruption. Although interns generally feel respected at work, they frequently experience disruptive behavior. Interns described more disruptive behaviors than a convenience sample of attending physicians at our institution.

Improving end-of-life care: recommendations on professional development for physicians

Improving end-of-life care: recommendations on professional development for physicians

Italian Law “Measures to guarantee the access to palliative and pain treatments”: rebound on headaches’ management

The Italian Law 38/2010 assures the citizens' right to have access to palliative care and to antalgic centres in case of either oncologic or non-oncologic pain. It represents an opportunity for headaches' managements in Italy, promoting the creation of regional and national networks of headache centres and local diagnostic and therapeutic clinical pathways for patient affected with headache. This law should also support collaborations between both antalgic and headache centres networks in order to promote innovative or experimental procedures for chronic and refractory headaches. Moreover, art. 10 of the Law 38/2010 may facilitate the prescription of many headache prophylactic drugs but it may be a risk for opioids overuse headache. Educational programs and the Continuous Professional Development for physicians and all different healthcare professionals in headache area are warranted.

Case Western Reserve University School of Medicine and Cleveland Clinic

Case Western Reserve University School of Medicine and Cleveland Clinic

Critical Events in the Lives of Interns

Early residency is a crucial time in the professional development of physicians. As interns assume primary care for their patients, they take on new responsibilities. The events they find memorable during this time could provide us with insight into their developing professional identities. To evaluate the most critical events in the lives of interns. Forty-one internal medicine residents at one program participated in a two-day retreat in the fall of their first year. Each resident provided a written description of a recent high point, low point, and patient conflict. We used a variant of grounded theory to analyze these critical incidents and determine the underlying themes of early internship. Independent inter-rater agreement of >90% was achieved for the coding of excerpts. The 123 critical incidents were clustered into 23 categories. The categories were further organized into six themes: confidence, life balance, connections, emotional responses, managing expectations, and facilitating teamwork. High points were primarily in the themes of confidence and connections. Low points were dispersed more generally throughout the conceptual framework. Conflicts with patients were about negotiating the expectations inherent in the physician-patient relationship. The high points, low points, and conflicts reported by early residents provide us with a glimpse into the lives of interns. The themes we have identified reflect critical challenges interns face the development of their professional identity. Program directors could use this process and conceptual framework to guide the development and promotion of residents' emerging professional identities.

47. Evaluation of new implementation strategies, program effectiveness and dissemination of new pedagogical knowledge: Centre for faculty development's stepping stones teaching certificate program

This evaluation of the integrated Stepping Stones (SS) Teaching Certificate program, including its instructional development (workshops) and theory review (journal club) components, will inform further program development. Results of this project will also add to the limited amount of scholarly work in the area of faculty development program evaluation.&#x0D; Faculty development literature in the area of organized program assessment reveals use of either quantitative OR qualitative methods. In this project, a novel method combining both techniques was used to explore program impact. Participants completed 2 questionnaires to identify skill-set knowledge gaps in teaching effectiveness. Pre- and post-program quantitative gaps were generated. Focus groups were used for qualitative exploration. Areas explored pre-program included: a) motives for enrollment, b) program expectations and c) prior teaching preparation. Post-program discussion explored: the impact of the program on a) participant’s perceived gaps, b) teaching behaviour change, and c) its influence on their career in education. &#x0D; We believed the program’s interprofessional environment would foster development of a learning community having impact on faculty knowledge, skills and attitudes related to teaching, and potentially elicit behavioural change in teaching practices. Results from a 2004-2005 cohort of participants have identified a variety of benefits for faculty and their teaching practice. Results from a second separate cohort, 2005-2006 participants, validated the initial findings. Remarkable harmonization in the results of the qualitative analysis between the two cohort samples was evident. Statistically significant differences (p &lt; 0.05) were found in each of the domains examined qualitatively. &#x0D; Both qualitative and quantitatively, program effectiveness was demonstrated immediately following completion of the program. Follow up to assess the sustainability of the effects is ongoing. The analysis of the quantitative discrepancy (gaps) data has lead to a possible technique to assist in identifying unperceived educational needs. &#x0D; McLeod PJ, Steinert Y, Nasmith L, Conochie L. Faculty Development in Canadian medical schools: a 10-year update. CMAJ 1997; 156(10):1419-23.&#x0D; Hewson MG, Copeland HL, Fishleder AJ. What’s the use of faculty development? Program evaluation using retrospective self-assessments and independent performance ratings. Teach Learn Med 2001; 13(3):153-60.&#x0D; Moore EM. A Framework for Outcomes Evaluation in the Continuing Development of Physicians, in: The Continuing Professional Development of Physicians. Eds. Davis D, Barnes BE, Fox R. AMA Press, 2003.

Medical education and the physician workforce of India

The lack of resources in a country experiencing decades of successive wars, blockade, administrative corruption, and poor governance led to deteriorated standards throughout medical education. Although professional certification programs exist, continuing medical education accreditation and credit systems are required to monitor and certify the continuing professional development of physicians.

