Teaching professionalism during anesthesiology training

Edelstein, Steven B.; Stevenson, Julia; Broad, Kathleen

doi:10.1016/j.jclinane.2004.10.006

Cited by 22 publications

(19 citation statements)

References 16 publications

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“…Edelstein et al reported that many of the problems of professionalism observed in an operating room arose during periods of heightened stress. 32 Many faculty and residents were aware that the behaviour of individuals was adversely affected primarily when patient management became complicated. Lingard et al reported that tensions relating to a relatively small number of themes (e.g., perceptions of efficiency, safety, resources, and roles) often arose in the operating room.…”

Section: Strategies For Teaching and Modelling Professional Behaviourmentioning

confidence: 99%

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Bahaziq

Crosby

2011

Can J Anesth/J Can Anesth

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Purpose In this review, we examine the association between physician professional behaviour and indicators measuring patient outcomes and satisfaction with care as well the potential for complaints, discipline, and litigation against physicians. We also review issues related to the structured teaching of professionalism to anesthesia residents, including resident evaluation. Source A search of the OVID Medline and PubMed databases was carried out using keywords relevant to the topics under consideration. Program directors of Canadian anesthesiology training programs were also surveyed to assess the current state of professionalism training and evaluation in their programs. Principal findings Unprofessional behaviour is frequently manifested in practice by medical students, residents, and physicians, and it is associated with personality characteristics that are evident early in training. There is a correlation between unprofessional physician behaviours and patient dissatisfaction, complaints, and lawsuits as well as adverse outcomes of care. Physician health and workplace relationships are negatively impacted by such behaviours. Canadian program directors recognize the need to approach the teaching of professionalism in an organized fashion during physician training. Conclusions A framework is provided for defining behavioural expectations, and mechanisms are offered for teaching and evaluating behaviours and responding to individuals with behaviours that persistently breach defined expectations. There is a need to define explicitly not only the expectations for behaviour but also the processes by which the behaviours will be assessed and documented. In addition, emphasis is placed on the nature, order, and magnitude of the responses to behaviours that do not meet expectations.

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Section: Strategies For Teaching and Modelling Professional Behaviourmentioning

confidence: 99%

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Bahaziq

Crosby

2011

Can J Anesth/J Can Anesth

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“…7,8,10 Physicians have a duty to interact with other health care team members in a respectful and appropriate manner; the high-stakes environment of the operating room can add significant levels of stress and push individuals to the limits of acceptable behaviour. 2,7,11 Leadership and collaboration skills are required of anesthesiologists for optimal team functioning. Abundant evidence from the business literature confirms the deleterious impact that disagreeable individuals, be they in leadership positions or peers, can have on the entire workplace.…”

Section: Learning Medical Professionalismmentioning

confidence: 99%

“…2,11,12 National and provincial physician associations, specialty societies, the Royal College of Physicians and Surgeons of Canada, individual universities, and groups of physicians with an interest in physician health have developed programs designed to assist physicians in the maintenance of their own health. 17,18 It has been stated that personality traits common in physicians can make them particularly vulnerable to health problems; they may delay or even completely forego access to health care for themselves.…”

Section: Physician Health (Table 4)mentioning

confidence: 99%

Competency-based professionalism in anesthesiology: Continuing Professional Development

McKenna

Rosen

2012

Can J Anesth/J Can Anesth

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Purpose Fulfilling the current societal expectations for professionalism in medicine requires a clear understanding of the specific skills, attitudes, and behaviours expected of practitioners. This Continuing Professional Development (CPD) module discusses professionalism as it relates to the practice of anesthesiology. Principal findings While many of the attributes of the professional are generic, performance expectations must be interpreted in a specialty-specific context. Anesthesiologists face challenges to their professionalism in the timeconstrained, highly technical and stressful operating room environment. Ongoing shifts in the models of health care delivery require the adaptation of anesthesiology practice to meet changing demands. Consequently, anesthesiologists' practice environment has extended into preoperative assessment units, acute pain services, and perioperative medicine. Application of principles of biomedical ethics, understanding of medico-legal and regulatory aspects of practice, and attention to personal health and career sustainability are intrinsic aspects of professional practice. More recently, focus on adverse event management and continuous quality improvement has created the need for specific skill sets, which must be included in training and continuing professional development programs. The medical education literature suggests teaching and evaluation methods suited to the development of competence in all aspects of professionalism. Finally, professionalism requires the availability of remediation programs for learners and practitioners in difficulty. Conclusion The attitudes, skills, and behaviours that define professionalism in anesthesiology must be taught and evaluated to establish a basic level of competence by the completion of specialty training. Throughout their careers, anesthesiologists must continue their professional development to meet current and future societal expectations and shifting norms of health care delivery.

