Ys the message the institution’s goal to support and promote professionalism is not authentic. Finally, negative and disruptive role models should be removed from teaching roles.5,36 HOW SHOULD PROFESSIONALISM BE ASSESSED? Principles for assessing professionalism are listed in Table 3. As with any subject, the reason for assessing professionalism is to determine whether medical learners acquire, and RRx-001 web Practicing physicians have, this core competency. Assessment drives learning; medical learners will Wuningmeisu C custom synthesis attempt to master a subject if they know they will be assessed regarding it (i.e. “They don’t respect what you expect; they respect what you inspect”71). Furthermore, assessing professionalism conveys the message to patients, medical learners, practicing physicians, the public, and others that professionalism is important and valued.50 Consistent with Arnold and Stern’s framework12 are the results of a recent systematic review,72 in which five clusters of professionalism suitable for assessment were identified: commitment to maintaining and improving competence in oneself, others, and systems; adherence to ethical principles; effective interactions with patients and their loved ones; effective interactions with colleagues, allied health care team members, and others within the health care system; and reliability and accountability. In turn, nine clusters of assessment tools were identified: paper-based tests, observed clinical encounters, patients’ opinions, supervisor reports, self-administered rating scales, collated views of coworkers, records of professionalism lapses, critical incident reports, and simulation. Indeed, because of the nature of professionalism, no single tool for assessing professionalism exists. Instead, multiple assessment tools must be used.73,74 An important tool for assessing professionalism is multi-source feedback using 360-degree reviews. Using this tool is feasible in medical learners 25 and feasible, reliable, and valid in practicing physicians.75 Observers should include learners, peers, nurses, and other allied health care staff as each will have different perspectives of the individual’s professionalism. If possible, observations should be made in a variety of settings (e.g. outpatient clinic, inpatient ward, etc.) in which the individual works. Gathering data from multiple observers in variedTable 3. Principles for Assessing Professionalism in Medical Learners and Practicing Physicians (based on Table 4 of Mueller, 200933 with permission of The Keio Journal of Medicine). Multiple assessment tools should be used: Tests of knowledge (i.e. “cognitive base”) Multi-source 360-degree reviews (e.g. by faculty members, peers, allied health care staff [e.g. nurses], and others) Objective structured clinical examinations Patient assessments Simulation Critical incident reports Reviews of patient complaints and professionalism lapses Individuals should know they are being assessed for professionalism Commence at the start and continue throughout individuals’ careers; all levels of the medical hierarchy should be assessed Assessments should be relevant to the individual’s level of education and specialty setting Use collected data for formative and summative feedback and professionalism “portfolios”Rambam Maimonides Medical JournalApril 2015 Volume 6 Issue 2 eTeaching and Assessing Medical Professionalism settings helps ensure the observations are valid.5,76 As “most practicing physicians observe each other’s be.Ys the message the institution’s goal to support and promote professionalism is not authentic. Finally, negative and disruptive role models should be removed from teaching roles.5,36 HOW SHOULD PROFESSIONALISM BE ASSESSED? Principles for assessing professionalism are listed in Table 3. As with any subject, the reason for assessing professionalism is to determine whether medical learners acquire, and practicing physicians have, this core competency. Assessment drives learning; medical learners will attempt to master a subject if they know they will be assessed regarding it (i.e. “They don’t respect what you expect; they respect what you inspect”71). Furthermore, assessing professionalism conveys the message to patients, medical learners, practicing physicians, the public, and others that professionalism is important and valued.50 Consistent with Arnold and Stern’s framework12 are the results of a recent systematic review,72 in which five clusters of professionalism suitable for assessment were identified: commitment to maintaining and improving competence in oneself, others, and systems; adherence to ethical principles; effective interactions with patients and their loved ones; effective interactions with colleagues, allied health care team members, and others within the health care system; and reliability and accountability. In turn, nine clusters of assessment tools were identified: paper-based tests, observed clinical encounters, patients’ opinions, supervisor reports, self-administered rating scales, collated views of coworkers, records of professionalism lapses, critical incident reports, and simulation. Indeed, because of the nature of professionalism, no single tool for assessing professionalism exists. Instead, multiple assessment tools must be used.73,74 An important tool for assessing professionalism is multi-source feedback using 360-degree reviews. Using this tool is feasible in medical learners 25 and feasible, reliable, and valid in practicing physicians.75 Observers should include learners, peers, nurses, and other allied health care staff as each will have different perspectives of the individual’s professionalism. If possible, observations should be made in a variety of settings (e.g. outpatient clinic, inpatient ward, etc.) in which the individual works. Gathering data from multiple observers in variedTable 3. Principles for Assessing Professionalism in Medical Learners and Practicing Physicians (based on Table 4 of Mueller, 200933 with permission of The Keio Journal of Medicine). Multiple assessment tools should be used: Tests of knowledge (i.e. “cognitive base”) Multi-source 360-degree reviews (e.g. by faculty members, peers, allied health care staff [e.g. nurses], and others) Objective structured clinical examinations Patient assessments Simulation Critical incident reports Reviews of patient complaints and professionalism lapses Individuals should know they are being assessed for professionalism Commence at the start and continue throughout individuals’ careers; all levels of the medical hierarchy should be assessed Assessments should be relevant to the individual’s level of education and specialty setting Use collected data for formative and summative feedback and professionalism “portfolios”Rambam Maimonides Medical JournalApril 2015 Volume 6 Issue 2 eTeaching and Assessing Medical Professionalism settings helps ensure the observations are valid.5,76 As “most practicing physicians observe each other’s be.
