The purpose of the competency in Professionalism is to integrate and evaluate demonstrated respect, compassion and integrity; to evaluate residents’ responsiveness to patients and staff; to develop their personal and professional accountability as well as commitment to on-going personal and professional development; and to augment their sensitivity and responsiveness to issues regarding gender, culture, age, disability, and other pertinent issues. It is noted that Professionalism is a dynamic on-going process throughout the career of the PM&R physician.
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1. Supervised teaching: Attending physician/faculty will directly observe residents’ professional competencies in a multiple of settings which will include, but not be limited to:
- Outpatient clinics, to include senior continuity clinic
- Rotation-based patient care settings
- Inpatient settings
- Didactic and other scheduled conferences
2. Semi-Annual Review – twice per year, residents meet with Program Directors to discuss numerous issues including, but not limited to, professional development and performance. During this meeting Program Directors provide feedback on the resident’s professional development and performance.
3. Residency Committee – if the resident’s performance is of significant concern, Program Directors will refer the matter to the Residency Committee who will become involved in assessing and developing a plan to improve the resident’s Professionalism competency.
4. Orientation – During initial orientation, residents are provided with professional expectations for the program and given information about resources available at MSU, EWSH, and other sites. Professional expectations are also covered at alternate sites to address specifications pertinent to each rotation experience.
5. Didactic presentations — Residency program conducts specific didactic sessions during the rotating cyclic core curriculum which includes issues of medical ethics, professional development, the business of medicine, and medical legal considerations, and other topics.
6. Portfolios — Residents are expected to keep portfolios of their activities as part of their professional development. Portfolios are considered a collection of documents taken from residents’ actual didactic and clinical experiences, chosen by the resident (with advice from attending physicians and other faculty) to demonstrate their competency and to document learning and achievement related to an established learning plan. It is expected that the portfolio’s characteristic will be that of self-assessment, reflection on what has benn learned, and that they will be developed in a self-directed manner. Portfolios should be initiated and developed in a longitudinal manner to allow the tracking of progress. The purpose of portfolios is to provide an informative evaluation and allow the exhibition of “best work” on progress over time, diverse assignments, and other activities. Portfolios are designed to assist professionalism, personal growth, and scholarly achievement. It is expected that portfolios will include, but not be limited to, the following contents:
- A record of clinical procedures
- Summary of literature reviews used to make treatment decisions
- Patient or family counseling (or of junior residents, medical students, etc.)
- Research conducted (tracking of increased knowledge of research methods)
- Journal clubs attended
- Research Committee participation
- Research on line
- course participation
- Participation in a research activity
- Community/volunteer activity
- Examples of H&P’s, discharge summaries, and other medical records
- Curriculum vitae
- Presentations developed/given
- Lists of procedures completed
- Lists of specific disease processes treated.
- Fraud and HIPAA Training:
- All residents complete required fraud and HIPAA training at appropriate constituent institutions.
- At the start of, and throughout, the program, residents will care for patients with very complicated psychosocial conditions and presentations. Residents may care for patients with conditions and socio-economic or psychosocial issues that they themselves find unpleasant, however residents will be expected to treat all patients with respect and dignity and to provide the best possible best patient care regardless of their personal feelings. PM&R residents will provide care for patients in an inpatient and outpatient setting with very diverse cultural and ethnic backgrounds. Residents will come in contact with a patient mix from rural, suburban and urban communities as well as areas of wide variation in economic, educational, ethnic, religious, and other social characteristics. Throughout the program, residents will be expected to work with and care for people from various diverse backgrounds.
- Learning venue:
- Every resident activity is a learning venue for the professionalism competency.
Resident performance will be evaluated through supervised activities in hospital rotations, clinics and other venues. Residents will be routinely evaluated on professional performance in all rotations. These evaluations are collected in the electronic data base.
- Residents will also be evaluated at the semi-annual review regarding professional development and performance. Specific attention will be paid to performance in stressful or complicated situations involving patients, rehabilitation team members, and other circumstances. Residents whose performance in the area of professionalism is of concern will initially be dealt with by the Program Directors; should there be serious or multifaceted concerns, the Residency Committee may then meet to formulate specific educational objectives for remediation of assessed deficits.
- Residents will routinely complete evaluations, electronically, of faculty for each rotation they complete. These evaluations will include assessments of faculty members’ commitment to teaching and patient care, humanism, accessibility, and professional abilities. Residents will also complete evaluations of the program and rotations completed to assess effectiveness of the Professionalism related curriculum and the quality of instruction in this competency area.
The residency program is affiliated with the College of Human Medicine at Michigan State University, who’s Center for Bioethics and Medical Humanities is recognized nationally in the area of medical ethics. The Colleges of Human Medicine and Osteopathic Medicine have a rich tradition of dedication to encouraging strong, highly ethical professional behavior at all levels. Current limitations of the curriculum in this area is that it is very difficult to, in a totally objective fashion, evaluate residents in the area of professionalism. Strategies will be pursued by program leadership to increase the objectivity of resident evaluations in these areas.
The following is a partial list of expectations of residents throughout the curriculum in the area of professionalism:
- Administrative competence (the ability to be punctual, and complete tasks as assigned, following directions, and respond in a timely and courteous way to staff and patient care needs, including pages, abnormal test results, and patient care issues).
- Demonstrate understanding concerning moral and ethical concerns about receiving gifts from patients and pharmaceutical representatives.
- Recognize that physicians have responsibilities for the safety and well being of patients, colleagues, and staff.
- Demonstrate respect and compassion for all patients.
- Understand and recognize errors and notify attending physicians and, when appropriate, others when errors are made.
- Demonstrate the ability to be trustworthy and to always tell the truth.
- Perform patient referral, as well as coding and billing activities in an honest, forthright manner.
- Demonstrate the ability to maintain patient confidentiality and encourage others to do so.
- Manifest an interest in helping provide compassionate, quality care to all patients.
- Demonstrate an understanding that the physician’s prime concern is the patient’s interest in a physician-patient relationship.
- Demonstrate the ability to understand and work with patients and their families regarding issues such as advanced directives, resuscitation status, community reintegration, and discharge planning.
- Demonstrate the ability to address educational development, through proactive teaching, to medical students, interns, and other health care professionals.
The following objectives are those which we expect residents should be able to do in a routine fashion. These differ from the previous objectives which must be done regardless of circumstances and that, while expected, would not necessarily be appropriate regardless of circumstance:
- Understand the importance of and demonstrate the ability to discuss difficult issues such as poor prognosis, diagnosis of permanent disability, etc. with patients and their families.
- Consistently demonstrate self-directed learning (spontaneously present literature and evidence related to patient care).
- Demonstrate the ability to discuss and defend their own ethical understanding of their relationship with pharmaceutical representatives.
- Demonstrate the ability to provide coverage for colleagues who may be ill or need to be absent from regular responsibilities.
- Consistently demonstrate intellectual curiosity.
- Provide leadership in the residency program and in rehab team settings.
- Volunteer for activities that are for the good of the program such as interviewing prospective candidates, provide teaching of medical students, participate in activities such as Residency Committee, etc.
- Participate in community organizations or other activities as a volunteer.
Revision Date: 7//2008