Professionalism lapses in health professions training: Navigating the 'Yellow Card' moments for transformative...

Area of Science:

• Medical Education
• Professionalism Studies
• Qualitative Research

Background:

• Professionalism lapses are increasingly reported in health professions training, impacting trainee progression.
• Current understanding of how training programs facilitate professional identity development following lapses is limited.

Purpose of the Study:

• To identify factors that facilitate and impair transformations around professionalism lapses in health professions training programs.
• To explore trainee and faculty perspectives on responding to professionalism lapses.

Main Methods:

• Qualitative study involving interviews with 5 faculty and 20 trainees across various health professions programs.
• Reflexive thematic analysis of verbatim transcripts, informed by social and transformative learning theories.
• Triangulation of faculty and trainee perspectives to ensure comprehensive understanding.

Main Results:

• Professionalism lapses are subjectively defined, influenced by personal, institutional, and situational norms.
• Responses to lapses are affected by power hierarchies, potentially leading to inequitable treatment and superficial trainee engagement.
• Facilitating transformation requires building trainee confidence, agency, trust, and engagement through focused support and advocacy.

Conclusions:

• Addressing professionalism lapses necessitates a nuanced understanding of personal, institutional, and situational dynamics.
• Creating environments that encourage reflection, dialogue, and support can enhance trainee navigation of lapses.
• Effective interventions promote trainee confidence and agency, contributing to professional socialization and identity development.