Professionalism and Ethics
Key Points:
- Clear expectations for behavior (Code of Conduct) need to be set.
- Gaps in professionalism must be documented for appropriate interventions to be undertaken.
- Unprofessional behavior erodes teamwork and is a patient safety risk.
- Even indirect exposure to unprofessional behavior is associated with burnout and cynicism.
Objectives:
- Act as a model of professionalism
- Support a culture of professionalism
- Prevent, identify, and remediate professionalism issues in learners
Recommended Resources:
Brief Review
Watch
♥Empathy: The Human Connection to Patient Care. Cleveland Clinic. 4 minutes.
http://youtu.be/cDDWvj_q-o8?list=PL95B29FDF6B7A3B17
Empathy: The Power of Outrospection. The RSA. 10 minutes.
http://youtu.be/BG46IwVfSu8
UNE Medical Professionalism Video Assignment. Brodie Hyde. 5 minutes.
http://youtu.be/wIXmcVxmdvY
♥Social Media Professionalism in the Medical Community. ACOG News. 4 minutes.
http://youtu.be/3N8A5LMlego
Read
Al-Eraky MM. Twelve Tips for teaching medical professionalism at all levels of medical education. Med Teach. 2015 Mar 17:1-8. PubMed PMID: 25776227.
http://informahealthcare.com/doi/abs/10.3109/0142159X.2015.1020288
Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman-Levitan S, Meyer GS, Healy GB. Perspective: a culture of respect, part 2: creating a culture of respect. Acad Med. 2012 Jul;87(7):853-8. doi: 10.1097/ACM.0b013e3182583536. PubMed PMID: 22622219
http://www.ncbi.nlm.nih.gov/pubmed/22622219
Boehm FH. Teaching bedside manners to medical students. Acad Med. 2008 Jun;83(6):534. doi: 10.1097/ACM.0b013e3181722d7c. PubMed PMID: 18520454.
http://www.medscape.com/viewarticle/576326
Mueller PS. Incorporating professionalism into medical education: the Mayo Clinic experience. Keio J Med. 2009 Sep;58(3):133-43. Review. PubMed PMID: 19826207
http://www.ncbi.nlm.nih.gov/pubmed/19826207
Ainsworth MA, Szauter KM. Medical student professionalism: are we measuring the right behaviors? A comparison of professional lapses by students and physicians. Acad Med. 2006 Oct;81(10 Suppl):S83-6. PubMed PMID: 17001143.
"Previous investigations have suggested that problematic behavior in medical school is associated with subsequent disciplinary action by a state medical board. Other studies have demonstrated that relatively simple behaviors, such as failing to complete required course evaluations and failing to report immunization compliance were predictors of unprofessional behavior found by the school in subsequent years. Professionalism deficiencies early in medical school have also been shown to predict poor clinical performance in subsequent courses."
http://www.ncbi.nlm.nih.gov/pubmed/17001143
The Case of the Facebook Faceplant by Dr. Brent Thoma. ALiEM MEdIC Series case 1.02.
http://aliem.com/wp-content/uploads/Case-of-the-Facebook-Faceplant.pdf
The Case of the Not So Humorous Humerus by Dr. Amy Walsh; Edited by Dr. Teresa Chan. ALiEM MEdIC Series case 1.08.
http://aliem.com/wp-content/uploads/Case-of-the-Not-So-Humorous-Humerus.pdf
The Case of the Woman in White by Dr. Amy Walsh. ALiEM MEdIC Series case 1.03.
http://aliem.com/wp-content/uploads/Case-of-the-Woman-in-White.pdf
The Case of the Backroom Blunder by Heather Murray. ALiEM MEdIC Series case 2.01.
http://www.aliem.com/wp-content/uploads/Case-of-the-Backroom-Blunder-2.01.pdf
The Case of the Ebola Outbreak Ethics by Sarah Luckett-Gatopoulous. ALiEM MEdIC Series case 2.03.
http://www.aliem.com/wp-content/uploads/Case-of-the-Ebola-Outbreak-Ethics-2.03.pdf
The Case of the Late Letter by Eve Purdy. ALiEM MEdIC Series case 2.04.
http://www.aliem.com/wp-content/uploads/Case-of-the-Late-Letter-2.04.pdf
Do
Loo L, Geslani V, Baz S, Tudtud-Hans L. The Professionalism Matrix: A Framework to Analyze Professional & Unprofessional Behaviors. MedEdPORTAL Publications; 2014. Included in this workshop are the background slides, the Professionalism Matrix, a detailed workshop plan, and several scenarios that can be used for discussion. Slides can be adapted to fit the specific needs of the particular learning environment.
https://www.mededportal.org/publication/9961
Krug E, Kavanagh M. Ethical Challenges Faced by Medical Students. MedEdPORTAL Publications; 2014. This workshop pairs the use of brief video vignettes with small group discussion to highlight some key ethical principles and present strategies for dealing with ethical conundrums medical students are likely to face.
https://www.mededportal.org/publication/9679
In-Depth Review
Watch
Professionalism and Medical Education's Hidden Curriculum. UVA Medical Center Hour. 58 minutes.
http://youtu.be/qR2yc_R0l-E
Your Medical School Journey: Training in Medical Professionalism. UW TV. 52 minutes.
http://youtu.be/hC6qyVwOq4M
Enhancing Empathy in Medical Care. Robert Wood Johnson Medical School. iTunesU. Audio only podcast. 61 minutes.
https://itunes.apple.com/us/podcast/enhancing-empathy-in-medical/id429504516?i=92596342&mt=2
Professionalism and Medicine's Social Contract. Robert Wood Johnson Medical School. iTunesU. Audio only podcast. 58 minutes.
https://itunes.apple.com/us/podcast/professionalism-medicines/id429504516?i=92596343&mt=2
Read
♥Ontario Disruptive Behavior Guidebook. College Of Physicians and Surgeons of Ontario April 2008.
http://www.cpso.on.ca/CPSO/media/uploadedfiles/CPSO_DPBI_Guidebook1.pdf
Project Professionalism. American Board of Internal Medicine. 1995.
http://www.abim.org/pubs/profess.pdf
AMA Journal of Ethics
http://journalofethics.ama-assn.org/
♥Leonard JM, et al. Medical Ethics for Physicians. Chapter 9 reviews setting up a workable ethical decision-making framework. Free on the iBookstore.
https://itunes.apple.com/us/book/medical-ethics-for-physicians/id569223836?mt=11
Understanding Medical Professionalism by American Board of Internal Medicine Foundation. 2014. $40.45
http://www.amazon.com/Understanding-Professionalism-American-Internal-Foundation/dp/0071807438/ref=sr_1_1?s=books&ie=UTF8&qid=1431982872&sr=1-1
Do
Bhansali P, Singhal G, Held M, Fromme H. How to Be a Super Model: Using Role Modeling to Become an Exemplary Educator. MedEdPORTAL Publications; 2014. The purpose of this workshop is to assist participants in better understanding the characteristics of effective role modeling and create a paradigm for how to consciously incorporate role modeling into the daily education of students, residents, and colleagues in varied domains, including teaching, professionalism, communication, and patient care.
https://www.mededportal.org/publication/9899
Resiliency
Doctors make mistakes. Can we talk about that? Brian Goldman. TED Talks. 19 minutes.
https://www.ted.com/talks/brian_goldman_doctors_make_mistakes_can_we_talk_about_that?language=en
♥The fringe benefits of failure. JK Rowling. TED Talks. 20 minutes.
https://www.ted.com/talks/jk_rowling_the_fringe_benefits_of_failure