1. Enhancing Professionalism in Osteopathic Medical Education AACOM 2007

2. Richard LaBaere, II, D.O., M.PH. Genesys Regional Medical Center DME Assistant Dean – Michigan Region ATSU - KCOM John R. Gimpel, D.O., M.Ed. Vice President for Clinical Skills Testing NBOME Associate Professor of Family Medicine Georgetown University School of Medicine Patricia Sexton, M.S. Assistant Professor, Biochemistry ATSU-KCOM Nehad El-Sawi, Ph.D. Associate Dean for Curriculum & Faculty Enrichment ATSU-SOMA

3. Medical Professionalism What? What is it? Why? Why is it important? When? When does it develop? Who? Who is responsible? How? How do we teach and assess it?

4. Our work today… Introduction Attributes of professionalism Assessment of professionalism Application and evaluation of real-life scenarios Next steps

5. Introduction

6. While the knowledge of medicine and the skills required to practice medicine are vital, how knowledge and skills are applied is perhaps more important …

7. Students are learning from us when we least expect it…

8. Driving Forces: The public The Core Competencies Institutional values

9. Trends Show Impact to State Boards Increasing evidence of correlation between problematic behavior in medical school and subsequent deficiencies in professionalism Papadakis, Terhani, et.al., NEJM, 2005 Papadakis, Hodgson, et.al., Academic Medicine 2004 Murden, Way, et.al., Academic Medicine 2004 Gimpel, Schwartz, et al, GUSOM 2003

10. Attributes of Professionalism

11. A definition: Professionalism is demonstrated through a foundation of …competence, communication skills, and ethical and legal understanding…Professionalism is demonstrated through a foundation of …competence, communication skills, and ethical and legal understanding…

12. …upon which is built the aspiration to wise application of the principles of professionalism -- David Stern and Louise Arnold: Measuring Medical professionalism

14. Mother Teresa on Professionalism “When they come back from their education, they are concerned about titles and offices and parking privileges. So take all of that away from them and send them to the hospice of the dying. There they hold people’s hands, and pray with them and feed them. After six months of that, they typically get things straight again…”

15. Being “Professional” Professionals honor the idea that the rewards of the profession emanate from service, not entitlement The litmus test for professionalism lies in the root of the behavior

16. Assessment of Professionalism

17. Sign Hanging In Einstein’s Office at Princeton “Not everything that counts can be counted, and not everything that can be counted counts.”

18. Competency AssessmentDoes Shows how Knows how Knows Performance assessment in vivo: SPs, Video, Sim, Portfolios, Logs SPs, Video, Sim, Portfolios, Logs Performance assessment in vitro: OSCE, SP-based test, MJTs (Clinical) Context based tests: MCQ, essay type, oral… Factual tests: MCQ, essay type, oral…

19. Learners Value What You Test… Authentic assessment- realistic Admission Practices Institutional plan and symmetry Formative or Summative? Use multiple raters and multiple types of measurement to enhance validity CQI

20. Case Scenarios Report back with the answers to these 3 questions: What is the professionalism issue? What tools would you use to assess professionalism in this instance? What could be done on an individual or institutional level to prevent this behavior from occurring or, to reinforce the behavior?

21. Summary A common definition is important Behaviors and attitudes are learned implicitly and explicitly – we must reward what we value and give effective feedback about inappropriate behavior. Think about the institutional culture you wish to create

22. Continue the Dialogue…