Faculty Collaboration Database

The professionalism curriculum as a cultural change agent in surgical residency education. Am J Surg 2012 Jan;203(1):14-20

Date

10/11/2011

Pubmed ID

21983000

DOI

10.1016/j.amjsurg.2011.05.007

Scopus ID

2-s2.0-83555174711 (requires institutional sign-in at Scopus site)   36 Citations

Abstract

BACKGROUND: Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture.

METHODS: The goal of this study was to assess whether professionalism has taken root in the surgical resident culture 3 years after implementing our professionalism curriculum. Evidence was derived from 3 studies: (1) annual self-assessments of the residents' perceived professionalism abilities to perform 20 defined tasks representing core Accrediting Council on Graduate Medical Education professionalism domains, (2) objective metrics of their demonstrated professionalism skills as rated by standardized patients annually using the objective structure clinical examination tool, and (3) a national survey of the Surgical Professionalism and Interpersonal Communications Education Study Group.

RESULTS: Study 1: aggregate perceived professionalism among surgical residents shows a statistically significant positive trend over time (P = .016). Improvements were seen in all 6 domains: accountability, ethics, altruism, excellence, patient sensitivity, and respect. Study 2: the cohort of residents followed up over 3 years showed a marked improvement in their professionalism skills as rated by standardized patients using the objective structure clinical examination tool. Study 3: 41 members of the national Surgical Professionalism and Interpersonal Communications Education Study Group rated their residents' skills in admitting mistakes, delivering bad news, communication, interdisciplinary respect, cultural competence, and handling stress. Twenty-nine of the 41 responses rated their residents as "slightly better" or "much better" compared with 5 years ago (P = .001). Thirty-four of the 41 programs characterized their department's leadership view toward professionalism as "much better" compared with 5 years ago.

CONCLUSIONS: All 3 assessment methods suggest that residents feel increasingly prepared to effectively deal with the professionalism challenges they face. Although professionalism seminars may have seemed like an oddity several years ago, residents today recognize their importance and value their professionalism skills. As importantly, department chairpersons report that formal professionalism education for residents is viewed more favorably compared with 5 years ago.

Author List

Hochberg MS, Berman RS, Kalet AL, Zabar SR, Gillespie C, Pachter HL, Surgical Professionalism and Interpersonal Communications Education Study Group

Author

Adina L. Kalet MD Institute Director, Professor in the Kern Institute for Transforming Medical Education department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Altruism
Attitude of Health Personnel
Communication
Conflict of Interest
Curriculum
Education, Medical, Graduate
Ethics, Medical
Female
General Surgery
Humans
Internship and Residency
Interprofessional Relations
Male
New York City
Patient Simulation
Physician-Patient Relations
Privacy
Professional Competence
Self-Assessment
Surveys and Questionnaires
Truth Disclosure