Presenter: Sarah Z. Cole, DO, FAAFP A Work in Progress (15 minutes) Is there an association between a Family Medicine intern’s sense of professional self-identity & Milestone success? Presenter: Sarah Z. Cole, DO, FAAFP A Work in Progress (15 minutes)

Disclosures I have no disclosures to report

Terms Self-identity Professionalism Professional self-identity (PSI) A dynamic complex of attitudes about one’s self that can be measured (Arthur, 1995) Professionalism Motivating force whereby an occupational group comes together with the purpose to enforce shared promises that ensures public trust (Wynia et al, 2014) Professional self-identity (PSI) An individual’s conceptualization of self in the context of a professional role (Crossley, 2009) .

PSI Questionnaire Developed and validated at the University of Sheffield School of Medicine, UK Completed electronically Residents rank themselves on specific tasks as to whether they “feel”… Like a first day intern Like a second year resident Ready to practice independently Not Applicable There are several

PSI Questionnaire 2. When I am communicating with patients or families 1. When I am working with other healthcare professionals 2. When I am communicating with patients or families 3. When I am assessing patients 4. When working with others in a culturally diverse health care environment 5. When I am considering ethical or moral issues 6. When using patient records 7. When I find myself in an emergency involving a patient 8. When facilitating a patient’s transfer to a higher acuity level of care 9. When reflecting on my practice experience to identify my learning needs 10. When teaching others

Background Do you feel like a doctor yet? Jennifer Allen, MD, PGY-3 Mercy Family Medicine St. Louis Sheffield survey of Professional Self-Identity Voluntary, anonymous 15 MFM Residents (5 per PGY) Conclusion Sense of PSI increases each PGY Residents rated themselves highest in communication with patients/families & work with patient records Residents rated themselves lowest in emergency management & inter-professional work

Question Is there an association between a resident’s sense of PSI and success in FM residency (using Milestones as marker of success)?

Methods Using the Sheffield PSI survey, residents rate their sense of “feeling like a doctor” at the beginning of each PGY Compare to the resident’s ACGME Family Medicine Milestone levels using correlation coefficient Presented as de-identified, aggregate data Deemed Exempt by Mercy Hospital IRB

Methods Correlation Coefficient Indicates whether there is a relationship between two variables A number between -1 and 1 0 = No relationship between the data sets -1 = A strong negative linear relationship, OR inverse relationship 1 = A strong positive linear relationship, OR direct relationship

Results: Positive Correlation (Correlation Coefficient >0.75) PSI-6 When using patient records I feel like PSI-9 When reflecting on my practice to identify learning needs I feel like

Result: Negative Correlation (Correlation Coefficient <-0.75) PSI-2 When communicating with patients I feel like PSI-7 When I find myself in an emergency with a patient I feel like

Results No correlation between PSI and ITE scores Ranking %ile on ERAS Match list

Conclusions FM interns who have a stronger sense of PSI when working with patient records or self-reflecting on practice experience to identify learning needs may achieve earlier Milestone success (direct correlation) with: Advocating for individual and community health Appraising and assimilating scientific evidence Utilizing technology to optimize communication Attaining medical knowledge needed to practice FM Maintaining personal health Performing procedures

Conclusions FM interns who have a weaker sense of PSI when communicating with patients or managing emergent conditions may achieve earlier Milestone success (inverse correlation) in: Caring for patients with chronic conditions Partnering with patient and family Attaining medical knowledge needed to practice FM Maintaining personal health Performing procedures

Discussion How can this information be used early in training for a resident’s individual learning plan? What modifications should be made to residency curriculum? Can PSI be assessed in candidates to program as predictor of success?

Discussion Limitations Single program Limited sample size One class

Special thanks to Jennifer Allen, MD Iesha Clay Draper, OMS-IV

References Arthur, David; Measuring the Professional self-concept of Nurses: Developing a measurement instrument. Nurse Education Today. 1995, 15. 328-335. Crossley, Jim; Vivenkananda-Schmidt, Pirashanthie; The Development and evaluation of a Professional Self-identity Questionaire to measure evolving professional self-identity in health and social care students. Medical Teacher, 2009 31: e603-e607 Wynia, M.K.; Papadakis, M.A.; Sullivan, W. M.; Hafferty, F.W.;. More than a list of values and desired behaviors: a foundational understanding of medical professionalism Academic Medicine. 89(5):712-4, May 2014.

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