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Sahiti Q, Shearer C, Thomson C, Sutherland L, Bowes D. Addressing medical resident mistreatment: A resident-centred approach. MEDICAL TEACHER 2024; 46:769-775. [PMID: 37972586 DOI: 10.1080/0142159x.2023.2279903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Mistreatment negatively impacts the wellbeing of medical learners and is related to worse patient outcomes and team functioning. Resident perspectives on improving mistreatment reporting structures and investigations have not been explored. We aimed to understand residents' views on safe reporting structures, investigations, and resolution processes. METHOD We conducted an exploratory sequential mixed method study beginning with a series of qualitative interviews to inform an anonymous online survey to all Dalhousie University residents (N = 645). RESULTS When interviewed, residents (N = 10) discussed personal experiences with mistreatment, barriers to reporting, and how these processes could better serve them. Themes from the interviews were imbedded in an anonymous online survey to explore their prevalence among a larger group. Residents (N = 120; 19%) completed the online survey and revealed that mistreatment was very common yet underreported. Barriers to reporting included confidentiality concerns, perceptions that reporting would not change anything, and fear of retaliation. Desired outcomes for perpetrators depended on the perpetrator's position and incident severity, and most prefer a remedial approach. CONCLUSION Resident mistreatment remains prevalent and current processes of dealing with reports may be inadequate. Residents have thoughtful insights for improving institutional policies and procedures and should be meaningfully engaged.
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Affiliation(s)
| | - Cindy Shearer
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Postgraduate Medical Education, Dalhousie University, Halifax, Canada
| | - Carolyn Thomson
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Postgraduate Medical Education, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Family Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Office of Resident Affairs, Dalhousie University, Halifax, Canada
| | - Lisa Sutherland
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Office of Resident Affairs, Dalhousie University, Halifax, Canada
| | - David Bowes
- Faculty of Medicine, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Postgraduate Medical Education, Dalhousie University, Halifax, Canada
- Faculty of Medicine, Department of Radiation Oncology, Dalhousie University, Halifax, Canada
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Chandra Shaw S, Datta K, Lall M, Jaipurkar R, Shakya A, Kanitkar M. Development of a hybrid undergraduate portfolio for the AETCOM module. Med J Armed Forces India 2024; 80:192-198. [PMID: 38525458 PMCID: PMC10954497 DOI: 10.1016/j.mjafi.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background A structured Attitude Ethics and Communication (AETCOM) module for undergraduates exists. For ensuring that the module achieves what it is intended to achieve, there was a felt need to develop a learning portfolio with an emphasis on reflections and with a scope for assessment. Methods The AETCOM module by NMC has laid out objectives, lesson plans, and case-based scenarios. Hybrid portfolio development was necessary to align the sessions to the objectives and lesson plans and to help students capture their learning process with self-reflection, and at the same time, ensure the scope of assessment of these activities. Hence, writing reflections was considered the most important step. Measures were taken to train students in writing reflections, and faculty development workshops were also conducted. An evaluation was done using Kirkpatrick model level I-III using student's feedback form, scores of rubric matrix for assessment of reflections and one-on-one interaction with students by trained faculty. Faculty perspectives on portfolio development were collected. Results A significant improvement in students' self-assessment scores on AETCOM module was seen (p <0.05). An assessment of reflections using a rubric matrix showed that all the students reached at least grade B by the end of three months. More than 90% of faculty members felt that the faculty is vital for assessing AETCOM. Conclusion The development of a hybrid portfolio for AETCOM requires faculty development and special sessions for students on writing reflections. The hybrid portfolio provides the learner to self reflect, and a rubric matrix can be used to assess reflections.
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Affiliation(s)
- Subhash Chandra Shaw
- Senior Advisor (Pediatrics & Neonatologist), Army Hospital (R&R), New Delhi, India
| | - Karuna Datta
- Professor & Head, Department of Sports Medicine, Armed Forces Medical College, Pune, India
| | - Mahima Lall
- Professor, Department of Microbiology, Armed Forces Medical College, Pune, India
| | - Raksha Jaipurkar
- Professor & Head, Department of Physiology, Armed Forces Medical College, Pune, India
| | - A.K. Shakya
- Training Officer (UG), Armed Forces Medical College, Pune, India
| | - Madhuri Kanitkar
- Vice Chancellor, Maharashtra University of Health Sciences, Nashik, Maharashtra, India
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Caretta-Weyer HA, Eva KW, Schumacher DJ, Yarris LM, Teunissen PW. Postgraduate Selection in Medical Education: A Scoping Review of Current Priorities and Values. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:S98-S107. [PMID: 37983402 DOI: 10.1097/acm.0000000000005365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
PURPOSE The process of screening and selecting trainees for postgraduate training has evolved significantly in recent years, yet remains a daunting task. Postgraduate training directors seek ways to feasibly and defensibly select candidates, which has resulted in an explosion of literature seeking to identify root causes for the problems observed in postgraduate selection and generate viable solutions. The authors therefore conducted a scoping review to analyze the problems and priorities presented within the postgraduate selection literature to explore practical implications and present a research agenda. METHOD Between May 2021 and February 2022, the authors searched PubMed, EMBASE, Web of Science, ERIC, and Google Scholar for English language literature published after 2000. Articles that described postgraduate selection were eligible for inclusion. 2,273 articles were ultimately eligible for inclusion. Thematic analysis was performed on a subset of 100 articles examining priorities and problems within postgraduate selection. Articles were sampled to ensure broad thematic and geographical variation across the breadth of articles that were eligible for inclusion. RESULTS Five distinct perspectives or value statements were identified in the thematic analysis: (1) Using available metrics to predict performance in postgraduate training; (2) identifying the best applicants via competitive comparison; (3) seeking alignment between applicant and program in the selection process; (4) ensuring diversity, mitigation of bias, and equity in the selection process; and (5) optimizing the logistics or mechanics of the selection process. CONCLUSIONS This review provides insight into the framing and value statements authors use to describe postgraduate selection within the literature. The identified value statements provide a window into the assumptions and subsequent implications of viewing postgraduate selection through each of these lenses. Future research must consider the outcomes and consequences of the value statement chosen and the impact on current and future approaches to postgraduate selection.
