1 / 18

Neha Sachdev, MD

Fostering a Culture of Accountability and Respect: Resident Leadership and Development of a Professionalism Curriculum. Neha Sachdev, MD. Objectives. Background Why Professionalism? Research Methods Initial Results] Interventions Timeline/Next Steps. Background.

aren
Télécharger la présentation

Neha Sachdev, MD

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Fostering a Culture of Accountability and Respect: Resident Leadership and Development of a Professionalism Curriculum Neha Sachdev, MD

  2. Objectives • Background • Why Professionalism? • Research Methods • Initial Results] • Interventions • Timeline/Next Steps

  3. Background • Northwestern McGaw Family Medicine Residency • One of 11 original Teaching Health Center programs • Partnership with Erie Family Health Center (FQHC), Northwestern McGaw Medical Center and Norwegian American Hospital (America’s Essential Hospital) • Leadership Emphasis and Culture

  4. Why Study Professionalism? • ACGME Core Competency / Milestones • Central to formation of professional identity • Unprofessional conduct in learners strongly correlates with future disciplinary actions • Residents identify importance of professionalism education in training • Increasing demands on resident-time • Required for future leadership

  5. Research Methods • Outcomes Measures • Quantitative • Pre-post-post survey with PMEX • 24 residents, 6 fellows, 11 faculty members and residency coordinator • Qualitative • Small group interviews with R1and R2 classes • Process Measures • Peer to peer formative feedback sessions • Longitudinal skill-building sessions • Longitudinal case-based sessions

  6. PMEX Survey • Validated tool • Specific, observable behaviors • 9 questions in 4 major categories • Doctor/Patient Skills • Time Management • Reflective Skills • Interpersonal Skills

  7. Assessment- PMEX

  8. Pre Results Characteristics: 21 Respondents-Faculty & Residents, response rate of 62%

  9. Key Findings = Lowest mean scores in Reflective skills, Highest mean scores in Doctor-Patient Relationship skills

  10. Interventions • Peer to peer feedback sessions on inpatient service • CCC formalization with resident presence • Formal feedback training- • SBI method

  11. Timeline • Winter/Spring 2014 • First Post PMEX Assessment collected • Small group interviews with PGY1 and PGY2residents • 6 professional skill-building sessions held with PGY2/PGY3 residents • Summer/Fall 2014 • First Post PMEX analysis • Formal feedback sessions implemented in clinic,MCH service • 3 ‘On Doctoring’ sessions held with all residents and faculty • 4 ‘On Doctoring’ sessions held with PGY2/3 residents • Winter 2015 • Second Post PMEX Assessment collected • Follow-up small group interviews with PGY2/PGY3 residents

  12. Focus Group Questions We are interested in understanding how residents learn about professionalism. How would you defineprofessionalism, what do you think it is? 2) We are interested in understanding your training and educational experiences in professionalism. Can you describe some of the ways that you have learned about professionalism? What has been the best educational experience? Why was this an effective method or approach? Can you describe some of the least effective ways to learn about professionalism? What made that educational experience ineffective? 3) What are some of the challenges to teaching professionalism in residency? What are your suggestions on how to teach professionalism effectively during residency? 4) Are there any other comments or experiences that you can share that would help us build an effective professionalism curriculum for residents?

  13. Focus Group Themes Identified Methods of teaching/learning professionalism - Reflection - Didactic - Case-based/situational - Role-modeling/mentors - Code of conduct/standards - Evaluations (Individualized) Difficulties with teaching/identifying professionalism - Skepticism - Blurring of roles (peer vs friend vs colleague) - Time/scheduling Professionalism Definitions (positives and negatives) - Respect - Leadership - Patient care & communication - Interprofessional relationships - Learned vs. innate - Self-assessment - Behavior under stress & fatigue

  14. Timeline/Next Steps • Winter/Spring 2014 • First Post PMEX Assessment collected • Small group interviews with PGY1 and PGY2residents • 6 professional skill-building sessions held with PGY2/PGY3 residents • Summer/Fall 2014 • First Post PMEX analysis • Formal feedback sessions implemented in clinic,MCH service • 3 ‘On Doctoring’ sessions held with all residents and faculty • 4 ‘On Doctoring’ sessions held with PGY2/3 residents • Winter 2015 • Second Post Assessment collected • Follow-up small group interviews with PGY2/PGY3 residents

