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Resident and Faculty Unprofessionalism in Obstetrics and Anesthesiology
Abstract Number: T-01
Abstract Type: Original Research
Introduction: Unprofessional resident behavior predicts poor performance, increases patient complaints and litigation, and is associated with later adverse actions by state licensing boards. The Liaison Committee on Medical Education, the ACGME, and the American Board of Medical Specialties, all require formal training and assessment of resident professionalism. We aimed to determine the frequency and underlying themes of resident and faculty unprofessionalism in obstetrics and anesthesiology compared to other clinical services at an academic teaching institution.
Methods: After local IRB approval, “Professionalism Button” activations conveniently located on our institutional GME website from July 2013 (inception of the button) through September 2016 were analyzed among 24 clinical services. "Professionalism Button" activations could be for either professionalism lapses or exemplary professional behavior. Professionalism lapses were identified among the following identified themes: “unethical and unprofessional behavior,” “poor patient treatment,” “unprofessional language,” “unprofessional attire,” and “patient endangerment.” Exemplary professional behavior themes identified included: “job well done,” “excellent patient care,” “excellent team player,” and “excellent interpersonal skills.” Frequency data greater than the third interquartile was considered significant.
Results: There were 211 button activations, 143 (67.8%) for professionalism lapses, and 68 (32.2%) for exemplary professional behavior. “Unethical and unprofessional behavior” (49.5%) and “poor patient treatment” (25.9%) were the most common reasons for lapses in professionalism. “A job well done” (30.3%) was the most common reason for exemplary resident professional behavior. Resident professionalism lapses across the 24 clinical services with the highest frequency (>3rd IQR) were Internal Medicine (25.7%), Surgery (17.7%), Emergency Medicine (6.2%), Neurology (6.2%), Neurosurgery (5.3%), and Otolaryngology (5.3%), (Fig). Faculty professionalism lapses across the 24 clinical services with the highest frequency (>3rd IQR) were Internal Medicine (31.6%), Surgery (21.1%), Emergency Medicine (10.5%), Obstetrics and Gynecology (10.5%), Nursing (10.5%), Neurology (5.3%), Orthopaedics (5.3%), and Anesthesiology (5.3%), (Fig).
Conclusions: Clinical services with high inpatient contact had the highest frequency for “Professionalism Button” activations. Faculty (rather than resident) unprofessionalism in the specialties of Obstetrics and Anesthesiology occurred at a higher frequency compared to other specialties.