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Affiliation(s)
- Holly A Caretta-Weyer
- H.A. Caretta-Weyer is associate professor and associate residency director, Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California; ORCID: https://orcid.org/0000-0002-9783-5797
| | - Kevin W Eva
- K.W. Eva is associate director and senior scientist, Centre for Health Education Scholarship, and professor and director, educational research and scholarship, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: http://orcid.org/0000-0002-8672-2500
| | - Daniel J Schumacher
- D.J. Schumacher is professor of pediatrics, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: http://orcid.org/0000-0001-5507-8452
| | - Lalena M Yarris
- L.M. Yarris is professor and vice chair of faculty development, Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon
| | - Pim W Teunissen
- P.W. Teunissen is professor of workplace learning in health care, School of Health Professions Education, and gynecologist, Department of Obstetrics & Gynecology, Maastricht University and Maastricht University Medical Center, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-0930-0048
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Desai MK, Kapadia JD. Medical Professionalism and Ethics. J Pharmacol Pharmacother 2022. [DOI: 10.1177/0976500x221111448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Frequent media reports of disputes between medical teachers, resident doctors, and patients have been disturbing thus indicating an increasing gap and decline in the values of the profession. The foundation of medical professionalism and ethics is trust, truth, human values, and strong societal commitment. Our professional responsibilities as medical educators have immediate and long-term impact on the quality of training, patient care, and overall image of the professional group in the society. Formal teaching and training in professionalism and medical ethics that emphasize humanistic aspects and standard of conduct, respectively, are equally essential as biomedical aspects. Interestingly, the principles of medical ethics and attributes of professionalism overlap. However, real-life experiences and complex clinical scenarios place medical educators at the crossroads that contradict their professional commitments resulting in ethical dilemmas. COVID-19 pandemic has further challenged the principles of medical professionalism, especially patient welfare, autonomy, and social justice to prioritize patient care and make tricky decisions based on insufficient resources including withholding and withdrawing potentially lifesaving treatments. Unfortunately, until now the teaching and training in medical professionalism and ethics have remained subtle and medical students learn by chance. The recent introduction of the AETCOM module and Code of Medical Ethics in the curriculum is a ray of hope to brighten the image of medical professionals.
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Affiliation(s)
- Mira K. Desai
- Department of Pharmacology, Nootan Medical College, Visnagar, Gujarat, India
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Barber C, Burgess R, Mountjoy M, Whyte R, Vanstone M, Grierson L. Associations between admissions factors and the need for remediation. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:475-489. [PMID: 35171399 DOI: 10.1007/s10459-022-10097-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/23/2022] [Indexed: 06/14/2023]
Abstract
This study examines the way in which student characteristics and pre-admissions measures are statistically associated with the likelihood a student will require remediation for academic and professionalism offenses. We anchor our inquiry within Irby and Hamstra's (2016) conceptual framework of constructs of professionalism. Data from five graduating cohorts (2014-2018) from McMaster University (Hamilton, Canada) (N = 1,021) were retroactively collected and analyzed using traditional and multinominal logistic regression analyses. The relationship among student characteristics, pre-admissions variables, and referral for potential remediation both by occurrence (yes/no) as well as type (academic/professional/no referral) were examined separately. Findings indicate that gender (OR = 0.519, 95% CI 0.326-0.827, p < 0.01) and undergraduate grade point average (GPA) (OR = 0.245, 95% CI 0.070-0.855, p < 0.05) were significantly associated with instances of referral for potential professionalism and academic remediation, respectively. Women were less likely than men to require remediation for professionalism (OR = 0.332, 95% CI 0.174-0.602, p < 0.001). Undergraduate GPAs (OR = 0.826, 95% CI 0.021-0.539, p < 0.01) were significantly associated with remediation for academic reasons. Lower undergraduate GPAs were associated with a higher likelihood of remediation. These findings point to the admissions variables that are associated with instances that prompt referral for potential remediation. Where associations are not significant, we consider the application of different conceptualizations of professionalism across periods of admissions and training. We encourage those involved in applicant selection and student remediation to emphasize the importance of the interactions that occur between personal and contextual factors to influence learner behaviour and professional identity formation.
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Affiliation(s)
- Cassandra Barber
- McMaster Program for Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Canada
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - Raquel Burgess
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W., Hamilton, ON, L8P 1H6, Canada
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, USA
- MD Undergraduate Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Margo Mountjoy
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W., Hamilton, ON, L8P 1H6, Canada
- MD Undergraduate Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Rob Whyte
- MD Undergraduate Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Department of Anesthesia, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Meredith Vanstone
- McMaster Program for Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W., Hamilton, ON, L8P 1H6, Canada
- MD Undergraduate Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Lawrence Grierson
- McMaster Program for Education Research, Innovation, and Theory (MERIT), Faculty of Health Sciences, McMaster University, Hamilton, Canada.
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, 100 Main St. W., Hamilton, ON, L8P 1H6, Canada.
- MD Undergraduate Program, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Canada.
