Enhancing professionalism in post-graduate medical education: the initial implementation and evaluation of a longitudinal curriculum for geriatrics residents in Toronto, Canada
DOI :
https://doi.org/10.36834/cmej.79033Résumé
Background: Professionalism is vital in medicine, yet gaps exist in its teaching within post-graduate medical education (PGME).
Methods: We developed an eight-session curriculum on professionalism for geriatrics residents at the University of Toronto. Topics included personal-professional identity, physician well-being, communication, and leadership, incorporating a focus on self-reflection throughout. We evaluated the curriculum in two ways: (1) we captured immediate reactions using standard evaluations with Likert-scale questions on teaching effectiveness. (2) Graduated residents participated in semi-structured interviews to assess deeper reactions and longer-term impacts on professional identity and practice. Interview transcripts were rigorously analyzed using thematic.
Results: The teaching effectiveness scores averaged from 80 written evaluations were excellent: 4.45/5 (89%). We interviewed 12 of 22 eligible graduates (55%). Thematic analysis demonstrated that the curriculum impacted residents in three key thematic areas: (1) it led participants to understand their role as physicians in a more comprehensive way, while staying consistent with their personal values and strengths. (2) Communication skills training in particular equipped learners with important skills needed to enact their professional standards. (3) Through developing a supportive community and practicing mindful self-reflection, participants reported improvements in their well-being.
Conclusions: This paper demonstrates that professionalism can and should be integrated into the formal curriculum of post-graduate medical education. Key success factors in our study included a focus on fostering peer support and training in communication skills as a concrete method to actualize personal professional standards.
Références
1. Martin LD, Zadinsky JK. Frequency and outcomes of workplace incivility in healthcare: a scoping review of the literature. J Nurs Manag. 2022 Oct 1;30(7):3496-518. https://doi.org/10.1111/jonm.13783
2. Mgboji GE, Woreta FA, Fliotsos MJ, et al. Prevalence of incivility between ophthalmology and emergency medicine residents during interdepartmental consultations. AEM Educ Train. 2021 Oct 1 ;5(4):e10653. https://doi.org/10.1002/aet2.10653
3. Berger AS, Niedra E, Brooks SG, Ahmed WS, Ginsburg S. Teaching professionalism in postgraduate medical education: a systematic review of published curricula. Acad Med. 2019. https://doi.org/10.1097/ACM.0000000000002987
4. Altirkawi K. Teaching professionalism in medicine: what, why and how? Sudan J Paediatr. 2014;14(1):31-8.
5. Birden H, Glass N, Wilson I, Harrison M, Usherwood T, Nass D. Defining professionalism in medical education: a systematic review. Med Teach. 2014 Jan;36(1):47-61. https://doi.org/10.3109/0142159X.2014.850154
6. Birden H, Glass N, Wilson I, Harrison M, Usherwood T, Nass D. Teaching professionalism in medical education: a Best Evidence Medical Education (BEME) systematic review. BEME Guide No. 25. Med Teach. 2013 Jul;35(7):e1252-66. https://doi.org/10.3109/0142159X.2013.789132
7. Frank JR, Snell L, Sherbino J Editors. CanMEDS 2015 Physician Competency Framework. Ottawa: Royal College of Physicians and Surgeons of Canada. 2015. p. 1-30. Available from: http://www.royalcollege.ca/portal/page/portal/rc/canmeds/resources/publications
8. Irby DM, Hamstra SJ. Parting the clouds: three professionalism frameworks in medical education. Acad Med. 2016 Dec;91(12):1606-11. https://doi.org/10.1097/ACM.0000000000001190
9. Cruess SR, Cruess RL, Steinert Y. Supporting the development of a professional identity: general principles. Med Teach. 2019 Jun 3;41(6):641-9. https://doi.org/10.1080/0142159X.2018.1536260
10. Kern DE, Thomas PA, Hughes MT. Curriculum development for medical education. Baltimore, Maryland: The Johns Hopkins University Press; 2009. 58-78 p.
