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Setting Expectations on Professionalism in Residency: Orientation Workshop on Common Professionalism Issues. Jayne M. Peterson, MD Banner Good Samaritan Medical Center. Professionalism in Residency. One of 6 Core Competencies required for board certification by the ABIM

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Setting Expectations on Professionalism in Residency:Orientation Workshop on Common Professionalism Issues

Jayne M. Peterson, MD

Banner Good Samaritan Medical Center

professionalism in residency
Professionalism in Residency
  • One of 6 Core Competencies required for board certification by the ABIM
  • Traditionally difficult to define, to “measure” and to teach
  • “Unwritten rules” only “discovered when you make a mistake”


Medical Professionalism. Chicago: ACGME, 2006 (Accessed Jan. 8, 2007 at

Stern, D, Papadakis, M. The Developing Physician – Becoming a Professional. NEJM 2006;355:1794-9.

setting expectations in our residency
Setting Expectations in Our Residency
  • Resident Manual
  • Orientation for PGY 1 prior to starting residency
  • Workshop for PGY 2’s prior to moving to supervisory role with follow up workshop in early PGY 3 year
  • Monthly orientation to each new rotation
  • Advisor Meetings twice per year
definitions of professionalism
Definitions of Professionalism
  • Prokos = Trust
  • Respect - for patients & families, peers, other healthcare team members
  • Appropriate behavior – polite, dedicated, compassionate, hardworking, timely, well groomed, honest, maintain confidentiality
unprofessional behavior examples observed by attendings
Unprofessional Behavior Examples Observed by Attendings
  • Not taking responsibility for errors, communicating with patient’s family members
  • Not following “pay back rules”, leaving work undone or not insuring continuity of care during handoffs, not working as a team, falsely calling out “sick”
  • Discussing patients in a nonprofessional manner in multidisciplinary meetings
  • Being late for clinical duties without good reason
  • Poor communication skills in difficult situations
  • Poor appearance both in dress and attitude/interest
  • Criticizing other staff & colleagues in public
resident observed unprofessional behavior
Resident Observed Unprofessional Behavior
  • Gossiping about other members of healthcare team
  • Yelling at ancillary staff
  • Talking about patients in elevator
  • Residents shirking post call duties to interns, or not assisting in workload
  • Bad attitudes – “getting hits” or “whining”
  • Asking for weekdays off so have less patients “schedule squabbling”
  • Poor “checkouts” & leaving early
  • “putting down” students & interns
  • Poor conference attendance
  • Calling in sick or not showing up for expected duties
why do you think this unprofessional behavior occurred
Why do you think this unprofessional behavior occurred?
  • Stress/time issues
  • No consequences
  • Fatigue/frustration
  • “People are not secure in who they are” “just their personality” “arrogance”
  • Clinical duties not well defined/uncomfortable with role in health team
personal professionalism plans
Personal Professionalism Plans
  • Open your envelope from 2007
  • Did you do what you said you would do?
  • Do you have a way to measure your change?
professionalism quality improvement
Professionalism Quality Improvement

Identify Something you want to change:

  • Plan – What are your opportunities & barriers to change? How will I know that the change was effective?
  • Do – Try it
  • Study – Measure the change
  • Act – See if you can incorporate the change in your life. Start the cycle over again.
summary of pdsa cycle
Summary of PDSA Cycle





example jayne peterson
Example – Jayne Peterson

Opportunity: Time Management – I waste too much time looking for things on my desk

Plan – Organize my desk & then deal with each item only once – toss it, file it, or complete it.

Do – schedule clean up date, get a new on-desk file system

Study – In one month – is my desk still clean and can I find what I need?

Act – If in one month it is working – I will keep this system and move on to my book shelf.

resident small group discussion
Resident Small Group Discussion
  • How can we improve professionalism in our residency program?
  • What do you think should be the consequence of unprofessional behavior?
  • Does it matter what the behavior is?
  • Share a personal professional plan for 2008-2009 with your group and how you plan to measure it.