Abstract
Background
Professionalism is identified as a competency of resident education. Best approaches to teaching and evaluating professionalism are unknown, but feedback about professionalism is necessary to change practice and behavior. Faculty discomfort with professionalism may limit their delivery of feedback to residents.
Objectives
A pilot program to implement a 360-degree evaluation of observable professionalism behaviors and determine how its use impacts faculty feedback to residents.
Design
Internal Medicine (IM) residents were evaluated during ambulatory rotations using a 360-degree assessment of professional behaviors developed by the National Board of Medical Examiners®. Faculty used evaluation results to provide individual feedback to residents.
Patients/Participants
Fifteen faculty members.
Measurements and Main Results
Faculty completed pre- and post-intervention surveys. Using a 7-point Likert scale, faculty reported increased skill in giving general feedback (4.85 vs 4.36, p < .05) and feedback about professionalism (4.71 vs 3.57, p < .01) after the implementation of the 360-degree evaluation. They reported increased comfort giving feedback about professionalism (5.07 vs 4.35, p < .05) but not about giving feedback in general (5.43 vs 5.50).
Conclusions
A 360-degree professionalism evaluation instrument used to guide feedback to residents improves faculty comfort and self-assessed skill in giving feedback about professionalism.
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References
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Acknowledgement
The authors thank the NBME® for use of the Assessment of Professional Behaviors instrument and Dr. Stephen Clyman, Margaret Farrell, and Dr. Matthew Holtman for their assistance in the planning, implementation, and design of this project. We are grateful for the assistance of the staff and faculty at Internal Medicine Associates and the residents in the Internal Medicine Residency Program at Mount Sinai Medical Center.
Conflicts of interest
None disclosed.
Funding
Dr. Stark was supported by grants from the Empire Clinical Research Investigator Program, New York State Department of Health and U.S. Department of Health and Human Services, Health Resources and Services Administration CFDA 93–895.
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Appendix: Faculty survey
Appendix: Faculty survey
___________________________________________________________
Please rate your level of skill in giving general feedback to interns/residents:
1 2 3 4 5 6 7
Unskilled Expert
___________________________________________________________
Please rate your level of skill in giving feedback about professionalism to interns/residents:
1 2 3 4 5 6 7
Unskilled Expert
___________________________________________________________
I feel comfortable giving feedback to the interns/residents I work with.
1 2 3 4 5 6 7
Strongly Disagree Strongly Agree
___________________________________________________________
I feel comfortable giving feedback to interns/residents about their knowledge.
1 2 3 4 5 6 7
Strongly Disagree Strongly Agree
___________________________________________________________
I feel comfortable giving feedback to interns/residents about their interpersonal communication skills.
1 2 3 4 5 6 7
Strongly Disagree Strongly Agree
___________________________________________________________
I feel comfortable giving feedback interns/residents about their professional behavior.
1 2 3 4 5 6 7
Strongly Disagree Strongly Agree
___________________________________________________________
I provide feedback to the interns/residents I work with.
1 2 3 4 5 6 7
Never Always
___________________________________________________________
The feedback I give to interns/residents includes an assessment of their medical knowledge.
1 2 3 4 5 6 7
Never Always
___________________________________________________________
The feedback I give to interns/residents includes an assessment of their interpersonal communication skills.
1 2 3 4 5 6 7
Never Always
___________________________________________________________
The feedback I give to interns/residents includes an assessment of their professionalism.
1 2 3 4 5 6 7
Never Always
___________________________________________________________
How important is providing house staff with feedback about medical knowledge?
1 2 3 4 5 6 7
Not at all Important Extremely Important
___________________________________________________________
How important is providing house staff with feedback about interpersonal communication skills?
1 2 3 4 5 6 7
Not at all Important Extremely Important
___________________________________________________________
How important is providing house staff with feedback about professionalism?
1 2 3 4 5 6 7
Not at all Important Extremely Important
___________________________________________________________
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Stark, R., Korenstein, D. & Karani, R. Impact of a 360-degree Professionalism Assessment on Faculty Comfort and Skills in Feedback Delivery. J GEN INTERN MED 23, 969–972 (2008). https://doi.org/10.1007/s11606-008-0586-0
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DOI: https://doi.org/10.1007/s11606-008-0586-0