11. Verkerk MA, de Bree MJ, Mourits MJ. Reflective professionalism: interpreting CanMEDS' “professionalism.” J Med Ethics. 2007;33(11):663-6. https://doi.org/10.1136/jme.2006.017954
12. Smidt A, Balandin S, Sigafoos J, Reed VA. The Kirkpatrick model: a useful tool for evaluating training outcomes. J Intellect Dev Disabil. 2009 Sep 19;34(3):266-74. https://doi.org/10.1080/13668250903093125
13. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006 Jan;3(2):77-101. https://doi.org/10.1191/1478088706qp063oa
14. Candela A. Exploring the function of member checking. Qual Report. 2019 Mar 24; https://doi.org/10.46743/2160-3715/2019.3726
15. Wolf ZR. Exploring the audit trail for qualitative investigations. Nurse Educ. 2003;28(4):175-8. https://doi.org/10.1097/00006223-200307000-00008
16. Cruess R, McIlroy JH, Cruess S, Ginsburg S, Steinert Y. The professionalism mini-evaluation exercise: A preliminary investigation. Acad Med. 2006. ;81(10 SUPPL.). https://doi.org/10.1097/00001888-200610001-00019
17. Cataldo KP, Peeden K, Geesey ME, Dickerson L. Association between Balint training and physician empathy and work satisfaction. Fam Med. 2005 May;37(5):328-31.
18. McCue JD. A stress management workshop improves residents' coping skills. Arch Intern Med. 1991;151(11):2273. https://doi.org/10.1001/archinte.1991.00400110117023
19. Chin H, Ingerman Å, Block L, Hergès HO. Navigating the complex dynamics of anesthesiologists' professional identity formation in the context of their specialty training program: a phenomenographic perspective. BMC Med Educ. 2024 May 15;24(1):539. https://doi.org/10.1186/s12909-024-05527-7
20. Pawlina W. Not “how should I learn?” or “how should I act?” but, “who shall I become?”: a précis on the roots of early professional identity formation in the anatomy course. Anat Sci Educ. 2019 Sep;12(5):465-7. https://doi.org/10.1002/ase.1914
21. Cope A, Bezemer J, Mavroveli S, Kneebone R. What attitudes and values are incorporated into self as part of professional identity construction when becoming a surgeon? Acad Med. 2017 Apr;92(4):544-9. https://doi.org/10.1097/ACM.0000000000001454
22. Jarvis-Selinger S, Pratt DD, Regehr G. Competency is not enough: integrating identity formation into the medical education discourse. Acad Med. 2012 Sep;87(9):1185-90. https://doi.org/10.1097/ACM.0b013e3182604968
23. Holden MD, Buck E, Luk J, et al. Professional identity formation: creating a longitudinal framework through TIME (Transformation in Medical Education). Acad Med. 2015 Jun;90(6):761-7. https://doi.org/10.1097/ACM.0000000000000719
24. Ng SL, Baker L, Cristancho S, Kennedy TJ, Lingard L. Qualitative research in medical education. In Chichester, UK: John Wiley & Sons, Ltd; 2018. p. 427-41. https://doi.org/10.1002/9781119373780.ch29
25. Tanujaya B, Prahmana R, Mumu J. Likert Scale in social sciences research: problems and difficulties. FWU J Soc Sci. 2023 Jan 24;16:89-101. https://doi.org/10.51709/19951272/Winter2022/7
26. Boggild MK, Gold WL, Richardson L, Kinoshita K. Incorporating living from the heart into medical education. Med Teach. 2018 Jun 3;40(6):639-40. https://doi.org/10.1080/0142159X.2018.1426849
27. Mead E. PERMA model activities & worksheets to apply with clients. 2020. Available from https://positivepsychology.com/happiness-wellbeing-coaching-perma/#worksheets.
28. Emanuel EJ, Emanuel LL. Four models of the physician-patient relationship. JAMA. 1992 Apr 22;267(16):2221-6. https://doi.org/10.1001/jama.1992.03480160079038
29. Ho A. "They just don't get it!" When family disagrees with expert opinion. J Med Ethics. 2009 Aug;35(8):497-501. https://doi.org/10.1136/jme.2008.028555
30. Tinetti M, Naik A, Dindo L. Conversation guide and manual for identifying patients' health priorities. 2018. Available from: https://patientprioritiescare.org/wp-content/uploads/2018/11/Conversation-Guide-for-Patients-and-Caregivers-for-Identifying-their-Health-Priorities.pdf [Accessed Nov 24, 2022].
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© Kristina M Kokorelias, Muhammad Harris Sheikh, Maryam Naimi, Bernice Ho, Edwin W Wong, Stephanie G Brooks, Dov Gandell, Arielle S Berger 2025
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