Fostering professionalism requires institutional leadership and faculty buy-in. At the University of Pennsylvania School of Medicine, policies and educational programs were developed to enhance professionalism in three areas: conduct of clinical trials, relations with pharmaceutical manufacturers, and the clinical and teaching environment. Responsible conduct of clinical trials has been addressed with mandatory online education and certification for clinical investigators, but some still fail to recognize conflicts of interest. Activity of pharmaceutical representatives has been strictly regulated, meals and gifts from pharmaceutical companies prohibited, and the role of the pharmaceutical industry in the formulary process and in continuing medical education curtailed. Some faculty members have resented such restrictions, particularly in regard to their opportunity to give paid lectures. Professionalism in the clinical and teaching environment has been addressed with interdisciplinary rounding, experiential learning for medical students and residents in small groups, increased recognition of role models of professionalism, and active management of disruptive physicians. Leadership has been exerted through policy development, open communications, and moral suasion and example. Faculty members have expressed both their support and their reservations. Development of communication strategies continues, including town hall meetings, small groups and critical incident narratives, and individual feedback. The understanding and endorsement of faculty, staff, and trainees are an essential element of the professionalism effort.
"In summary, learning environments and cultures that optimize workload and promote greater professional development have several key features. They facilitate task assignment appropriate to learning, foster robust communication and professionalism skills, and include community-building activities (Table 2) (Mazotti et al. 2011; Chou et al. 2011; Humphrey et al. 2007; Wasserstein et al. 2007). All of these can foster entrustment decisions for clinical tasks. "
[Show abstract][Hide abstract] ABSTRACT: Clinical supervision requires that supervisors make decisions about how much independence to allow their trainees for patient care tasks. The simultaneous goals of ensuring quality patient care and affording trainees appropriate and progressively greater responsibility require that the supervising physician trusts the trainee. Trust allows the trainee to experience increasing levels of participation and responsibility in the workplace in a way that builds competence for future practice. The factors influencing a supervisor's trust in a trainee are related to the supervisor, trainee, the supervisor-trainee relationship, task, and context. This literature-based overview of these five factors informs design principles for clinical education that support the granting of entrustment. Entrustable professional activities offer promise as an example of a novel supervision and assessment strategy based on trust. Informed by the design principles offered here, entrustment can support supervisors' accountability for the outcomes of training by maintaining focus on future patient care outcomes.
Advances in Health Sciences Education 07/2013; 19(3). DOI:10.1007/s10459-013-9474-4 · 2.12 Impact Factor
"Professionalism is increasingly receiving attention in undergraduate as well as postgraduate training programmes (van Mook et al. 2009a, 2009d). Definitions and approaches to teaching and assessment of professionalism are variable (van Luijk et al. 2000; Wasserstein et al. 2007; Viggiano et al. 2007; Smith et al. 2007; Hickson et al. 2007b; van Mook et al. 2009f, 2009e, 2009g). Although most of the published literature on professionalism pertains to promoting professionalism through learning, teaching and assessment (Stern 2006; Wear & Aultman 2006; Thistlethwaite & Spencer 2008; Cruess et al. 2009), reports on unprofessional behaviour of students and physicians frequently draw disproportionate attention (O'Neill 2000; Esmail 2005; Postma et al. 2006; Rynja et al. 2006). "
[Show abstract][Hide abstract] ABSTRACT: Given the changes in society we are experiencing, the increasing focus on patient-centred care and acknowledgement that medical education including professionalism issues needs to continue not only in the residency programmes but also throughout the doctors career, is not surprising. Although most of the literature on professionalism pertains to learning and teaching professionalism issues, addressing unprofessional behaviour and related patient safety issues forms an alternative or perhaps complementary approach. This article describes the possibility of selecting applicants for a medical school based on personality characteristics, the attention to professional lapses in contemporary undergraduate training, as well as the magnitude, aetiology, surveillance and methods of dealing with reports of unprofessional behaviour in postgraduate education and CME.
Medical Teacher 11/2010; 32(11):891-8. DOI:10.3109/0142159X.2010.497823 · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Ground heat field distribution characteristics of Shanghai proper and Pudong New Area have been obtained by using NOAA-11/AVHRR data. The relationship between the remotely sensed temperature and the real temperature is established by using the direct comparison method. Good results are obtained
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