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Pavithra A, Sunderland N, Callen J, Westbrook J. Unprofessional behaviours experienced by hospital staff: qualitative analysis of narrative comments in a longitudinal survey across seven hospitals in Australia. BMC Health Serv Res 2022; 22:410. [PMID: 35351097 PMCID: PMC8962235 DOI: 10.1186/s12913-022-07763-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/07/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Unprofessional behaviours of healthcare staff have negative impacts on organisational outcomes, patient safety and staff well-being. The objective of this study was to undertake a qualitative analysis of narrative responses from the Longitudinal Investigation of Negative Behaviours survey (LION), to develop a comprehensive understanding of hospital staff experiences of unprofessional behaviours and their impact on staff and patients. The LION survey identified staff experiences and perceptions related to unprofessional behaviours within hospitals. METHODS Two open-ended questions within the LION survey invited descriptions of unprofessional staff behaviours across seven hospitals in three Australian states between December 2017 and November 2018. Respondents were from medical, nursing, allied health, management, and support services roles in the hospitals. Data were qualitatively analysed using Directed Content Analysis (DCA). RESULTS From 5178 LION survey responses, 32% (n = 1636) of participants responded to the two open-ended questions exploring staff experiences of unprofessional behaviours across the hospital sites surveyed. Three primary themes and 11 secondary themes were identified spanning, i) individual unprofessional behaviours, ii) negative impacts of unprofessional behaviours on staff well-being, psychological safety, and employee experience, as well as on patient care, well-being, and safety, and iii) organisational factors associated with staff unprofessional behaviours. CONCLUSION Unprofessional behaviours are experienced by hospital staff across all professional groups and functions. Staff conceptualise, perceive and experience unprofessional behaviours in diverse ways. These behaviours can be understood as enactments that either negatively impact other staff, patients or the organisational outcomes of team cohesion, work efficiency and efficacy. A perceived lack of organisational action based on existing reporting and employee feedback appears to erode employee confidence in hospital leaders and their ability to effectively address and mitigate unprofessional behaviours.
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Affiliation(s)
- Antoinette Pavithra
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
| | - Neroli Sunderland
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Joanne Callen
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Johanna Westbrook
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Bourgeois-Law G, Teunissen PW, Varpio L, Regehr G. Attitudes Towards Physicians Requiring Remediation: One-of-Us or Not-Like-Us? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:S36-S41. [PMID: 31365392 DOI: 10.1097/acm.0000000000002896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE The data for this paper were collected as part of a larger project exploring how the medical profession conceptualizes the task of supporting physicians struggling with clinical competency issues. In this paper, the authors focus on a topic that has been absent in the literature thus far-how physicians requiring remediation are perceived by those responsible for organizing remediation and by their peers in general. METHOD Using a constructivist grounded theory approach, the authors conducted semistructured interviews with 17 remediation stakeholders across Canada. Given that in Canada health is a provincial responsibility, the authors purposively sampled stakeholders from across provincial and language borders and across the full range of organizations that could be considered as participating in the remediation of practicing physicians. RESULTS Interviewees expressed mixed, sometimes contradictory, emotions toward and perceptions of physicians requiring remediation. They also noted that their colleagues, including physicians in training, were not always sympathetic to their struggling peers. CONCLUSIONS The medical profession's attitude toward those who struggle with clinical competency-as individuals and as a whole-is ambivalent at best. This ambivalence grows out of psychological and cultural factors and may be an undiscussed factor in the profession's struggle to deal adequately with underperforming members. To contend with the challenge of remediating practicing physicians, the profession needs to address this ambivalence and its underlying causes.
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Affiliation(s)
- Gisèle Bourgeois-Law
- G. Bourgeois-Law is clinical associate professor, Department of Obstetrics and Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada, and PhD candidate, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0002-4726-3663. P.W. Teunissen is professor of medical education, School of Health Professions Education, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands, and gynecologist, Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, the Netherlands; ORCID: https://orcid.org/0000-0002-0930-0048. L. Varpio is professor, Department of Medicine, and associate director of research, Graduate Programs in Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-1412-4341. G. Regehr is professor, Department of Surgery, and associate director for research, Centre for Health Education Scholarship, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; ORCID: https://orcid.org/0000-0002- 3144-331
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Mak-van der Vossen MC, de la Croix A, Teherani A, van Mook WNKA, Croiset G, Kusurkar RA. A Road Map for Attending to Medical Students' Professionalism Lapses. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:570-578. [PMID: 30489285 DOI: 10.1097/acm.0000000000002537] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To develop a road map for educators attending to medical students' professionalism lapses, aiming to offer an empirical base for approaching students who display such lapses. METHOD Between October 2016 and January 2018, 23 in-depth interviews with 19 expert faculty responsible for remediation from 13 U.S. medical schools were conducted about the way they handle students' professionalism lapses. Three researchers independently completed three rounds of coding. Data collection, coding, and analysis were performed in a constant comparative process. A constructivist grounded theory approach was used to develop an explanatory model for attending to students' professionalism lapses. RESULTS Based on participants' descriptions, the authors developed a three-phase approach for attending to professionalism lapses. In phase 1, experts enacted the role of concerned teacher, exploring the lapse from the student's perspective. In phase 2, they functioned as supportive coach, providing feedback on professionalism values, improving skills, creating reflectiveness, and offering support. In phase 3, if the student did not demonstrate reflectiveness and improvement, and especially if (future) patient care was potentially compromised, participants assumed an opposite role: gatekeeper of the profession. CONCLUSIONS An explanatory model for attending to professionalism lapses that fits in the overarching "communities of practice" framework was created. Whereas phase 1 and 2 aim at keeping students in the medical community, phase 3 aims at guiding students out. These findings provide empirical support to earlier descriptive, opinion-based models and may offer medical educators an empirical base for attending to students who display professionalism lapses.
