Role Modeling

Role Modeling & Professionalism
Instructor Name
Residents will learn the impact their
behavior and conduct have on others
as an instructor and throughout their
At the end of the session, the learner will
be able to:
 Define professionalism & its importance
 Describe characteristics of a good &
bad role modeling
 Explain how to measure professionalism
through evaluation
Have you personally observed or
benefited from working with physicians
who consistently demonstrated the best
qualities of patient care, clinical
judgment and professionalism?
ACGME Competencies
Patient Care
Medical Knowledge
Interpersonal and Communication Skills
Practice Based Learning & Improvement
Systems Based Practice
Defining Professionalism: ACGME
Professionalism is commitment to
carrying out professional
responsibilities, adherence to ethical
principles, and sensitivity to a diverse
patient population.
 How to you demonstrate it?
 How do you measure it?
 Does it really matter?
 How do you teach it?
Measuring Professionalism w/
Demonstrates respect, compassion, integrity
Responsive and accountable to needs of
patients, society and the profession
Committed to excellence
Ethical in clinical care, patient
confidentiality, informed consent, and
business practices
Sensitive to culture, age, gender, disabilities
Does it Matter?
Medical School Behavior
Disciplinary action by state medical
board was strongly associated with
unprofessional behavior in medical
Strongest Associations
Those described as irresponsible
Those w/ diminished ability to improve
their behavior
Papadakis, et al, NEJM 353:2673-82
Does it Matter?
What about Residency?
Does performance during residency
predict likelihood of future disciplinary
actions against practicing physicians?
Papadakis et al, Ann Intern Med 2008;148:869-76
Study Design
Retrospective cohort IM residents
Trained from 1990 to 2000
425 AGCME accredited programs
66, 171 residents
Compared ABIM certification evaluation by
program directors (global form), 1-9 scale to
future disciplinary action by state board
 Unprofessional behavior (83%)
 Incompetence (1%)
Disciplinary Actions by State
Boards: Unprofessional Behavior
Failure to meet CME
Fraud/billing (medicare/aid)*
Controlled substance Rx violations
Substance abuse (self)*
Sexual misconduct*
Professional conduct (pt safety)
Convicted of a crime*
Records (maintain, misrepresent)
Fail to conform to minimal practice
*most associated with loss of license
 Only 1% of diplomates were
during the 17 year study interval
 Median years to first action 11 yrs
(3 – 16)
 Number of disciplinary actions 4.1
(1 – 48)
Papadakis et al, Ann Intern Med 2008;148:869-76
 Most physicians don’t get into trouble
 Most residents with “issues” hopefully
resolve them
 Or not egregious enough?
 Patient safety issues
What Makes a Role Model?
Positive Role Models
Clinical Attributes
Skilled (technical and clinical reasoning)
Personal Attributes
Attentive to patients and to students
Passionate about work
Strategies to Improve Role
Cruess, S. R, Cruess, R. L, Steinert, Y. (2008). Role modelling--making the most of a powerful
teaching strategy. BMJ 336: 718-721
Be aware of being a role model
Demonstrate clinical competence
Protect time for teaching
Show a positive attitude for what you do
Implement a student centered approach to
Strategies con’t
Facilitate reflection on clinical experiences
and what has been modeled
Encourage dialogue with colleagues
Engage in pertinent staff development
Work to improve the institutional culture
Whenever possible be explicit about what
you are modeling
What do your students think?
UAB Medical Student Clerkship
Intern Evaluation
 Dr. Intern was an outstanding mentor
in facilitating my medical education. I
could not have asked for a more
professional, devoted individual who
always seemed to place the interests of
the patients and his team members
above those of his own.
Intern Evaluation
 He is an excellent role model and is
extremely helpful and approachable.
He is always available for questions
about any patient on the team. He
takes time to teach. He made my
experience on medicine very enjoyable.
Intern Evaluation
 She is an excellent intern. She is very
knowledgeable, approachable, and
dedicated to teaching students. She
takes the time to go over assessment
and plans with students, and she allows
students the opportunity to write
admission and daily orders. One of the
best interns I have seen.
Resident Evaluation
 I loved working with Dr. X. She was
very constructive with us and really
helped me improve my differentials, my
notes, and my thought process in
working up patients. She interacts well
with patients and shows genuine
concern for them. She is an excellent
role model.
Intern Evaluation
Dr. X was always available for questions
and concerns. He was a great
individual to work with. He presented
an image of what a medical student
should strive towards.
Resident Evaluation
 Dr. X. does an excellent job integrating
all members of the team, including
medical students, into roles that allow
them to contribute to the whole. He is
extremely patient with students when
they express difficulty with a concept.
Things to Remember
 The first steps to becoming a positive role
model is recognize your behavioral habits.
 A moment of lost composure that translates
into snapping at a nurse or belittling a
patient, reflects on you and, ultimately, may
influence the practices and habits of your
 Realize your habits can be habit-forming for
 Professionalism is a require ACGME
 Don’t underestimate your influence
 Positive role model
 Life long efforts to maintain our
 Thank you for all you do
They may forget what you said, but
they will never forget how you made
them feel.
-Carol Buchner
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