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“…Les méthodes d'enseignement de l'éthique au cours de la formation des résidents en anesthésie-réanimation ont été rarement rapportées dans la littérature. Parmi ces méthodes, Edelstein et al 10 ont décrit des présenta-tions magistrales suivies de séances de discussion de cas. La Société américaine d'anesthésie, dans son syllabus sur l'éthique (http://www.asahq.org/publications AndServices/EthicsSyllabus.pdf ) 13 , propose des sessions de discussion de cas à partir d'une série de questions pré-établies.…”

Section: Résultatsunclassified

“…Cette compétence comporte des habiletés d'identification, de délibération et de décision et elle est orientée vers le dialogue et l'action. Dans cette perspective, les institutions académiques développent de plus en plus explicitement un enseignement structuré de l'éthique au cours de la formation médicale postdoctorale 6,7,8,9,10 . Parmi les méthodes utilisées, les séances d'apprentissage au raisonnement éthique (ARE) privilégient le travail en petits groupes et l'analyse des problèmes éthiques à partir de cas vécus et présentés par les résidents 11 .…”

Section: Introductionunclassified

Les séances d’apprentissage du raisonnement éthique appliquées à la formation des résidents en anesthésie-réanimation

2007

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Les séances d'apprentissage du raisonnement éthique appliquées à la formation des résidents en anesthésie-réanimation. La conception de l'éthique médicale véhiculée par cet apprentissage s'est adossée sur un modèle collaboratif et dialogique, différent des approches normatives ou prescriptives. Dans ce modèle, l'éthique est ancrée dans la pratique clinique et orientée vers la réflexion, l'action et le dialogue. Elle est une composante de l'expertise professionnelle et peut être déclinée en un ensemble de compétences qui doivent résulter d'apprentissages spé-cifiques. Ces compétences concernent : 1) la perception et l'identification des enjeux et conflits éthiques ; 2) l'analyse et la délibération à partir des données contextuelles ; 3) la prise de décisions raisonnables, c'est-à-dire élaborée avec les personnes impliquées, cohérente avec la délibération et basée sur le discernement des circonstances réelles de la situation et 4) le maintien du dialogue avec toute entité susceptible d'être affectée par la décision. Au-delà de l'acquisition de ces compétences, cette conception de l'éthique vise la formation de futurs médecins qui combinent le « savoir » et le « vouloir » agir au bénéfice de l'autre, aussi bien singulier que collectif, dans le respect de toutes les composantes de la dignité humaine. Ethical reasoning learning sessions applied to postgraduate anesthesiology education Concepts et InnovationsA partir de ces cadres conceptuels, il nous a semblé pertinent de commencer la formation en éthique par des séances d'ARE qui sont une méthode d'analyse de cas appuyée sur des situations concrètes réellement vécues et discutées en petits groupes avec des tuteurs. Les compétences en éthique, visées à l'issue de cette formation préliminaire, ne sont que partielles, encore largement en développement. Les séances d'ARE seront ultérieurement incluses dans un modèle formalisé de l'apprentissage de l'ensemble des compétences éthiques, à partir de plusieurs méthodes éducatives, tout au long du curriculum d'anesthésie-réanimation.Les dix résidents qui étaient en formation dans notre département d'anesthésie réanimation ont participé aux séances d'ARE. Leur niveau académique variait de la première à la quatrième année postdoctorale et leurs apprentissages formels préalables en éthique médicale se limitaient à des lectures et à des discussions personnelles avec leurs superviseurs cliniques. La participation des résidents a été facultative.

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Teaching professionalism during anesthesiology training

Cited by 22 publications

References 16 publications

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency

Competency-based professionalism in anesthesiology: Continuing Professional Development

Les séances d’apprentissage du raisonnement éthique appliquées à la formation des résidents en anesthésie-réanimation

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