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Affiliation(s)
- Marianne C Mak-van der Vossen
- M.C. Mak-van der Vossen is general physician, coordinator of professional behavior, and PhD student, Department of Research in Education, VUmc School of Medical Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands; ORCID: https://orcid.org/0000-0001-7810-6575. A. de la Croix is assistant professor, LEARN! Academy, Vrije Universiteit, and researcher, Department of Research in Education, VUmc School of Medical Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands. A. Teherani is professor of medicine and education researcher, Center for Faculty Educators, School of Medicine, University of California, San Francisco, San Francisco, California. W.N.K.A. van Mook is internist/intensivist, Department of Intensive Care Medicine, postgraduate dean, Maastricht University Medical Center, and professor of medical education, Maastricht University, Maastricht, The Netherlands. G. Croiset is professor of education and training, Health and Life Sciences, and dean of education and training, University Medical Center Groningen, Groningen, The Netherlands. R.A. Kusurkar is associate professor of medical education and head, Department of Research in Education, VUmc School of Medical Sciences, Amsterdam University Medical Centers, Amsterdam, The Netherlands; ORCID: https://orcid.org/0000-0002-9382-0379
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Guraya SY, van Mook WN, Khoshhal KI. Failure of faculty to fail failing medical students: Fiction or an actual erosion of professional standards? J Taibah Univ Med Sci 2019; 14:103-109. [PMID: 31435399 PMCID: PMC6694968 DOI: 10.1016/j.jtumed.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Literature has shown that some assessors assign passing grades to medical students who, in fact, should not have passed. This inability of the faculty to fail underperforming students can jeopardise the reputation of professional programs, be it in the medical field or beyond. Simultaneously, weak students become incompetent physicians and, thus, endanger the community they serve. The impetus for conducting this systematic review was to identify barriers to faculty in failing struggling medical students. METHODS The databases of MEDLINE, Scopus, Wiley online library, Cochrane library, OVID, Taylor and Francis, CINAHL, Springer link, ProQuest, and ISI Web of knowledge were searched using Medical Subject Headings (MeSH) terms 'Faculty failure' AND 'Failing students' AND 'Failure to fail' OR 'Assessment'. The data were synthesised, and the results were analysed. RESULTS This search showed a wealth of barriers to faculty contributing to a 'failure to fail' such as their concerns about legal action and an appeals process; the stress of failing students; a lack of knowledge about proper documentation; unavailability of support, resources, and offices for faculty; absence of administrative guidelines; and complex dismissal procedures discouraging the faculty from failing students. CONCLUSION Institutional faculty development programs and training workshops should facilitate the education of supervisors and assessors for timely evaluation and regular documentation of trainee assessment. The provision of legal advice in cases of appeal and professional support by the resource and support office is emphasised.
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Affiliation(s)
- Salman Y. Guraya
- Clinical Sciences Department, College of Medicine University of Sharjah, Sharjah, United Arab Emirates
| | - Walther N.K.A. van Mook
- Department of Intensive Care, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University Medical Centre, the Netherlands
| | - Khalid I. Khoshhal
- Department of Orthopedics, College of Medicine Taibah University, Almadinah Almunawwarah, KSA
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Mahajan R, Goyal PK, Sidhu TK, Kaur U, Kaur S, Gupta V. Module for Interns in Medical Ethics: A Developmental Diegesis. Int J Appl Basic Med Res 2017; 7:S52-S56. [PMID: 29344459 PMCID: PMC5769172 DOI: 10.4103/ijabmr.ijabmr_170_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/10/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Media report is rife with incidences of doctor-patients' conflict, and this partly is due to communication gap and unethical practices being adopted by the doctors. Our regular curriculum fails to impart any training in ethical issues in patient care. Imparting training to students in these soft-skills is the need of the hour. AIM AND OBJECTIVES To develop a module for interns in medical ethics (MIME) in patient care, validate it and pilot run the module for standardization. METHODOLOGY After conducting faculty development workshop in curriculum designing and three rounds of Delphi with alumni, a module in medical ethics was developed and peer validated. The questionnaire for pilot run, questionnaire for future use of module delivery and pre- and post-test were also peer validated. The module was delivered to 17 interns as pilot run in the form of 4 days' workshop. After pilot run, the module was standardized to 10 broad topics and 3 days' workshop. The questionnaire for future delivery of module in regular routine was also validated during pilot run. RESULTS Twenty-five faculty members participated in 1 day faculty development workshop and 59 alumni completed three rounds of Delphi. After peer review by five experts, a module of 11 broad areas was developed and was pilot run on 17 interns. Based on the feedback from pilot run, a standardized, validated 18 h teaching MIME in patient care was developed. CONCLUSION Pilot study proves that curriculum innovation in the form of medical ethics training to interns; when as undergraduate students, they actively participate in patient care under supervision will go a long way in inculcating soft skills like ethics, compassion and communication in them.
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Affiliation(s)
- Rajiv Mahajan
- Department of Pharmacology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Parmod Kumar Goyal
- Department of Forensic Medicine, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Tanvir Kaur Sidhu
- Department of Community Medicine, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Upinder Kaur
- Department of Anaesthesiology and Intensive Care, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Sandeep Kaur
- Department of Physiology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Vitull Gupta
- Department of Medicine, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
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Stegers-Jager KM, Cohen-Schotanus J, Themmen APN. The Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) Model: An Integrated Model for Medical Student Success. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2017; 92:1525-1530. [PMID: 28445223 DOI: 10.1097/acm.0000000000001685] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Not all students cope successfully with the demands of medical school, and students' struggles may result in study delay or dropout. To prevent these outcomes, medical schools need to identify students who are experiencing academic difficul ties and provide them with timely interventions through access to support programs. Although the importance of early identification and intervention is well recognized, less is known about successful strategies for identifying and supporting struggling students.Building on the literature and their own empirical findings, the authors propose an integrated, school-wide model for medical student success comprising a continuum of academic and behavioral support. This Four-Tier Continuum of Academic and Behavioral Support (4T-CABS) model focuses on improving both academic and behavioral outcomes by offering support for students at four levels, which range from adequate instruction for all, to targeted small-group interventions, to individualized support, and also include exit support for students who might be better off in another degree program. Additionally, medical schools should provide both academic and behavioral support; set high, yet realistic expectations and clearly communicate these to students; and intervene early, which requires timely identification of at-risk students who would benefit from the different types and tiers of support. Finally, interventions should be evidence based and fit the needs of the identified groups of students. The authors argue that adopting the core principles of the 4T-CABS model will enable medical schools to maximize academic engagement and performance for all students.
