Residents’ perceptions of professionalism in training and practice: Barriers, promoters, and duty hour requirements
- 76 Downloads
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 profession-alism 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.
Key wordsmedical education residency professionalism work hours
Unable to display preview. Download preview PDF.
- 1.ABIM Founation. American Board of Internal Medicine, ACP-ASIM Foundation. American College of Physicians-American Society of Internal Medicine, European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136:243–6.Google Scholar
- 3.ACGME. ACGME Outcome Project. Available at: http://www.acgme.org/outcome/comp/compFull.asp#5. Accessed July 14, 2005. Chicago, IL: ACGME; 1999.Google Scholar
- 4.ACGME. Resident duty hours and the working environment. Available at: http://www.acgme.org/acWebsite/dutyHours/dh_Lang703.pdf. Accessed July 14, 2005. Chicago, IL: ACGME; 2003.Google Scholar
- 9.Miller WL, Crabtree BF. Clinical research: a multimethod typology and qualitative roadmap. In: Miller WL, Crabtree BF, eds. Doing Qualitative Research. 2nd ed. Thousand Oaks, CA: Sage Publications Inc.; 1999:21–3.Google Scholar