Empowering trainees to promote professionalism

Area of Science:

• Medical Education
• Professionalism in Healthcare
• Behavioral Science

Background:

• Unprofessional behavior in medical settings can negatively impact patient care.
• Empowering trainees to address peer misconduct promotes accountability and a professional learning environment.
• Addressing incidents not witnessed by supervisors is crucial for comprehensive professionalism training.

Purpose of the Study:

• To train medical trainees in effectively addressing observed unprofessional behavior among colleagues.
• To evaluate the impact of this training on the direct addressing, reporting, or ignoring of unprofessional incidents.
• To assess changes in the resolution satisfaction of addressed incidents 6-12 months post-training.

Main Methods:

• Eighty-four trainees participated in objective structured clinical examination (OSCE) scenarios focused on addressing inappropriate behavior.
• Baseline and follow-up surveys (6-12 months post-OSCE) collected data on witnessed incidents and intervention methods.
• Intervention methods included direct addressing (with satisfaction rating), reporting, or ignoring unprofessional behavior.

Main Results:

• A significant increase in identified unprofessional incidents was observed post-training (1.12 to 1.69 per resident).
• The percentage of directly addressed incidents rose from 43% to 61%, with satisfactory resolution increasing from 43% to 79%.
• Trainees were significantly more likely to address incidents directly than to report them (p=0.001).

Conclusions:

• The training intervention effectively increased the rate of trainees addressing unprofessional behavior and improved satisfaction with these interventions.
• The intervention successfully promoted a culture of professionalism by empowering trainees to manage peer misconduct.
• While addressing and reporting rates changed, the proportion of unaddressed/unreported incidents remained similar.