Continuing professional development of physicians in Uruguay: Lessons from a countrywide experience

This article describes the advancement of continuing professional development (CPD) for physicians in Uruguay and explains the motivations for a CPD system, the role of the faculty of medicine and the other stakeholders, the strategic goals, and current results, including strengths and weaknesses. The work described here had three strategic objectives: (1) initiate a CPD accreditation program, (2) train physician leaders in CPD, and (3) promote the creation of a national system for CPD. By the end of 2006, the accreditation program had 34 accredited institutions. Over a 10-year period, 150 physician leaders from different regions of the country and with different specialties had been trained in the framework and methodological issues of CPD. Legislation is expected to be introduced into parliament during 2007 for coordinating CPD efforts at a national level.

When the Body Forgets to Heal

This article has no abstract.

Continuous professional development: raising the bar for pediatricians.

Physicians are increasingly accountable to patients and institutions for proof that they are maintaining medical competence in a rapidly changing health care environment.1 An essential factor in the professional development of physicians is a lifelong commitment to learning. Changes in clinical practice and advances in research have created new educational needs for physicians during the past 2 decades. Coupled with expanded learning methodologies, these needs have prompted unique approaches to traditional continuing medical education (CME). Criticism exists that the current structure of CME may be ineffective in altering physician performance with its distant, disconnected, and teacher-centered approach to education.1–8 In a systematic review of the usefulness of CME strategies, Davis et al6 found that CME in North America is concentrated mostly in formal interventions (eg, conferences) that have limited impact in changing physician performance and/or health care outcomes. They attribute this ineffectiveness in part to the fact that most CME strategies are not individualized to the physician-learner.6 Physicians are expected to learn specific knowledge and skills presented in different formats by experts and then to incorporate this learning into their own practices at a later time. Content in CME activities, especially delivered by lectures, often is not immediately relevant to a participant’s clinical practice. Evidence has shown that if the new knowledge is not directly relevant to the physician, then it is less likely that he or she will be able to integrate it in a way that ultimately enhances patient outcomes.2 There are important aspects to CME that may have value for participants, including confirmation of medical knowledge and reinforcement of good clinical practice. The methods to obtain CME chosen by practitioners are also shifting, as constraints of time and money are becoming increasingly influential in determining CME preferences. As clinical productivity … Reprint requests to (T.C.S.) Lucile Packard Children’s Hospital, Department of Pediatrics, 725 Welch Rd #5731, Palo Alto, CA 94304. E-mail: theodore.sectish{at}medcenter.stanford.edu

Self- and peer assessment in a first-year communication and interviewing course.

Peer and self-evaluation are crucial in the professional development of physicians. However, these skills must be learned, and there are barriers to their acceptance and successful utilization. To overcome these obstacles, it has been suggested that these concepts should be addressed longitudinally throughout medical education. Therefore, first-year medical students were introduced to peer and self-assessment as part of a videotape review during an interviewing course by having students complete written peer and self-assessments of the interviews. Students' self-assessments were compared with the assessments of peers and faculty. Written evaluations showed peers were more lenient than faculty and students were most critical of their own performances. Students could provide balanced assessments of their peers but were predominately negative regarding their own performances. It appears first-year students are capable of evaluating their peers but have difficulty accurately assessing their own performance. Further interventions are needed to foster self-assessment skills in first-year students.

Becoming a doctor: fostering humane caregivers through creative writing

We qualitatively examined themes covered in a creative writing elective designed to enhance pre-clinical medical students’ writing, observation, and reflection skills relative to experiences in their medical education. Qualitative analysis of writings’ themes was carried out via iterative consensus building process and validated through member checks and literature review. Fourteen students completed the elective, seven for each year it was given. Students submitted 86 written pieces. Qualitative analysis demonstrated the presence of nine themes: students’ role confusion, developing a professional identity, medicine as a calling, physician privilege and power, humanizing the teacher, the limits of medicine, death and dying, anticipating future challenges, and identification with the patient. Students evaluated this creative writing course favorably, indicating value in writing and reflection. Themes covered are of concern to second-year medical students as well as other trainees and practicing physicians. Writing may aid in the professional development of physicians.

Learning: current knowledge and the future

Some empirically based statements about learning are presented. The basic conclusion is that most of that knowledge will still be valid in the future and that some is dependent on various cultural factors that need to be further explored. Two research areas that ought to be encouraged for the future are presented. One addresses cognitive processing and professional development of physicians. The other one deals with the development of students' understanding of concepts. Examples of how students retain their wrong understanding of concepts despite training and good assessment results are presented, as well as findings by Schön, Mann, and Slotnick.

Inside Doctoring: Stages and Outcomes in the Professional Development of Physicians

Inside Doctoring: Stages and Outcomes in the Professional Development of Physicians