1. New York University School of Medicine
THE PROFESSIONALISM CURRICULUM AS A CULTURAL CHANGE AGENT IN SURGICAL RESIDENCY EDUCATION
Mark S. Hochberg, M.D., Adina Kalet, M.D., Sondra Zabar, M.D., Colleen Gillespie, PhD., Russell S. Berman, M.D., H. Leon Pachter, M.D. and the SPICE Study Group
Department of Surgery
New York University School of Medicine

2. SPICE NATIONAL STUDY GROUP Surgical Professionalism and Interpersonal Communication Education
Albert Einstein
American College of Surgeons
Association of American Medical
Chiba University (Japan)
Cleveland Clinic
Columbia University-College of Physicians and Surgeons
Cornell
Creighton University
Dartmouth Medical School
Drexel Medical
Emory University
Florida International
Florida State University
Georgetown University Medical
Gold Foundation
Harvard/Beth Israel
Harvard/Brigham and
Hofstra University Medical
King Saud University (Riyadh, Saudi Arabia)
Johns Hopkins
Loyola University Medical
LSU Health Center
Macy Foundation
Maine Medical Center
McGill University
Medical College of Georgia
Michigan State University
Mount Sinai Medical Center
National Board of Medical Examiners
Northwestern University School of Medicine
Ottawa Medical Center
Rush University (Chicago)
Southern Illinois University
SUNY/Downstate
Texas Tech Univ. Health Science Center
Tufts Medical School/Baystate
Tulane University
United States University of Health Sciences
University of Arizona
University of British Columbia (Canada)
University of California, Irvine
University of California San Francisco-Fresno
University of Florida School of Medicine
University of Georgia
University of Hawaii  
University of Illinois-Chicago
University of Illinois-Urbana
University of Kansas
University of Minnesota
University of Missouri-Columbia
University of Missouri-Kansas
University of New Mexico
University of North
University of North Dakota
University of Rochester
University of South
University of Southern California
University of Tennessee/Knoxville
University of Texas/San Antonio
University of Utah
University of Washington Medical School
University of Western Ontario (Canada)
Vanderbilt Medical School
Virginia Commonwealth University
Virginia Tech Medical School
Washington University St. Louis
Wayne State University

3. ACGME SIX CORE COMPETENCIES
Patient care
Medical knowledge
Practice based learning and improvement
Interpersonal and communication skills
Professionalism
Systems based practice
CHALLENGE FOR SURGEONS: #4 AND #5

4. WHEN WAS THE PROFESSIONALISM COMPETENCY MANDATED BY THE ACGME/RRC?
1999
2002
2004
2006

5. ER Transfer to Surgery 5

6. NYU PROFESSIONALISM SEMINAR TOPICS
Advanced Communication Skills for Surgical Practice
Admitting Mistakes - Ethical and Communication Issues
Delivering Bad News – Your Chance to Become a Master Surgeon    
Interdisciplinary Respect  -- Working as a Team  
Working Across Language and Cultures: The Case for Informed Consent     
Medical malpractice and the Surgeon
Stress of Surgical Practice – The Life You Save May Be Your Own

7. OUR TWO QUESTIONS:
Has professionalism education as mandated by the ACGME/RRC in 2002 taken hold?
Is there any evidence that surgical residents’ professionalism skills have improved over time?

8. EVALUATION OF PROFESSIONALISM EDUCATION
STUDY #1 Resident self-assessment of professionalism abilities – annually over four years
STUDY #2 Objective metrics of resident performance during professionalism OSCEs as graded by standardized patients – annually over three years
STUDY #3 SPICE Study Group national survey of 41 departments of surgery

9. STUDY #1 SUBJECTIVE METRICS

10. STUDY # 2 OBJECTIVE METRICS
Studied one cohort of nine surgical residents over a three year period
Each resident completed a six-station OSCE on professionalism each year
The same set of OSCEs are administered as residents entered their PGY1, PGY2 and PGY3 years
Standardized Patients varied over the years – all received similar training; rated each task as “well done”, “partially done” or “not done” by the resident
54 OSCEs per year; total 162 OSCEs over the three year study period

11. STUDY # 2 OBJECTIVE METRICS

12. STUDY #3 SPICE NATIONAL SURVEY

13. STUDY #3 SPICE NATIONAL SURVEY

14. STUDY #3 SPICE NATIONAL SURVEY

15. Let’s go to the videotape
Ending Well 15

16. ER Transfer to Surgery: Take 216

17. FUNDING SUPPORT Josiah Macy, Jr. Foundation
Arthur Vining Davis Foundations

18. THANK YOU! Adina Kalet, MD adina.kalet@nyumc.org
Mark Hochberg, MD
Sondra Zabar, MD

20. Mostly NOT Significant except Ethics: PGY 2 < 420