Institutional Leadership and Faculty Response: Fostering Professionalism at the University of Pennsylvania School of Medicine

University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Academic Medicine (Impact Factor: 2.93). 12/2007; 82(11):1049-56. DOI: 10.1097/ACM.0b013e31815763d2
Source: PubMed


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.

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    • "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). "
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