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Leadership & Professionalism: Practical Tools in the Workplace for Residency Training Officers

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  1. Leadership & Professionalism: Practical Tools in the Workplace for Residency Training Officers Erlyn A. Sana, PhD <erlynsana@yahoo.com.ph>

  2. The resident’s workplace: the ward

  3. The resident’s workplace: the OPD

  4. The Ob-Gyn resident’s workplace • Conference Rooms • Library • Lecture Halls • Classrooms with peers and/or consultants • Call room • Obstetrics Admission Section (OBAS) • Consultation Room • Labor Room • Delivery Room • Operating Room • Intensive Maternal Unit

  5. The Ob-Gyn resident’s teaching-learning milieu TOs

  6. Professional roles & general terminal competencies expected of residents Leadership & Professionalism

  7. Professionalism • Those sets of values that sustain the interest of the patient above one’s own self-interest, • Entails a wide range of attitudes and behaviours such as altruism, humility, commitment to excellence, duty & commitment to service, honour & respect for others, integrity & compassion, and accountability to patients, colleagues and society • American Board of Internal Medicine (CPA Bulletin, 2002)

  8. Leadership • The process through which an individual attempts to intentionally influence another individual or a group in order to accomplish a goal. • Locus of leadership: a person • Focus of leadership: other individual or groups • Most critical element: influence • Shortell and Kaluzny, 1997

  9. Leadership traits • Personal: integrity, courage, discipline, loyalty, a sense of justice, sacrifice, honor, unselfishness, tact, decisiveness, reliability, moral character & enthusiasm • Leadership skills and techniques • Intellectual breadth • Intellectual depth • Resident Leadership Webinar

  10. The trouble with attitudes as learning outcomes: When we follow codes of conduct or rules of decorum, we are often just play acting, acting appropriately in outer conduct, irrespective of what is in our hearts. Sherman, 2005 ; cited in Rees, & Knight, Acad Med, 2007

  11. Characterization Organization Valuing Responding Receiving The Affective Domain of Learning(Krathwohl, et al., 1960) Consistency Compliance Identification Internalization

  12. Practical tools to teach leadership & professionalism Workplace Approaches to teach Clinical (experiential) teaching-learning Actual clinical work Bedside teaching Rounds Endorsements Audits • Clinical environment (Accreditation Council for Graduate Medical Education, 2004) Teaching : facilitating, explaining, clarifying, closing consciously by the experiential learning cycle, inculcating, indoctrination, role modelling, and values clarification

  13. Practical tools to teach leadership & professionalism Workplace Approaches to teach Lectures Simulations Cooperative and team learning Independent study Discussions and seminars • Classrooms and other related settings (Accreditation Council for Graduate Medical Education, 2004) Teaching : facilitating, explaining, clarifying, closing consciously by the experiential learning cycle, inculcating, indoctrination, role modelling, and values clarification

  14. Testing implications of concepts in new situations (Behavioral) Observations & Reflections (Perceptual) Formation of abstract Concepts & generalizations (Symbolic) The experiential learning cycle (Kolb, 1984) Concrete Experience (Affective)

  15. The Ob-Gyn resident’s teaching-learning milieu

  16. Values clarification(Raths, 1960) • Choosing: Asking residents about the choices they made in given circumstances • Prizing : asking residents if they are satisfied with their choices • Acting: asking and observing residents if they can publicly affirm their choices

  17. Consultant Fellow SR Resident JR Resident Intern Nurse NA Manong Bantay Pasyente Clerks Germs Food chain in Ward X (Sana, 2001)(By order of harassment)

  18. Facilitating learning Competence Approachability Respectability Confidence Orderliness Caring Inhibiting learning Temper/mood Inconsistency Discouraging Ingratitude Anxiety Impulsiveness Consultants’ personal attitudes and effects to residents (Morada, 2003)

  19. Assessment(Best and Khan, 1989) • The collection of data, organizing them to measure how the learners have achieved the expected levels of competencies as a result of instruction

  20. The Nature of Assessment Standard Constructs of leadership & professionalism Applying the Standard Measurement Collecting relevant data Constructing tests Making questionnaires Determining who accomplishes tools When and for how much (content valid)

  21. Valid raters of attitudes (Henerson, et al, 1987)

  22. When to assess

  23. Types of Assessment used for leadership & professionalism (Norcini & Burch, 2007)

  24. Innovations in clinical evaluations (Norcini & Burch, 2007) Simulated /Controlled Naturalistic / Work place Case based discussion Direct Observation of Procedural Skills (DOPS) Structured Clinical Operative Test (SCOT) Mini-CEX (www.hcat.nhs.uk) • Objective Structured Clinical Examination (OSCE) • Objective Structured Assessment of Technical Skills (OSATS) • OSOE (Oral Examination) • OSPE (Practical Examination) Value of feedback The teaching-learning environment The environment for assessment

  25. The Ob-Gyn resident’s teaching-learning milieu