Trainees with Competence Problems in the Professionalism Domain

Introducing the QACP: development and preliminary validation of an instrument to measure psychotherapist's core competencies

The movement towards the conceptualization, description and evaluation of psychotherapists' competencies has been widely developed in the last years and has relevant implications for psychotherapy, training, and continuous education. In Italy, this movement has been supported by the Committee for Psychotherapists' Competencies established in 2010 by FIAP (Italian Federation of Psychotherapy's Associations) and CNSP (National Association of Psychotherapy's Training Institutes) and has involved more than 1000 psychotherapists from different approaches, by means of conferences, expert meetings, workshops, and focus groups. One of the outcomes of this process has been the development of a new self-assessment tool for core competencies (i.e., those that are shared by therapists from all modalities): the QACP (Questionario per l'Autovalutazione delle Competenze dello Psicoterapeuta). The present study aims to present the process of development and the preliminary proofs of the validity of this tool. Construct and knowngroup validity of the questionnaire were examined, and reliability was estimated by computing the internal consistency reliability coefficients for both the overall and the subscale scores. Overall, the instrument showed satisfactory psychometric characteristics. The limitations of the study and the results are discussed and directions for further research are proposed.

Dual and duelling purposes: An exploration of educators' perspectives on the use of reflective writing to remediate professionalism in residency

CONTEXT

Professionalism lapses have high stakes for learners and educators. Problems with professionalism, unless appropriately and effectively remediated, may portend serious problems in practice. Yet, remediation for unprofessional behaviour is particularly challenging-and understudied. Increasingly, educators are turning to reflective writing as a remediation strategy in residency, yet little is known about what educators expect reflective writing to accomplish, how they choose reflective writing tasks, why they use reflective writing, or how they evaluate whether a learner has met expectations. We aimed to understand why and how postgraduate medical educators use reflective writing as an educational intervention to remediate professionalism.

METHOD

In this constructivist grounded theory study, we interviewed 13 medical education professionals with experience using reflective writing to remediate professionalism across five Canadian medical schools. Data collection and analysis occurred iteratively using constant comparison to identify themes and to understand the relationships among them.

RESULTS

Medical educators reported using reflective writing as a learning tool to develop insight and as an assessment tool to unearth evidence of insight. The goal of learning may compete with the goal of assessment, creating tension that leads to uncertainty about the sincerity, quality and effectiveness of reflective writing as well as concerns about learner safety. Educators reported uncertainty about whether learners write to pass or to introspect and about how to judge the effectiveness of reflective writing as a learning tool. They expressed concern about creating a safe environment for learners-one that enables the genuine reflection required for insight development-while meeting requirements of remediation.

CONCLUSIONS

Educators express ambivalence about using reflective writing to remediate professionalism in residency. Understanding the potential and pitfalls of reflective writing may inform more tailored and effective approaches to remediate professionalism.

Pilot study to identify attributes of professionalism in sonography

INTRODUCTION

While a list of competency standards exists for sonographers, the profession does not have a specific statement concerning professionalism. What constitutes professionalism within sonography is important and needs to be considered from the perspective of all stakeholders. This paper reports the results of the first two exploratory phases of a larger study investigating professionalism in sonography.

METHODS

Phase 1 involved interviews with experienced and early-career sonographers to identify attributes of professionalism within the context of sonography. Attributes identified in phase 1 were used to frame survey questions for phase 2. In phase 2, sonography patients were asked to rate the attributes using Likert-type responses, and to provide additional comments at the end of each category. Patients had the opportunity to add attributes not mentioned in the survey.

RESULTS

Content analysis of Phase 1 interview data identified 27 professional attributes organised into seven categories. Phase 2 results indicated that only a few attributes were rated as not important or not applicable by patients. Highest-rating attributes by patients included verbal communication, patient privacy, trust, behaviour, empathy, and respect. Attributes that were not rated as highly included rapport, physical presentation, dedication to learning and improving oneself, personality, and role model.

CONCLUSION

Due to the complexities around a clear definition of professionalism within the context of sonography, this study has highlighted the need for a comprehensive list of attributes to identify what professionalism in sonography means.

IMPLICATIONS FOR PRACTICE

Having a clear understanding of the concept of professionalism within the context of sonography will provide a guide for sonographers and sonography students, and enable academic and on-site clinical trainers to explicitly teach what professionalism looks like and feels like in sonography practice.