Moving the needle: Changing the culture around professionalism for faculty as evaluated by medical students
Rationale
Professionalism is an integral aspect of physician growth and development and a core competency in medical education. Clinical experiences and faculty role models are the most powerful determinants of professional behaviors and values in the practice of medicine.1,2 Yet, with significantly greater stress placed on clinical faculty in the last 25 years, there has been increasing concern over an erosion of the attitudes and behaviors of practicing physicians and the resulting negative impact on the professional development of medical students and resident physicians3. Given its importance, faculty professionalism is assessed annually in the American Association of Medical Colleges graduate questionnaire (AAMC GQ) survey of fourth year medical students, providing medical education leaders with data on their performance compared to medical schools nationally, as well as year-over-year trends..
Many schools struggle with faculty professionalism data that is reported through the GQ and their students’ perception of a poorly perceived professional clinical environment. The three schools presenting at this session have received low learning environment scores at different times and have employed interventions to change the culture at their institutions, with varying success, to address the underlying root causes.
In this session, we will discuss overall challenges of addressing the learning environment and faculty professionalism. After that, each student will report its GQ data, root causes identified, and interventions to address those root causes. After the presentations, participants will break out into small groups and, using a structured guide, review data from their own schools as well as interventions that have been tried to address those issues. Participants will come together at the end for a facilitated discussion to summarize their conversations and discuss ideas and opportunities to bring to their home institution to improve the learning environment.
Learning Objectives
• Review the quality improvement approach and interventions that have been shown to be effective at improving professionalism at UC Davis, UC Riverside, and UC San Diego
• Develop a list of high-impact interventions that can be utilized to improve professionalism in the learning environment at your institution
• Describe your approach to implementation of interventions unique to your institutionand ways in which these incidents can be shared with the broader educational community
Session Plan
• 10 minutes: Describe why changing professionalism outcomes is a “wicked problem”
• 24 minutes: Review the approach and adoption of interventions at UC Davis, UC Riverside, and UC San Diego where these institutions have strived to improve culture of professionalism (8 mins each)
• 30 minutes: Breakout sessions where participants discuss professionalism challenges at their home institutions and brainstorm interventions to improve their culture.
• 25 minutes: Plenary group discussion to identify consensus approaches and opportunities to enact culture change
Products/materials
• PPT
Experience
• Mithu Molla MD – Director of the Learning Environment, Co-Chair Learning Climate Committee, UCD SOM
• Sharad Jain MD – Associate Dean for Students, Co-Chair Learning Climate Committee, UCD SOM
• Mark Servis MD – Vice Dean for Medical Education, UCD SOM
• Christina Granillo, PhD - Director of Academic Success, Chair of the Grievance Committee and co-Chair of our Learning Environment Council
• Michelle Daniel, MD, MHPE, FACEP - Vice Dean for Medical Education, Professor of Clinical Emergency Medicine UC San Diego SOM
• Emma M Simmons MD, MPH – Senior Associate Dean of Student Affairs, UC Riverside SOM
Bibliography
1- Orit Karnieli-Miller, PhD, et al. Medical Students’ Professionalism Narratives: A Window on the Informal and Hidden Curriculum. Academic Medicine, Vol 85, No.1/January 2010
2- Inui TS, et al. A Flag in the Wind: Educating for Professionalism in Medicine. Washington DC: Association of American Medical Colleges; 2003.
3- Swick H, et al. Teaching Professionalism in Undergraduate Medical Education. JAMA, September 1, 1999- Vol 282, No.9
4- Binder R, et al. Preventing and Managing Unprofessionalism in Medical School Faculties. Acad Med. 2015;90:442-446