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Affiliation(s)
- Karen M Stegers-Jager
- K.M. Stegers-Jager is assistant professor, Institute of Medical Education Research Rotterdam, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands. J. Cohen-Schotanus is emeritus professor of medical education, Center for Research and Innovation in Medical Education, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands. A.P.N. Themmen is professor of experimental endocrinology and medical education, Institute of Medical Education Research Rotterdam, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
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Mak-van der Vossen M, van Mook W, van der Burgt S, Kors J, Ket JC, Croiset G, Kusurkar R. Descriptors for unprofessional behaviours of medical students: a systematic review and categorisation. BMC MEDICAL EDUCATION 2017; 17:164. [PMID: 28915870 PMCID: PMC5603020 DOI: 10.1186/s12909-017-0997-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 09/04/2017] [Indexed: 05/17/2023]
Abstract
BACKGROUND Developing professionalism is a core task in medical education. Unfortunately, it has remained difficult for educators to identify medical students' unprofessionalism, because, among other reasons, there are no commonly adopted descriptors that can be used to document students' unprofessional behaviour. This study aimed to generate an overview of descriptors for unprofessional behaviour based on research evidence of real-life unprofessional behaviours of medical students. METHODS A systematic review was conducted searching PubMed, Ebsco/ERIC, Ebsco/PsycINFO and Embase.com from inception to 2016. Articles were reviewed for admitted or witnessed unprofessional behaviours of undergraduate medical students. RESULTS The search yielded 11,963 different studies, 46 met all inclusion criteria. We found 205 different descriptions of unprofessional behaviours, which were coded into 30 different descriptors, and subsequently classified in four behavioural themes: failure to engage, dishonest behaviour, disrespectful behaviour, and poor self-awareness. CONCLUSIONS This overview provides a common language to describe medical students' unprofessional behaviour. The framework of descriptors is proposed as a tool for educators to denominate students' unprofessional behaviours. The found behaviours can have various causes, which should be explored in a discussion with the student about personal, interpersonal and/or institutional circumstances in which the behaviour occurred. Explicitly denominating unprofessional behaviour serves two goals: [i] creating a culture in which unprofessional behaviour is acknowledged, [ii] targeting students who need extra guidance. Both are important to avoid unprofessional behaviour among future doctors.
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Affiliation(s)
- Marianne Mak-van der Vossen
- Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands
- LEARN! Research Institute for Education and Learning, VU University, Amsterdam, the Netherlands
- Department for General Practice and Elderly Care Management, VU Medical Center, Amsterdam, the Netherlands
| | - Walther van Mook
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Medical Education Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Stéphanie van der Burgt
- Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands
- LEARN! Research Institute for Education and Learning, VU University, Amsterdam, the Netherlands
| | - Joyce Kors
- AVAG Midwifery Academy Amsterdam Groningen, Amsterdam, the Netherlands
| | - Johannes C.F. Ket
- Medical Library, University Library, Vrije Universiteit, Amsterdam, the Netherlands
| | - Gerda Croiset
- Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands
- LEARN! Research Institute for Education and Learning, VU University, Amsterdam, the Netherlands
| | - Rashmi Kusurkar
- Department of Research in Education, VUmc School of Medical Sciences, Amsterdam, the Netherlands
- LEARN! Research Institute for Education and Learning, VU University, Amsterdam, the Netherlands
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Taylor CL, Grey NJA. Professional behaviours demonstrated by undergraduate dental students using an incident reporting system. Br Dent J 2017; 218:591-6. [PMID: 25998353 DOI: 10.1038/sj.bdj.2015.386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2015] [Indexed: 11/09/2022]
Abstract
Critical incident reporting is widely used across healthcare and other sectors for reporting adverse events or behaviours. More recently it has been used in medical education as a means of assessing student professionalism. The aims of this study were to determine the usage of critical incident forms when reporting behaviours related to professionalism demonstrated by undergraduate dental students, and the types of behaviours exhibited. Three types of form could be awarded for highly professional (green), minor unprofessional (yellow) and serious unprofessional (red) behaviours. All forms completed over a two-year period were analysed recording the year of student, type of card and demographic of the member of staff reporting the incident. All text relating to the nature of the incident was entered into a qualitative data analysis software package and analysed thematically. In total, 583 cards were awarded, 55% green, 34% yellow and 11% red. Seventy-four percent of cards were awarded in a clinical environment, with administrative staff using them the most (29%). The overwhelming professional behaviours demonstrated related to altruism. The most common unprofessional behaviours related to a lack of conscientiousness, although a greater range of common unprofessional behaviours were reported. In conclusion, critical incidents forms were widely used for reporting both professional and unprofessional behaviours particularly in clinical environments by a range of staff. Such forms may be a valuable addition to the professionalism assessment portfolio, capturing behaviours not previously reported using traditional methods.
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Affiliation(s)
- C L Taylor
- Clinical Lecturer/Hon StR in Restorative Dentistry, Oxford Road, Manchester, M19 1PL
| | - N J A Grey
- University of Manchester Dental School, JR Moore Building, University of Manchester, Oxford Road, Manchester, M19 1PL
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Mahajan R, Aruldhas BW, Sharma M, Badyal DK, Singh T. Professionalism and ethics: A proposed curriculum for undergraduates. Int J Appl Basic Med Res 2016; 6:157-63. [PMID: 27563578 PMCID: PMC4979294 DOI: 10.4103/2229-516x.186963] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Professionalism is the attributes, behaviors, commitments, values, and goals that characterize a profession. In medical professional, it encompasses strong societal role and involves emotional component too. On the other hand, ethics is the study of morality – careful and systematic analysis of moral decisions and behaviors and practicing those decisions. Medical ethics focuses primarily on issues arising out of the practice of medicine. It is generally believed that professionalism and ethics are caught by watching your teachers and seniors and not taught formally. Professionalism and ethics are previously diffused passively to the students through “the hidden curriculum,” leaving a lot to chance. However, over the time, it has been advocated that graduates need to be formally trained in the concepts of professionalism and ethics. In this paper, we propose a formal curriculum on professionalism and ethics, tailor-made for Indian medical graduates.
