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Unprofessionalism in anesthesiology: A qualitative study on classifying unprofessional behavior in anesthesiology residency education - 25/04/24

Doi : 10.1016/j.jclinane.2024.111429 
Fei Chen a, , Samuel T. Belgique b, Courtney Canter a, Christy K. Boscardin c, Chelsea Willie d, John D. Mitchell e, f, Kristina Sullivan c, Susan M. Martinelli a
a Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, United States 
b HealthLakeland Regional Health, Lakeland, FL, 33805, United States 
c Department of Anesthesiology and Perioperative Care, University of California San Francisco, San Francisco, CA, 94143, United States 
d Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 53226, United States 
e Department of Anesthesiology, Pain Management, and Perioperative Care, Henry Ford Health, Detroit, MI, 48105, United States 
f Department of Anesthesiology, Michigan State University College of Human Medicine, Grand Rapids, MI, 49503, United States 

Corresponding author at: Department of Anesthesiology, University of North Carolina at Chapel Hill, N2198, CB7010, UNC Hospitals, Chapel Hill, NC 27599-7010, USA.Department of AnesthesiologyUniversity of North Carolina at Chapel Hill, N2198, CB7010, UNC HospitalsChapel HillNC27599-7010USA

Abstract

Study objective

This study aims to identify the domains that constitute behaviors perceived to be unprofessional in anesthesiology residency training programs.

Design

Qualitative study.

Setting

Anesthesiology residency training programs.

Patients

Not applicable. The participants involved residents, fellows, and faculty members purposefully sampled in four US-based anesthesiology residency programs.

Interventions

Participants were asked to submit examples of unprofessional behavior they witnessed in anesthesiology residents, fellows, or faculty members via a Qualtrics link.

Measurements

Not applicable. The behavior examples were independently reviewed and categorized into themes using content analysis.

Main results

A total of 116 vignettes were collected, resulting in a final list of 111 vignettes after excluding those that did not describe behavior exhibited by anesthesiology faculty or trainees. Fifty-eight vignettes pertained to unprofessional behaviors observed in faculty members and 53 were observed in trainees (residents and fellows). Nine unprofessionalism themes emerged in the analysis. The most common themes were VERBAL, SUPERVISION, QUALITY, ENGAGEMENT, and TIME. As to the distribution of role group (faculty versus trainee) by theme, unprofessional behaviors falling into the categories of BIAS, GOSSIP, LEWD, and VERBAL were observed more in faculty; whereas themes with unprofessional behavior primarily attributed to trainees included ENGAGEMENT, QUALITY, TIME, and SUPERVISION.

Conclusion

By reviewing reported professionalism-related vignettes within residency training programs, we identified classification descriptors for defining unprofessional behavior specific to anesthesiology residency education. Findings from this study enrich the definition of professionalism as a multi-dimensional competency pertaining to anesthesiology graduate medical education. This framework may facilitate preventative intervention and timely remediation plans for unprofessional behavior in residents and faculty.

Le texte complet de cet article est disponible en PDF.

Highlights

9 unprofessionalism themes were identified in anesthesiology residency programs.
Unprofessional behaviors most commonly belonged to the VERBAL theme.
Observation of unprofessional behaviors vary based on physician role.

Le texte complet de cet article est disponible en PDF.

Keywords : Anesthesiology, Professionalism, Unprofessional behavior, Graduate medical education


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Vol 95

Article 111429- août 2024 Retour au numéro
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