Open AccessResidents' Perceptions of Professionalism in Training and Practice: Barriers, Promoters, and Duty Hour Requirements
Author(s) -
Ratanawongsa Neda,
Bolen Shari,
Howell Eric E.,
Kern David E.,
Sisson Stephen D.,
Larriviere Dan
Publication year - 2006
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2006.00496.x
Subject(s) - medicine , accreditation , duty , graduate medical education , workload , likert scale , patient safety , cross sectional study , family medicine , medical education , nursing , health care , psychology , developmental psychology , philosophy , theology , pathology , computer science , economics , economic growth , operating system
BACKGROUND: The Accreditation Council for Graduate Medical Education duty hour requirements may affect residents' understanding and practice of professionalism. OBJECTIVE: We explored residents' perceptions about the current teaching and practice of professionalism in residency and the impact of duty hour requirements. DESIGN: Anonymous cross‐sectional survey. PARTICIPANTS: Internal medicine, neurology, and family practice residents at 3 teaching hospitals ( n =312). MEASUREMENTS: Using Likert scales and open‐ended questions, the questionnaire explored the following: residents' attitudes about the principles of professionalism, the current and their preferred methods for teaching professionalism, barriers or promoters of professionalism, and how implementation of duty hours has affected professionalism. RESULTS: One hundred and sixty‐nine residents (54%) responded. Residents rated most principles of professionalism as highly important to daily practice (91.4%, 95% confidence interval [CI] 90.0 to 92.7) and training (84.7%, 95% CI 83.0 to 86.4), but fewer rated them as highly easy to incorporate into daily practice (62.1%, 95% CI 59.9 to 64.3), particularly conflicts of interest (35.3%, 95% CI 28.0 to 42.7) and self‐awareness (32.0%, 95% CI 24.9 to 39.1). Role‐modeling was the teaching method most residents preferred. Barriers to practicing professionalism included time constraints, workload, and difficulties interacting with challenging patients. Promoters included role‐modeling by faculty and colleagues and a culture of professionalism. Regarding duty hour limits, residents perceived less time to communicate with patients, continuity of care, and accountability toward their colleagues, but felt that limits improved professionalism by promoting resident well‐being and teamwork. CONCLUSIONS: Residents perceive challenges to incorporating professionalism into their daily practice. The duty hour implementation offers new challenges and opportunities for negotiating the principles of professionalism.