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Affiliation(s)
- Rajiv Mahajan
- Department of Pharmacology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | | | - Monika Sharma
- Department of Pediatrics, Christian Medical College, Ludhiana, Punjab, India
| | - Dinesh K Badyal
- Department of Pharmacology, Christian Medical College, Ludhiana, Punjab, India
| | - Tejinder Singh
- Department of Pediatrics, Christian Medical College, Ludhiana, Punjab, India
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Abstract
Provision of regular feedback to trainees on clinical performance by supervising providers is increasingly recognized as an essential component of undergraduate and graduate health sciences education; however, many individuals have not been formally trained in this pedagogical skill. At the bedside or in the clinic, effective performance feedback can be accomplished by following four key steps. Begin by setting expectations that incorporate the trainee's personal goals and external objectives. Delineate how and when you will provide feedback to the learner. Next, directly observe the trainee's performance. This can be challenging while engaged on a busy clinical service, but a focus on discrete activities or interactions (e.g., family meeting, intravascular volume assessment using bedside ultrasound, or obtaining informed consent) is helpful. The third step is to plan and prioritize the feedback session. Feedback is most effective when given in a timely fashion and delivered in a safe environment. Limit the issues addressed because learners often disengage if confronted with too many deficiencies. Finally, when delivering feedback, begin by listening to the trainee's self-evaluation and then take a balanced approach. Describe in detail what the trainee does well and discuss opportunities for improvement with emphasis on specific, modifiable behaviors. The feedback loop is completed with a plan for follow-up reassessment. Through the use of these relatively simple practices, both the trainee and teacher can have a more productive learning experience.
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Markwell A, Smith S, Michalski M, Conroy S, Bell A. Performance managementversusbullying and harassment: An educator perspective. Emerg Med Australas 2015; 27:468-72. [DOI: 10.1111/1742-6723.12466] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Alex Markwell
- Department of Emergency Medicine; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
- School of Medicine; University of Queensland; Brisbane Queensland Australia
| | - Sharyn Smith
- Department of Emergency Medicine; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
- School of Medicine; University of Queensland; Brisbane Queensland Australia
| | - Mark Michalski
- Department of Emergency Medicine; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
- School of Medicine; University of Queensland; Brisbane Queensland Australia
| | - Sheree Conroy
- School of Medicine; University of Queensland; Brisbane Queensland Australia
- Department of Emergency Medicine; Toowoomba Hospital; Toowoomba Queensland Australia
| | - Anthony Bell
- Department of Emergency Medicine; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
- School of Medicine; University of Queensland; Brisbane Queensland Australia
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Fischbacher-Smith D. The enemy has passed through the gate. JOURNAL OF ORGANIZATIONAL EFFECTIVENESS: PEOPLE AND PERFORMANCE 2015. [DOI: 10.1108/joepp-03-2015-0010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Purpose
– The purpose of this paper is to highlight the potential role that the so-called “toxic triangle” (Padilla et al., 2007) can play in undermining the processes around effectiveness. It is the interaction between leaders, organisational members, and the environmental context in which those interactions occur that has the potential to generate dysfunctional behaviours and processes. The paper seeks to set out a set of issues that would seem to be worthy of further consideration within the Journal and which deal with the relationships between organisational effectiveness and the threats from insiders.
Design/methodology/approach
– The paper adopts a systems approach to the threats from insiders and the manner in which it impacts on organisation effectiveness. The ultimate goal of the paper is to stimulate further debate and discussion around the issues.
Findings
– The paper adds to the discussions around effectiveness by highlighting how senior managers can create the conditions in which failure can occur through the erosion of controls, poor decision making, and the creation of a culture that has the potential to generate failure. Within this setting, insiders can serve to trigger a series of failures by their actions and for which the controls in place are either ineffective or have been by-passed as a result of insider knowledge.
Research limitations/implications
– The issues raised in this paper need to be tested empirically as a means of providing a clear evidence base in support of their relationships with the generation of organisational ineffectiveness.
Practical implications
– The paper aims to raise awareness and stimulate thinking by practising managers around the role that the “toxic triangle” of issues can play in creating the conditions by which organisations can incubate the potential for crisis.
Originality/value
– The paper seeks to bring together a disparate body of published work within the context of “organisational effectiveness” and sets out a series of dark characteristics that organisations need to consider if they are to avoid failure. The paper argues the case that effectiveness can be a fragile construct and that the mechanisms that generate failure also need to be actively considered when discussing what effectiveness means in practice.
