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The Learning Environment for Professionalism (LEP) survey effectively tracks medical professionalism over time. While positive behaviors improved, a concerning trend of unfair patient treatment based on personal characteristics was identified.

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Area of Science:

  • Medical Education
  • Professionalism Assessment
  • Healthcare Quality Improvement

Background:

  • Professionalism is crucial for medical training and requires reliable assessment tools.
  • Existing tools may not adequately capture the nuances of the learning environment (LE).

Purpose of the Study:

  • To assess the feasibility and utility of the Learning Environment for Professionalism (LEP) survey for longitudinal monitoring.
  • To identify areas of strength and weakness in medical professionalism within training programs and institutions.

Main Methods:

  • The LEP survey was administered iteratively between 2013 and 2020 across seven training programs at four hospitals.
  • A total of 3783 ratings were analyzed longitudinally using univariate linear regression with Bonferroni correction (p≤.0045).

Main Results:

  • Positive professional behaviors demonstrated a consistent trend over time.
  • Some negative professionalism behaviors showed improvement.
  • A concerning pattern emerged regarding unfair patient treatment by attendings based on financial status, ethnicity, sexual, or religious preferences.

Conclusions:

  • Longitudinal application of the LEP survey is feasible across diverse medical training settings.
  • The LEP survey can identify areas needing attention and acknowledge exemplary professionalism.
  • Continuous monitoring of the learning environment serves as a valuable quality improvement metric for accreditation requirements.