Residents can play a lead role in a program aimed at teaching commitment to the highest standards of excellence in medicine, to the welfare of patients, and to the best interests of the larger society.
by Larry Beresford
Residents can play a lead role in a program aimed at teaching commitment to the highest standards of excellence in medicine, to the welfare of patients, and to the best interests of the larger society, according to an innovations poster presentation at HM12.1
Professionalism is important to physicians and medical trainees, says Pablo Garcia, MD, a critical-care fellow at the University of New Mexico (UNM) School of Medicine in Albuquerque and one of the project investigators who presented the results in San Diego.
“It directly impacts on patient care and the patient experience,” Dr. Garcia says. “But if we don’t police ourselves as a profession and set our own high standards, we may find that others outside of medicine will take notice.”
Academic medical centers have a particular interest in teaching professionalism to their trainees, not only because the Accreditation Council for Graduate Medical Education (ACGME) requires it, but also because of the profound impact of positive or negative examples by teachers—the “hidden curriculum”— on trainees, Dr. Garcia says.
The UNM project began with a lecture on elements of and threats to professionalism. A nine-item survey was completed by about half of the 70-member internal-medicine residency program. The results showed some less-than-ideal standards by residents. A team then met to develop nine vignettes involving real-world ethical situations, and small groups of four to six participants came together to discuss the vignettes and how they should be handled.
In some cases, attending physicians observed the groups and posed questions but did not lead the discussions, Dr. Garcia says. Over 12 months, all of the ethical scenarios were discussed at least once. Dr. Garcia was invited to speak to two other residency programs at UNM, pediatrics and emergency medicine, both of which developed their own vignettes for small-group discussion.
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