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Duvivier R, Kelly B, Veysey M. Selection and study performance. MEDICAL EDUCATION 2015; 49:638-639. [PMID: 25989412 DOI: 10.1111/medu.12691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Robbert Duvivier
- Medical Education Unit, School of Medicine & Public Health, University of Newcastle, New South Wales, Australia
- Teaching & Research Unit, Gosford Hospital, New South Wales, Australia
| | - Brian Kelly
- Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, New South Wales, Australia
- Department of Psychiatry, The Calvary Mater Hospital, Newcastle, New South Wales, Australia
| | - Martin Veysey
- Medical Education Unit, School of Medicine & Public Health, University of Newcastle, New South Wales, Australia
- Teaching & Research Unit, Gosford Hospital, New South Wales, Australia
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van Mook WNKA, van Luijk SJ, Zwietering PJ, Southgate L, Schuwirth LWT, Scherpbier AJJA, van der Vleuten CPM. The threat of the dyscompetent resident: A plea to make the implicit more explicit! ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2015; 20:559-74. [PMID: 24927810 DOI: 10.1007/s10459-014-9526-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 05/28/2014] [Indexed: 05/26/2023]
Abstract
Although several examples of frameworks dealing with students' unprofessional behaviour are available, guidance on how to deal locally or regionally with dysfunctional residents is limited (Hickson et al. in Acad Med 82(11):1040-1048, 2007b; Leape and Fromson in Ann Intern Med 144(2):107-115, 2006). Any 'rules' are mostly unwritten, and often emerge by trial and error within the specialty training programme (Stern and Papadakis in N Engl J Med 355(17):1794-1799, 2006). It is nevertheless of utmost importance that objectives, rules and guidelines comparable to those existing in undergraduate training (Project Team Consilium Abeundi van Luijk in Professional behaviour: teaching, assessing and coaching students. Final report and appendices. Mosae Libris, 2005; van Mook et al. in Neth J Crit Care 16(4):162-173, 2010a) are developed for postgraduate training. And that implicit rules are made explicit. This article outlines a framework based on the lessons learned from contemporary postgraduate medical training programmes.
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Affiliation(s)
- Walther N K A van Mook
- Department of Intensive Care Medicine, Maastricht University Medical Centre+, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands,
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Rougas S, Gentilesco B, Green E, Flores L. Twelve tips for addressing medical student and resident physician lapses in professionalism. MEDICAL TEACHER 2015; 37:901-907. [PMID: 25665630 DOI: 10.3109/0142159x.2014.1001730] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Medical educators have gained significant ground in the practical and scholarly approach to professionalism. When a lapse occurs, thoughtful remediation to address the underlying issue can have a positive impact on medical students and resident physicians, while failure to address lapses, or to do so ineffectively, can have long-term consequences for learners and potentially patients. Despite these high stakes, educators are often hesitant to address lapses in professionalism, possibly due to a lack of time and familiarity with the process. Attention must be paid to generalizable, hands-on recommendations for daily use so that clinicians and administrators feel well equipped to tackle this often difficult yet valuable task. This article reviews the literature related to addressing unprofessional behavior among trainees in medicine and connects it to the shared experience of medical educators at one institution. The framework presented aims to provide practical guidance and empowerment for educators responsible for addressing medical student and resident physician lapses in professionalism.
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Affiliation(s)
- Steven Rougas
- a The Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Bethany Gentilesco
- a The Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Emily Green
- a The Warren Alpert Medical School of Brown University , Providence , RI , USA
| | - Libertad Flores
- a The Warren Alpert Medical School of Brown University , Providence , RI , USA
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Yates J. "Concerns" about medical students' adverse behaviour and attitude: an audit of practice at Nottingham, with mapping to GMC guidance. BMC MEDICAL EDUCATION 2014; 14:196. [PMID: 25239087 PMCID: PMC4189166 DOI: 10.1186/1472-6920-14-196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 09/17/2014] [Indexed: 05/17/2023]
Abstract
BACKGROUND The development and maintenance of students' professional behaviour and attitude is of increasing importance in medical education. Unprofessional behaviour in doctors has the potential to jeopardise patient safety, compromise working relationships, and cause disruption and distress. The General Medical Council issues guidance to medical schools and students describing the standards that should be attained.Nottingham University medical school introduced a 'Concerns' form in 2009, to create a standardised, transparent and defensible means of recording and handling complaints about adverse attitudes or behaviours. This paper reports an audit of the system over the first three years. METHODS The routinely-held database was enhanced with further detail collected from relevant student records. The data were explored in terms of the types of complaint, students who were reported, the people who reported them, and the actions taken afterwards. The data were also mapped to the current GMC guidance. RESULTS 189 valid forms were generated, relating to 143 students. The form was used by a wide variety of people, including clinical and non-clinical teachers, administrators, Hall Wardens, and fellow students. The concerns ranged from infringements of regulations to serious fitness to practise issues. Most were dealt with by faculty or pastoral care staff but some required escalation to formal hearings. The complaints were mapped successfully to GMC documentation, with the highest proportions relating to the GMC categories 'Good Clinical Care' and 'Working with Colleagues'.Male and ethnic minority students appeared to be more likely to have a Concern raised, but this is a tentative conclusion that requires a larger sample. Undergraduate (as opposed to Graduate Entry) students may also be at greater risk. CONCLUSIONS A simple form, freely available, but designed to prevent frivolous or malicious use, has provided valuable data on unprofessional behaviour and the responses elicited. Some parts of the form require improvements, and these are underway to provide more efficient use, audit and review in future.
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Affiliation(s)
- Janet Yates
- Research Fellow, Medical Education Centre, School of Medicine, University of Nottingham Medical School, Nottingham NG7 2UH, UK.
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Ćurković M, Milošević M, Borovečki A, Mustajbegović J. Physicians' interpersonal relationships and professional standing seen through the eyes of the general public in Croatia. Patient Prefer Adherence 2014; 8:1135-42. [PMID: 25210442 PMCID: PMC4154889 DOI: 10.2147/ppa.s65456] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Medical professionalism, as a cornerstone of medicine's social contract with society, demands physicians adhere to high professional standards while placing public interest ahead of self-interest. This study's objective was to investigate perceptions of the basic elements of medical professionalism related to physicians' interpersonal relationships and their professional standing in the view of the broader public. METHODS A field survey was conducted using an independently created questionnaire on a nationally representative three-stage probabilistic sample of 1,008 Croatian citizens. By including weights, the sample became nationally representative in terms of sex, age, education, and regional representation. The survey was carried out from April 17 to May 13, 2012. RESULTS The Croatian public recognizes the importance of collaboration among physicians, but their everyday experiences tell a different story, in which almost half of the respondents evaluated physicians' collaboration as being mediocre, poor, or nonexistent. The perception of physicians' priorities and their primary interests, where every sixth respondent believes physicians always or almost always puts their own interest in front of that of the patients, as well as the perception of their inadequate adherence to professional standards, is indicative of a disillusioned stance of the public toward the medical profession in Croatia. CONCLUSION This research offered insight into findings that can have a profound and long-lasting effect on a health care delivery process if they are not further analyzed and rectified.
