Behaviors of highly professional resident physicians. Export

@article{citeulike:3496521, abstract = {CONTEXT: Unprofessional behaviors in medical school predict high stakes consequences for practicing physicians, yet little is known about specific behaviors associated with professionalism during residency. OBJECTIVE: To identify behaviors that distinguish highly professional residents from their peers. DESIGN, SETTING, AND PARTICIPANTS: Comparative study of 148 first-year internal medicine residents at Mayo Clinic from July 1, 2004, through June 30, 2007. MAIN OUTCOME MEASURES: Professionalism as determined by multiple observation-based assessments by peers, senior residents, faculty, medical students, and nonphysician professionals over 1 year. Highly professional residents were defined as those who received a total professionalism score at the 80th percentile or higher of observation-based assessments on a 5-point scale (1, needs improvement; 5, exceptional). They were compared with residents who received professionalism scores below the 80th percentile according to In-Training Examination (ITE) scores, Mini-Clinical Evaluation Exercise (mini-CEX) scores, conscientious behaviors (percentage of completed evaluations and conference attendance), and receipt of a warning or probation from the residency program. RESULTS: The median total professionalism score among highly professional residents was 4.39 (interquartile range [IQR], 4.32-4.44) vs 4.07 (IQR, 3.91-4.17) among comparison residents. Highly professional residents achieved higher median scores on the ITE (65.5; IQR, 60.5-73.0 vs 63.0; IQR, 59.0-67.0; P = .03) and on the mini-CEX (3.95; IQR, 3.63-4.20 vs 3.69; IQR, 3.36-3.90; P = .002), and they completed a greater percentage of required evaluations (95.6\%; IQR, 88.1\%-99.0\% vs 86.1\%; IQR, 70.6\%-95.0\%; P < .001) compared with residents with lower professionalism scores. In multivariate analysis, a professionalism score in the top 20\% of residents was independently associated with ITE scores (odds ratio [OR] per 1-point increase, 1.07; 95\% confidence interval [CI], 1.01-1.14; P = .046), mini-CEX scores (OR, 4.64; 95\% CI, 1.23-17.48; P = .02), and completion of evaluations (OR, 1.07; 95\% CI, 1.01-1.13; P = .02). Six of the 8 residents who received a warning or probation had total professionalism scores in the bottom 20\% of residents. CONCLUSION: Observation-based assessments of professionalism were associated with residents' knowledge, clinical skills, and conscientious behaviors.}, author = {Reed, D. A. and West, C. P. and Mueller, P. S. and Ficalora, R. D. and Engstler, G. J. and Beckman, T. J.}, citeulike-article-id = {3496521}, citeulike-linkout-0 = {http://dx.doi.org/10.1001/jama.300.11.1326}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18799445}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18799445}, day = {17}, doi = {10.1001/jama.300.11.1326}, issn = {1538-3598}, journal = {JAMA : the journal of the American Medical Association}, keywords = {education, professionalism, residents}, month = {September}, number = {11}, pages = {1326--1333}, posted-at = {2008-11-08 14:45:30}, priority = {2}, title = {Behaviors of highly professional resident physicians.}, url = {http://dx.doi.org/10.1001/jama.300.11.1326}, volume = {300}, year = {2008} }

TY - JOUR ID - citeulike:3496521 L3 - citeulike-article-id:3496521 N2 - CONTEXT: Unprofessional behaviors in medical school predict high stakes consequences for practicing physicians, yet little is known about specific behaviors associated with professionalism during residency. OBJECTIVE: To identify behaviors that distinguish highly professional residents from their peers. DESIGN, SETTING, AND PARTICIPANTS: Comparative study of 148 first-year internal medicine residents at Mayo Clinic from July 1, 2004, through June 30, 2007. MAIN OUTCOME MEASURES: Professionalism as determined by multiple observation-based assessments by peers, senior residents, faculty, medical students, and nonphysician professionals over 1 year. Highly professional residents were defined as those who received a total professionalism score at the 80th percentile or higher of observation-based assessments on a 5-point scale (1, needs improvement; 5, exceptional). They were compared with residents who received professionalism scores below the 80th percentile according to In-Training Examination (ITE) scores, Mini-Clinical Evaluation Exercise (mini-CEX) scores, conscientious behaviors (percentage of completed evaluations and conference attendance), and receipt of a warning or probation from the residency program. RESULTS: The median total professionalism score among highly professional residents was 4.39 (interquartile range [IQR], 4.32-4.44) vs 4.07 (IQR, 3.91-4.17) among comparison residents. Highly professional residents achieved higher median scores on the ITE (65.5; IQR, 60.5-73.0 vs 63.0; IQR, 59.0-67.0; P = .03) and on the mini-CEX (3.95; IQR, 3.63-4.20 vs 3.69; IQR, 3.36-3.90; P = .002), and they completed a greater percentage of required evaluations (95.6%; IQR, 88.1%-99.0% vs 86.1%; IQR, 70.6%-95.0%; P < .001) compared with residents with lower professionalism scores. In multivariate analysis, a professionalism score in the top 20% of residents was independently associated with ITE scores (odds ratio [OR] per 1-point increase, 1.07; 95% confidence interval [CI], 1.01-1.14; P = .046), mini-CEX scores (OR, 4.64; 95% CI, 1.23-17.48; P = .02), and completion of evaluations (OR, 1.07; 95% CI, 1.01-1.13; P = .02). Six of the 8 residents who received a warning or probation had total professionalism scores in the bottom 20% of residents. CONCLUSION: Observation-based assessments of professionalism were associated with residents' knowledge, clinical skills, and conscientious behaviors. IS - 11 JF - JAMA : the journal of the American Medical Association SN - 1538-3598 EP - 1333 TI - Behaviors of highly professional resident physicians. VL - 300 SP - 1326 KW - education KW - professionalism KW - residents AU - Reed, DA AU - West, CP AU - Mueller, PS AU - Ficalora, RD AU - Engstler, GJ AU - Beckman, TJ PY - 2008/09/17/ UR - http://dx.doi.org/10.1001/jama.300.11.1326 ER -