Professionalism Teaching Materials

Components of Professionalism Competency

The components in which trainees must demonstrate proficiency in this Accreditation Council for Graduate Medical Education (ACGME) competency are:

  1. Compassion, integrity, and respect for others
  2. Responsiveness to patient needs that supersedes self-interest
  3. Respect for patient privacy and autonomy
  4. Accountability to patients, society, and profession
  5. Sensitivity and responsiveness to diverse, patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation

A number of readily available resources and teaching tools are accessible through the following links.

Sleep and Fatigue Presentation

The video of the March 5, 2012 presentation by Dr. Lawrence J. Epstein on Sleep and Fatigue: Impact on Trainee's Learning and Performance is available to Partners residents, fellows, faculty, and staff.

Learning to Address Impairment and Fatigue

Learning to Address Impairment and Fatigue to Enhance Patient Safety - Volume 1
Learning to Address Impairment and Fatigue to Enhance Patient Safety - Volume 2

The ACGME requires that every program educate their faculty and trainees on fatigue. Each 25-minute learning module includes engaging video clips and text, as well as a bibliography to support the recommendations.

The LIFE Curriculum is a collaborative effort of Duke University Hospital, the UNC Hospitals, the NC AHEC, and the NC Physician's Health Program to assist graduate medical education programs, their residents, and faculty to prevent, identify, and manage resident fatigue and impairment. The project is funded in part by a grant from the Josiah Macy, Jr. Foundation.

Thank you for working together with us to meet this important requirement.

The self-assessment portion of the video is not available and CME Credits are no longer available. Residents and Fellows can self claim AMA category 2 credit.

Please note that the links to the “additional resources” in the video do not work. The “additional resources” are located below.

Introduction

  1. Life Curriculum Advisory Board
  2. Life Curriculum  Faculty
  3. Residents' Focus Group

Fatigue

  1. Work-Hour Restrictions: Do They Impact the Learning Experience
  2. Learning Objectives 
  3. Sleep Cycle  
  4. Fatigue and Impairment 
  5. Fatigue and Resident Health
  6. Fatigue and Resident Well-Being
  7. Night Floats, Fatigue, Handoffs
  8. ACGME Standards
  9. Accreditation Council for Graduate Medical Education (ACGME)
  10. ACGME clarifies misperceptions on Duty Hour Standards
  11. Milestone in the History of the Problem
  12. Additional References of Interest
  13. David Dinges, PhD, Bibliography
  14. Web Resources

Stress and Depression

  1. Learning Objectives
  2. Situational Stressors
  3. Personal Stressors
  4. Alleviating Stress in a Relationship: Recommendations
  5. Professional Stressors
  6. Physical, Emotional, Behavioral Signs and Symptoms of Stress
  7. Stress Management in Residency Programs
  8. Stress Management Techniques
  9. DSM-IV Criteria for Major Depressive Episode
  10. Additional References of Interest
  11. Web Resources

Substance Abuse

  1. Learning Objectives
  2. DSM-IV Criteria for Substance Abuse and Substance Dependence
  3. Signs and Symptoms Indicative of Substance Abuse
  4. Principles of Intervention
  5. Common Issues Involving Residents Suspected of Substance Abuse
  6. Reporting to the National Practitioner Data Bank: (NPDB)
  7. Steps Programs Can Take to Help Combat Substance Abuse
  8. Additional References of Interest 

Disruptive Behavior

  1. Learning Objectives
  2. Signs and Symptoms of Disruptive Behavior in Physicians
  3. Medical Staff Code of Conduct Policy and Procedures to Deal with Violations: Example 
  4. North Carolina Medical Board Statement on Harassment: Example

Burnout

  1. Learning Objectives
  2. Working Harder: The Vicious Cycle of Burnout
  3. Signs and Symptoms of Burnout
  4. Harrassment Policy- State Medical Board
  5. Resources for Money Management and Loan Repayment 
  6. Steps to Address a Resident’s Sense of Mistreatment
  7. Steps to Reduce Stress by Taking Care of Yourself
  8. Alternate Careers Related to Medicine
  9. Additional References of Interest 