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Affiliation(s)
- Marko Ćurković
- University Psychiatric Hospital Vrapče, Zagreb, Croatia
- Correspondence: Marko Ćurković, University Psychiatric Hospital Vrapče, Bolnička cesta 32, 10000 Zagreb, Croatia, Tel +385 1 378 0666, Fax +385 1 348 3660, Email
| | - Milan Milošević
- Department of Environmental and Occupational Health, School of Public Health “Andrija Štampar,” University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Ana Borovečki
- Department of Social Medicine and Organization of Health Care, School of Public Health “Andrija Štampar,” University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Jadranka Mustajbegović
- Department of Environmental and Occupational Health, School of Public Health “Andrija Štampar,” University of Zagreb, School of Medicine, Zagreb, Croatia
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Morihara SK, Jackson DS, Chun MBJ. Making the professionalism curriculum for undergraduate medical education more relevant. MEDICAL TEACHER 2013; 35:908-14. [PMID: 23931736 DOI: 10.3109/0142159x.2013.820273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND This study was an assessment of the professionalism curriculum at a community-based medical school from the perspective of undergraduate medical students. AIMS The goal of this study was to ascertain the perspectives of faculty and students on their interpretations of professionalism and its role in medical education to improve and expand existing professionalism curricula. METHOD An online survey was created and sent to all students (n = 245) and selected faculty (n = 41). The survey utilized multiple choice and open-ended questions to allow responders to provide their insights on the definition of professionalism and detail how professionalism is taught and evaluated at their institution. A content analysis was conducted to categorize open-ended responses and the resulting themes were further examined using SPSS 20.0 for Windows (IBM Corp., Armonk, NY) frequency analyses. RESULTS Students and faculty respondents were similar in their definitions of medical professionalism and their perceptions of teaching methods. Role modeling was the most common and preferred method of professionalism education. Responses to whether evaluations of professional behavior were effective suggested both students and faculty are unclear about current professionalism assessments. CONCLUSION This study showed that a cohesive standardized definition of professionalism is needed, as well as clearer guidelines on how professionalism is assessed.
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Mak-van der Vossen M, Peerdeman S, Kleinveld J, Kusurkar R. How we designed and implemented teaching, training, and assessment of professional behaviour at VUmc School of Medical Sciences Amsterdam. MEDICAL TEACHER 2013; 35:709-14. [PMID: 23782044 DOI: 10.3109/0142159x.2013.799637] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Training of doctors in The Netherlands seeks to develop clinical competences including professional behaviour. Behaving as a professional is not just a desirable trait but a clearly stated requirement for doctors and medical students. RESULTS We designed an educational theme, Professional Behaviour (PB), as a longitudinal thread throughout our six-year curriculum after defining PB as "The observable aspects of practising professionalism". This definition was translated into a set of practical skills that can be observed: "The ability to deal with tasks, to deal with others and to deal with oneself". We assess PB 29 times in the course of the medical curriculum. Students with an unsatisfactory PB do not get their degree irrespective of their medical knowledge. We train teachers to identify and report unprofessional student behaviour, and we offer these students interventions and support. CONCLUSIONS With the educational theme "Professional Behaviour" we have defined PB for our institute and firmly embedded it in the medical curriculum. We use workplace learning and role models for teaching PB. Different teachers carry out multiple formative and summative assessments, using standardized assessment scales. With these measures we intend to promote a culture of excellence in PB in our institute.
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Yates J. Development of a 'toolkit' to identify medical students at risk of failure to thrive on the course: an exploratory retrospective case study. BMC MEDICAL EDUCATION 2011; 11:95. [PMID: 22098629 PMCID: PMC3229499 DOI: 10.1186/1472-6920-11-95] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Accepted: 11/18/2011] [Indexed: 05/12/2023]
Abstract
BACKGROUND An earlier study at Nottingham suggested that 10-15% of the medical student intake was likely to fail completely or have substantial problems on the course. This is a problem for the students, the Faculty, and society as a whole. If struggling students could be identified early in the course and additional pastoral resources offered, some of this wastage might be avoided. An exploratory case study was conducted to determine whether there were common indicators in the early years, over and above academic failure, that might aid the identification of students potentially at risk. METHODS The study group was drawn from five successive cohorts. Students who had experienced difficulties were identified in any of four ways: from Minutes of the Academic Progress Committee; by scanning examination lists at key stages (end of the first two years, and finals at the end of the clinical course); from lists of students flagged to the Postgraduate Deanery as in need of extra monitoring or support; and from progress files of those who had left the course prematurely. Relevant data were extracted from each student's course progress file into a customised database. RESULTS 1188 students were admitted over the five years. 162 (14%) were identified for the study, 75 of whom had failed to complete the course by October 2010. In the 87 who did graduate, a combination of markers in Years 1 and 2 identified over half of those who would subsequently have the most severe problems throughout the course. This 'toolkit' comprised failure of 3 or more examinations per year, an overall average of <50%, health or social difficulties, failure to complete Hepatitis B vaccination on time, and remarks noted about poor attitude or behaviour. CONCLUSIONS A simple toolkit of academic and non-academic markers could be used routinely to help identify potential strugglers at an early stage, enabling additional support and guidance to be given to these students.
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Affiliation(s)
- Janet Yates
- Medical Education Unit, B94 Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK.
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