  15. “On-Doctoring” Curriculum • Defining Values • The Impaired Physician • Finding Inspiration in Medicine • Leadership and Communication • Risk Management and Legal Basics • Balance and Wellness • Lapses in Professional Conduct

  16. References • Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system--rationale and benefits. N Engl J Med. 2012 Mar 15;366(11):1051-6. doi: 10.1056/NEJMsr1200117. Epub 2012 Feb 22. • ACGME Program Requirements for Graduate Medical Education in Family Medicine. ACGME, September 29, 2013. http://www.acgme.org/acgmeweb/tabid/132/ProgramandInstitutionalAccreditation/MedicalSpecialties/FamilyMedicine.aspx, Accessed on February 2, 2014. • Baldwin DC Jr, Daugherty SR, Rowley BD. Unethical and unprofessional conduct observed by residents during their first year of training. Acad Med. 1998 Nov;73(11):1195-200. • Bahaziq W, Crosby E. Can J Anaesth. 2011 Nov;58(11):1039-50. doi: 10.1007/s12630-011-9579-2. Epub 2011 Aug 25. Review. • Barry D, Cyran E, Anderson RJ. Common issues in medical professionalism: room to grow. Am J Med. 2000 Feb;108(2):136-42. • Gillespie C, Paik S, Ark T, Zabar S, Kalet A. J Grad Med Educ. 2009 Dec;1(2):208-15. doi: 10.4300/JGME-D-09-00018.1. • Humphrey HJ, Smith K, Reddy S, Scott D, Madara JL, Arora VM. Promoting an environment of professionalism: the University of Chicago "Roadmap". Acad Med. 2007 Nov;82(11):1098-107. Erratum in: Acad Med. 2008 Nov;83(11):1048. • Cruess RL, Cruess SR. Teaching professionalism: general principles. Med Teach. 2006 May;28(3):205-8. • Taylor C, Farver C, Stoller JK. Acad Med. 2011 Dec;86(12):1551-4. doi: 10.1097/ACM.0b013e318235aa76. Review.

  17. References • Gaiser RR. AnesthAnalg. 2009 Mar;108(3):948-54. doi: 10.1213/ane.0b013e3181935ac1. Review. • Meade LB, Borden SH, McArdle P, Rosenblum MJ, Picchioni MS, Hinchey KT. From theory to actual practice: creation and application of milestones in an internal medicine residency program, 2004-2010. Med Teach. 2012;34(9):717-23. doi: 10.3109/0142159X.2012.689441. Epub 2012 May 30. • Lee AG, Beaver HA, Boldt HC, Olson R, Oetting TA, Abramoff M, Carter K. Teaching and assessing professionalism in ophthalmology residency training programs. SurvOphthalmol. 2007 May-Jun;52(3):300-14. Review. • Swing SR. Assessing the ACGME general competencies: general considerations and assessment methods. AcadEmerg Med. 2002 Nov;9(11):1278-88. • Regis T, Steiner MJ, Ford CA, Byerley JS. Professionalism expectations seen through the eyes of resident physicians and patient families. Pediatrics. 2011 Feb;127(2):317-24. doi: 10.1542/peds.2010-2472. Epub 2011 Jan 17. • Roberts LW, Warner TD, Hammond KA, Geppert CM, Heinrich T. Becoming a good doctor: perceived need for ethics training focused on practical and professional development topics. Acad Psychiatry. 2005 Jul-Aug;29(3):301-9. • 17. Ratanawongsa N, Bolen S, Howell E, Kern D, Sisson S, Larriviere D. Residents’ Perceptions of Professionalism in Training and Practice: Barriers, Promoters, and Duty Hour Requirements. J Gen Intern Med. 2006; 21:758–763. • 18. Cruess R, McIlroy JH, Cruess S, Ginsburg S, Steinert Y. The Professionalism Mini-Evaluation Exercise: A Preliminary Investigation.Acad Med. 2006 Oct; 81 (10): S74-S78.

More Related