Boundary Violations

  1. Learning Objectives
  2. Transference and Countertransference
  3. Policy Regarding Gifts
  4. Cultural Aspects of Care 
  5. Sex and Power
  6. Sexual Violation versus Sexual Impropriety
  7. Proposed Causes of Boundary Violations in Physicians
  8. Consequences to Patients of Boundary Violations
  9. The Slippery Slope
  10. Examples of a Professional Expectations Form for Residents
  11. Additional References of Interest 


Impairments

  1. Learning Objectives
  2. Notification of Corrective Action (Examples)
  3. Plan of Remediation During Corrective Action
  4. Letter: Feedback During Corrective Action Process
  5. Letter: Expectations and Recommendations to Pursue Disability Consult
  6. Non-renewal of Contract 
  7. Learning Disabilities and the ADA
  8. Cases that have shaped Disability Services 
  9. Examples of Included/Excluded Conditions Decided by the ADA and Subsequent Court Cases
  10. Acceptable and Unacceptable Questions for Applicants or Established Residents
  11. Example of an Essential Job Function List
  12. Additional References of Interest

Instructive Feedback

  1. Learning Objectives
  2. Top Ten Reasons We Avoid Talking with Someone About a Problem
  3. Six Traps in the Evaluation Process
  4. The Five-Stage Process for Giving and Receiving Critical Feedback
  5. Additional References of Interest


Conclusion

Corrective Action and Hearing Procedures: The 5 Step Protocol

ACGME Web-based Educational Resources

I. The ACGME offers a number of general and competency-specific resources to facilitate the teaching and assessment of a number of the core competencies. The Advancing Education in Medical Professionalism Booklet defines and answers questions about this competency, and offers suggestions and methods for teaching this competency to trainees, as well as assessing trainee proficiency in Professionalism.

II. Association of American Medical Colleges (AAMC) MedEd Portal provides several online modules for teaching professionalism, including the following:

  •     “On Doctoring:  Essays on Professionalism”
  •     “Assessment in Medical Education:  Focus on Professionalism”
  •     “Professionalism Workshop: Applying the Elements of Professionalism Through Scenario Learning”
  •     “360-Degree Communication and Professionalism Assessment Instrument”
  •     “360-Degree Professionalism Assessment Instrument”
  •     “Professionalism: Self-Study Module”

These and other resources are accessible on the AAMC web site.

III. The ABIM Foundation hosts resources  for teaching and evaluating professional behavior, including the Professionalism mini-evaluation exercise.

IV. The American College of Physicians (ACP) hosts a number of resources intended to facilitate the teaching of ethics and professional behavior, including the following:
The ACP Ethics Manual, 5th ed. includes discussion of a number of clinical topics, approaches to ethical dilemmas, and a case method for ethics decision making.
The ACP Ethics Case Studies, a professionalism case study series launched on Medscape, featuring case studies related to ethical and professional behavior and interactions. CME credit is available.

Publications Related to Professionalism

To obtain copies of the educational reviews and resources listed in the bibliography, contact the medical libraries at Massachusetts General Hospital (MGH) or Brigham and Women's Hospital (BWH).

MGH: Visit Mass General's Treadwell Library and click on the link 'Order Articles' on the left side of the page.
BWH: email article requests directly to the library.

Brownell AKW, Cote L: Senior residents’ views on the meaning of professionalism and how they learn it. Academic Medicine 2001;76:734-7.

Ginsburg S, Regehr G, Hatala R, McNaughton N, Frohna A, Hodges B, et al: Context, conflict, and resolution: a new conceptual framework for evaluating professionalism. Academic Medicine 2000;75(10 Suppl): S6-11.

Hawkins RE, Katsufrakis PJ, Holtman MC, Clauser BE: Assessment of medical professionalism: who, what, where, how, and … why? Medical Teacher 2009;Apr 31(4):348-61.

Klein EJ, Jackson JC, Kratz L, Marcuse EK, McPhillips HA, et al: Teaching professionalism to residents. Academic Medicine 2003;78(1):26-34.

Kuczewski M: Fostering professionalism: The Loyola Model. Cambridge Quarterly of Healthcare Ethics 2003;12:161-6.

Larkin GL: Mapping, modeling, and mentoring: charting a course for professionalism in graduate medical education. Cambridge Quarterly of Healthcare Ethics 2003;12:167-77.

Stern DT: Values on call:  a method for assessing the teaching of professionalism. Academic Medicine 1996;71(10 Suppl):S37-9.

Wear D: The House of God: another look. Academic Medicine 2002;77:496-501.

 

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