Dataset Information

Residents' perceptions of professionalism in training and practice: barriers, promoters, and duty hour requirements.

ABSTRACT:

Background

The Accreditation Council for Graduate Medical Education duty hour requirements may affect residents' understanding and practice of professionalism.

Objective

We explored residents' perceptions about the current teaching and practice of professionalism in residency and the impact of duty hour requirements.

Design

Anonymous cross-sectional survey.

Participants

Internal medicine, neurology, and family practice residents at 3 teaching hospitals (n=312).

Measurements

Using Likert scales and open-ended questions, the questionnaire explored the following: residents' attitudes about the principles of professionalism, the current and their preferred methods for teaching professionalism, barriers or promoters of professionalism, and how implementation of duty hours has affected professionalism.

Results

One hundred and sixty-nine residents (54%) responded. Residents rated most principles of professionalism as highly important to daily practice (91.4%, 95% confidence interval [CI] 90.0 to 92.7) and training (84.7%, 95% CI 83.0 to 86.4), but fewer rated them as highly easy to incorporate into daily practice (62.1%, 95% CI 59.9 to 64.3), particularly conflicts of interest (35.3%, 95% CI 28.0 to 42.7) and self-awareness (32.0%, 95% CI 24.9 to 39.1). Role-modeling was the teaching method most residents preferred. Barriers to practicing professionalism included time constraints, workload, and difficulties interacting with challenging patients. Promoters included role-modeling by faculty and colleagues and a culture of professionalism. Regarding duty hour limits, residents perceived less time to communicate with patients, continuity of care, and accountability toward their colleagues, but felt that limits improved professionalism by promoting resident well-being and teamwork.

Conclusions

Residents perceive challenges to incorporating professionalism into their daily practice. The duty hour implementation offers new challenges and opportunities for negotiating the principles of professionalism.

SUBMITTER: Ratanawongsa N

PROVIDER: S-EPMC1924703 | biostudies-literature | 2006 Jul

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Residents' perceptions of professionalism in training and practice: barriers, promoters, and duty hour requirements.

Ratanawongsa Neda N Bolen Shari S Howell Eric E EE Kern David E DE Sisson Stephen D SD Larriviere Dan D

Journal of general internal medicine 20060701 7

<h4>Background</h4>The Accreditation Council for Graduate Medical Education duty hour requirements may affect residents' understanding and practice of professionalism.<h4>Objective</h4>We explored residents' perceptions about the current teaching and practice of professionalism in residency and the impact of duty hour requirements.<h4>Design</h4>Anonymous cross-sectional survey.<h4>Participants</h4>Internal medicine, neurology, and family practice residents at 3 teaching hospitals (n=312).<h4>Me ...[more]

PMID: 16808778

Similar Datasets

Project description:BackgroundAlthough direct patient care is necessary for experiential learning during residency, inpatient perceptions of the roles of resident and attending physicians in their care may have changed with residency duty hours.ObjectiveWe aimed to assess if patients' perceptions of who is most involved in their care changed with residency duty hours.DesignThis was a prospective observational study over 12 years at a single institution.ParticipantsParticipants were 22,408 inpatients admitted to the general medicine teaching service from 2001 to 2013, who completed a 1-month follow-up phone interview.Main measuresPercentage of inpatients who reported an attending, resident, or intern as most involved in their care by duty hour period (pre-2003, post-2003-pre-2011, post-2011).Key resultsWith successive duty hour limits, the percentage of patients who reported the attending as most involved in their care increased (pre-2003 20 %, post-2003-pre-2011 29 %, post-2011 37 %, p < 0.001). Simultaneously, fewer patients reported a housestaff physician (resident or intern) as most involved in their care (pre-2003 20 %, post-2003-pre-2011 17 %, post-2011 12 %, p < 0.001). In multinomial regression models controlling for patient age, race, gender and hospitalist as teaching attending, the relative risk ratio of naming the resident versus the attending was higher in the pre-2003 period (1.44, 95 % CI 1.28-1.62, p < 0.001) than the post-2003-pre-2011 (reference group). In contrast, the relative risk ratio for naming the resident versus the attending was lower in the post-2011 period (0.79, 95 % CI 0.68-0.93, p = 0.004) compared to the reference group.ConclusionsAfter successive residency duty hours limits, hospitalized patients were more likely to report the attending physician and less likely to report the resident or intern as most involved in their hospital care. Given the importance of experiential learning to the formation of clinical judgment for independent practice, further study on the implications of these trends for resident education and patient safety is warranted.

Project description:BackgroundTo enhance the development of a curriculum in professionalism for medical students, the aim of this research was to evaluate medical students' responses regarding professionalism teaching and behaviors in their clinical experience at the Arabian Gulf University (AGU).MethodsA retrospective cross-sectional, questionnaire-based study involving Year 5 medical students at the AGU. We used a "climate of professionalism" survey that consisted of two parts. The first part asked students to rate their perceptions of the frequency of professionalism practices of their peers (medical students), residents, and faculty. The response choices included: "mostly", "sometimes", and "rarely". The second part asked the students to assess their perceptions of the professionalism teaching and behaviors of the faculty. The response choices included: "mostly", "sometimes", and "rarely". We calculated an overall score for the responses in both parts of the questionnaire by assigning 3, 2, and 1 points to the response choices, respectively. We also calculated subscale scores reflecting different professionalism constructs. We used descriptive statistics and a one-way Analysis of Variance (ANOVA) followed by multiple testing comparisons with Bonferroni correction to examine pairwise comparisons. A p < 0.05 was considered statistically significant.ResultsThe mean total scores of participants' ratings of professional behaviors of medical students, residents, and faculty for each academic year were approximately 60% of the total maximum score. The mean total scores of participants' rating of faculty's teaching and modeling behaviors concerning professionalism were approximately 58% of the maximum score. Compared with similar studies performed in the Arab Region, ratings regarding professional teaching and modeling of professionalism were lower.ConclusionWe recommend the further evaluation of professionalism teaching and behaviors at the AGU and further discussions regarding curriculum reform.

Dataset Information

Residents' perceptions of professionalism in training and practice: barriers, promoters, and duty hour requirements.

Background

Objective

Design

Participants

Measurements

Results

Conclusions

Publications

Residents' perceptions of professionalism in training and practice: barriers, promoters, and duty hour requirements.

Similar Datasets

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