Improving professionalism: making the implicit more explicit.

摘要

PURPOSE: Professionalism is one of the most challenging of the Accreditation Council for Graduate Medical Education Competencies to define, teach and evaluate. At University of Washington we assessed whether defining professionalism, and training faculty and residents in the evaluation process would improve professional behavior. MATERIALS AND METHODS: In 2003 the Accreditation Council for Graduate Medical Education Global Resident Competency Rating Form was distributed to faculty after each rotation to evaluate residents. The project included all 16 residents and 18 clinical faculty during a total of 15 rotations for 3 years at 4 Seattle area hospitals. After 21 months a training lecture on professionalism was presented to faculty and residents. Following this intervention all trained faculty completed a Graduate Medical Education Global Resident Competency Rating Form on every resident after each rotation. Three specific professionalism questions from the Graduate Medical Education Global Resident Competency Rating Form were chosen as representations of standard professional behaviors. These questions were used to assess the change in resident professional behavior. RESULTS: Pre-intervention and post-intervention scores were compared. Mean post-intervention scores were higher by 0.4 to 0.5 points for each of the 3 questions (each p <0.01). There was less variation in scores after the intervention, suggesting that 1) residents were more consistent in their professional behavior and/or 2) the faculty observation of resident professional behaviors was more focused. CONCLUSIONS: These results suggest that training faculty and residents in professionalism may have a significant positive influence on improving resident professional behavior as well as the faculty ability to more objectively evaluate resident professional behaviors based on defined standards.