Journal of General Internal Medicine

, Volume 23, Issue 7, pp 969–972 | Cite as

Impact of a 360-degree Professionalism Assessment on Faculty Comfort and Skills in Feedback Delivery

Brief Report

Abstract

Background

Professionalism is identified as a competency of resident education. Best approaches to teaching and evaluating professionalism are unknown, but feedback about professionalism is necessary to change practice and behavior. Faculty discomfort with professionalism may limit their delivery of feedback to residents.

Objectives

A pilot program to implement a 360-degree evaluation of observable professionalism behaviors and determine how its use impacts faculty feedback to residents.

Design

Internal Medicine (IM) residents were evaluated during ambulatory rotations using a 360-degree assessment of professional behaviors developed by the National Board of Medical Examiners®. Faculty used evaluation results to provide individual feedback to residents.

Patients/Participants

Fifteen faculty members.

Measurements and Main Results

Faculty completed pre- and post-intervention surveys. Using a 7-point Likert scale, faculty reported increased skill in giving general feedback (4.85 vs 4.36, p < .05) and feedback about professionalism (4.71 vs 3.57, p < .01) after the implementation of the 360-degree evaluation. They reported increased comfort giving feedback about professionalism (5.07 vs 4.35, p < .05) but not about giving feedback in general (5.43 vs 5.50).

Conclusions

A 360-degree professionalism evaluation instrument used to guide feedback to residents improves faculty comfort and self-assessed skill in giving feedback about professionalism.

KEY WORDS

professionalism feedback 360-degree evaluation internship residency 

Notes

Acknowledgement

The authors thank the NBME® for use of the Assessment of Professional Behaviors instrument and Dr. Stephen Clyman, Margaret Farrell, and Dr. Matthew Holtman for their assistance in the planning, implementation, and design of this project. We are grateful for the assistance of the staff and faculty at Internal Medicine Associates and the residents in the Internal Medicine Residency Program at Mount Sinai Medical Center.

Conflicts of interest

None disclosed.

Funding

Dr. Stark was supported by grants from the Empire Clinical Research Investigator Program, New York State Department of Health and U.S. Department of Health and Human Services, Health Resources and Services Administration CFDA 93–895.

References

  1. 1.
    ABIM Foundation, ACP-ASIM Foundation, European Federation of Internal Medicine. Medical professionalism in the new millennium: A physician charter. Ann Intern Med. 2002;136:243–6.Google Scholar
  2. 2.
    Accreditation Council on Graduate Medical Education. ACGME Outcome Project 1999 http://www.acgme.org/outcome/comp/compMin.asp. Accessed March 3, 2008.
  3. 3.
    Cruess SR , Cruess RL. Professionalism must be taught. BMJ. 1997;315:1674–7.PubMedGoogle Scholar
  4. 4.
    Jotkowitz AB , Glick S , Porath A. A physician charter on medical professionalism: A challenge for medical education. Eur J Intern Med. 2004;15:5–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Reynolds PP. Reaffirming professionalism through the education community. Ann Intern Med. 1994;120:609–14.PubMedGoogle Scholar
  6. 6.
    Cohen JJ. Professionalism in medical education, an American perspective: From evidence to accountability. Med Educ. 2006;40:607–17.CrossRefPubMedGoogle Scholar
  7. 7.
    Cruess RL. Teaching professionalism: theory, principles, and practices. Clin Orthop Relat Res. 2006;449:177–85.PubMedGoogle Scholar
  8. 8.
    Stern DT. Practicing what we preach? An analysis of the curriculum of values in medical education. Am J Med. 1998;104:569–75.CrossRefPubMedGoogle Scholar
  9. 9.
    Ende J. Feedback in clinical medical education. JAMA. 1983;250:777–81.CrossRefPubMedGoogle Scholar
  10. 10.
    Hewson MG , Little ML. Giving feedback in medical education: Verification of recommended techniques. J Gen Intern Med. 1998;13:111–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Branch WT , Paranjape A. Feedback and reflection: Teaching methods for clinical settings. Acad Med. 2002;77:1185–8.CrossRefPubMedGoogle Scholar
  12. 12.
    The National Board of Medical Examiners. Assessment of Professional Behaviors 2006–2007 Field Trial http://professionalbehaviors.nbme.org/OverviewForWeb.pdf. Accessed March 23, 2007.
  13. 13.
    Lynch DC , Surdyk PM , Eiser AR. Assessing professionalism: A review of the literature. Med Teach. 2004;26:366–73.CrossRefPubMedGoogle Scholar
  14. 14.
    Musick DW , McDowell SM , Clark N , Salcido R. Pilot study of a 360-degree assessment instrument for physical medicine & rehabilitation residency programs. Am J Phys Med Rehabil. 2003;82:394–402.CrossRefPubMedGoogle Scholar
  15. 15.
    Wood J , Collins J , Burnside ES , et al. Patient, faculty, and self-assessment of radiology resident performance: A 360-degree method of measuring professionalism and interpersonal/communication skills. Acad Radiol. 2004;11:931–9.PubMedGoogle Scholar
  16. 16.
    Joshi R , Ling FW , Jaeger J. Assessment of a 360-degree instrument to evaluate residents' competency in interpersonal and communication skills. Acad Med. 2004;79:458–63.CrossRefPubMedGoogle Scholar
  17. 17.
    Higgins RS , Bridges J , Burke JM , O'Donnell MA , Cohen NM , Wilkes SB. Implementing the ACGME general competencies in a cardiothoracic surgery residency program using 360-degree feedback. Ann Thorac Surg. 2004;77:12–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Papadakis MA , Hodgson CS , Teherani A , Kohatsu ND. Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board. Acad Med. 2004;79:244–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Papadakis MA , Teherani A , Banach MA , et al. Disciplinary action by medical boards and prior behavior in medical school. N Engl J Med. 2005;353:2673–82.CrossRefPubMedGoogle Scholar

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Rachel Stark
    • 1
  • Deborah Korenstein
    • 2
  • Reena Karani
    • 3
  1. 1.Department of MedicineMontefiore Medical Center/Albert Einstein College of MedicineNew YorkUSA
  2. 2.Division of General Internal MedicineMount Sinai School of MedicineNew YorkUSA
  3. 3.Brookdale Department of Geriatrics and Adult DevelopmentMount Sinai School of MedicineNew YorkUSA

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