Neha Sachdev MD Objectives Background Why Professionalism Research Methods Initial Results Interventions TimelineNext Steps Background Northwestern McGaw Family Medicine Residency ID: 1028032
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1. Fostering a Culture of Accountability and Respect: Resident Leadership and Development of a Professionalism CurriculumNeha Sachdev, MD
2. ObjectivesBackgroundWhy Professionalism?Research MethodsInitial Results]InterventionsTimeline/Next Steps
3. BackgroundNorthwestern McGaw Family Medicine ResidencyOne of 11 original Teaching Health Center programsPartnership with Erie Family Health Center (FQHC), Northwestern McGaw Medical Center and Norwegian American Hospital (America’s Essential Hospital)Leadership Emphasis and Culture
4. Why Study Professionalism?ACGME Core Competency / MilestonesCentral to formation of professional identityUnprofessional conduct in learners strongly correlates with future disciplinary actionsResidents identify importance of professionalism education in trainingIncreasing demands on resident-timeRequired for future leadership
5. Research MethodsOutcomes MeasuresQuantitativePre-post-post survey with PMEX24 residents, 6 fellows, 11 faculty members and residency coordinatorQualitativeSmall group interviews with R1 and R2 classes Process Measures Peer to peer formative feedback sessions Longitudinal skill-building sessions Longitudinal case-based sessions
6. PMEX SurveyValidated toolSpecific, observable behaviors9 questions in 4 major categoriesDoctor/Patient SkillsTime ManagementReflective SkillsInterpersonal Skills
7. Assessment- PMEX
8. Characteristics: 21 Respondents-Faculty & Residents, response rate of 62%Pre Results
9. 9Key Findings = Lowest mean scores in Reflective skills, Highest mean scores in Doctor-Patient Relationship skills
10. Interventions Peer to peer feedback sessions on inpatient service CCC formalization with resident presence Formal feedback training- SBI method
11. Timeline Winter/Spring 2014 First Post PMEX Assessment collected Small group interviews with PGY1 and PGY2 residents 6 professional skill-building sessions held with PGY2/PGY3 residents Summer/Fall 2014 First Post PMEX analysis Formal feedback sessions implemented in clinic, MCH service 3 ‘On Doctoring’ sessions held with all residents and faculty 4 ‘On Doctoring’ sessions held with PGY2/3 residents Winter 2015 Second Post PMEX Assessment collected Follow-up small group interviews with PGY2/PGY3 residents
12. Focus Group QuestionsWe are interested in understanding how residents learn about professionalism. How would you define professionalism, what do you think it is? 2) We are interested in understanding your training and educational experiences in professionalism. Can you describe some of the ways that you have learned about professionalism? What has been the best educational experience? Why was this an effective method or approach? Can you describe some of the least effective ways to learn about professionalism? What made that educational experience ineffective?3) What are some of the challenges to teaching professionalism in residency? What are your suggestions on how to teach professionalism effectively during residency?4) Are there any other comments or experiences that you can share that would help us build an effective professionalism curriculum for residents?
13. Focus Group Themes IdentifiedProfessionalism Definitions (positives and negatives) - Respect - Leadership - Patient care & communication - Interprofessional relationships - Learned vs. innate - Self-assessment - Behavior under stress & fatigueMethods of teaching/learning professionalism - Reflection - Didactic - Case-based/situational - Role-modeling/mentors - Code of conduct/standards - Evaluations (Individualized)Difficulties with teaching/identifying professionalism - Skepticism - Blurring of roles (peer vs friend vs colleague) - Time/scheduling
14. Timeline/Next Steps Winter/Spring 2014 First Post PMEX Assessment collected Small group interviews with PGY1 and PGY2 residents 6 professional skill-building sessions held with PGY2/PGY3 residents Summer/Fall 2014 First Post PMEX analysis Formal feedback sessions implemented in clinic, MCH service 3 ‘On Doctoring’ sessions held with all residents and faculty 4 ‘On Doctoring’ sessions held with PGY2/3 residents Winter 2015 Second Post Assessment collected Follow-up small group interviews with PGY2/PGY3 residents
15. “On-Doctoring” CurriculumDefining ValuesThe Impaired PhysicianFinding Inspiration in MedicineLeadership and CommunicationRisk Management and Legal BasicsBalance and WellnessLapses in Professional Conduct
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