Content

 Learner Modules: Each module is comprised of 10 elements: rationale, questions for reflection, key principles, learning goals, pre and post tests, introduction, content including videos, conclusion, exercises and references. Modules include over 150 videos. Here is a brief synopsis of each of the modules.  

1. Personal Growth and Professional Formation

with Dennis H. Novack, MD (Drexel University College of Medicine)

All healthcare professional organizations have defined the elements of being a professional, and most of these definitions are similar. They emphasize putting the patients’ interests first, respecting patients’ autonomy and commitments to acting with integrity, excellence, caring, altruism, honesty, confidentiality and more. Yet once students graduate and enter practice or postgraduate training, they are not automatically a professional. Two important questions for learners to answer during and after their training are, “How do I become a professional? and What does becoming a professional mean?” This module helps learners answer those questions.

2. Bioethics and Foundations of Professionalism

with Janet Malek, PhD (Baylor College of Medicine), Joseph Carrese, MD (Johns Hopkins Berman Institute of Bioethics) and David Doukas, MD (Tulane University School of Medicine)

Every clinical encounter is an ethical encounter. Healthcare providers have to diagnose with accuracy and treat according to best practices. They must do all this in a way that meets their ethical obligations to their patients and to society. Ethical care means respecting patients as persons, supporting their human right to direct their own care and manage the enormous power given to healthcare providers by society to function independently, perform invasive actions and set their own standards of care. 


3. The Hidden Curriculum and Professional Formation

with Orit Karnieli-Miller, PhD (Tel Aviv University) and Robert Vu, MD (Indiana University School of Medicine)

In healthcare professional training, professional formation focuses on the development of core knowledge, skills, behaviors and commitments that shape beliefs and practices among trained healthcare professionals. Professional formation is shaped by two main categories of influences: internal and external. The internal factors refer to the learners’ core values, perspectives and experiences, along with the resulting attitudes and behaviors. These factors in turn shape the way that learners interact with external factors such as the clinical environment, role models and clinical experiences. This module focuses on the relationship between these factors and emphasizes the learners’ active role in creating their professional identities.

4. The Healthcare Professional's Role in Regulating Peers and the Profession

with Eric Holmboe, MD, FACP, FRCP (ACGME)

Values guide a professional’s behavior. When professionals behave in accord with their values, they feel that they are doing the right thing, at the right time and are content with their work. When professional values are challenged, difficulties arise. Within the process of professional formation, the learners’ values will be challenged. Those experiences will include both positive and negative ones. Although challenging, these can become opportunities for growth and development. The latter can be accomplished through critical observation of the environment, reflection of self and these experiences, and an on-going search for the ways to integrate one’s own values and those of the profession and act accordingly.

5. Social Justice

with Preston Reynolds, MD, PhD (University of Virginia School of Medicine)

The Professionalism Charter, a 2002 statement by the American Board of Internal Medicine, the American College of Physicians and the European Federation of Internal Medicine, asserted that there are three fundamental principles of medical professionalism – the primacy of patient welfare, respect for patient autonomy and the principle of social justice. The Charter stated that, “...physicians should work actively to eliminate discrimination in health care, whether based on race, gender, socioeconomic status, ethnicity, religion or any other social category.” This module highlights questions to understand patients’ social determinants of health, provides reflective questions to uncover biases and offers an internet link to an innovative video on “white privilege.” The module describes the skills necessary to achieve excellence in equity and social justice.

6. Beyond Recovery: Learning and Growing in the Wake of an Error

with Margaret Plews-Ogan, MD, FACP (University of Virginia School of Medicine) and Natalie May, PhD (University of Virginia School of Medicine)

The 1999 report “To Err is Human” brought to the forefront the ubiquitous nature of mistakes in medicine and focused national attention on efforts to prevent errors. Serious mistakes happen to all clinicians. Preventing errors is a critical undertaking, since a recent analysis asserts that medical errors are the third leading cause of death in the U.S. behind heart disease and cancer. Although progress has been made, medicine is a human endeavor, and mistakes will continue to be something that all clinicians must face. Clinicians have a responsibility to report errors and to disclose them to patient and families honestly and with compassion. This module presents conceptual and practical approaches to coping, learning and growing after making a serious error. 


7. Interprofessional Teamwork in Healthcare

with Chris Arenson, MD (Sidney Kimmel Medical College - Thomas Jefferson University), Elizabeth Speakman, EdD, RN, CDE, ANEF (Jefferson College of Nursing), Katrina A. Fritz, MA, BSN, RN (St. Luke's University Health Network) and Janet L. Trial, EdD, CNM, MSN (Keck School of Medicine of USC)

The World Health Organization and the National Academy of Medicine recognize the importance of effective teamwork in reducing medical errors, as well as improving patient safety, patient care and overall healthcare outcomes. To achieve the Triple Aim (improve the patient experience, improve the health of populations and reduce the per capita cost of healthcare), each organization has also identified the need for formal interprofessional education in the identified core competencies of interprofessional teamwork This module describes the elements of an effective team, teamwork barriers and conflict management.


8. Boundary Issues

with Elizabeth Gaufberg, MD, MPH (Harvard Medical School)

The healthcare provider-patient relationship involves a special kind of intimacy. Providers touch patients’ lives and bodies in highly intimate and personal ways. These interactions of caring and warmth must be shared within mutually understood professional boundaries; however, boundary challenges arise regularly in clinical practice. Awareness of these challenges and responses to them that are simultaneously human and professional require mindfulness and practice. This module examines and illustrates the following: Intimacy and professionalism, concepts of boundaries and limits, social and professional behavior norms, discernment and alarms, alarm signal responses, principles for examining and resolving challenges, and strategies and skills for responding to boundary challenges.


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9. Moral Distress and Moral Courage

with Suzana Makowski, MD, MMM, FACP (University of Massachusetts Medical School) and Steven Rosenzweig, MD (Drexel University College of Medicine)

Moral distress was first written about in the nursing literature; however, it has been identified as a concern among all healthcare professionals. A core contributor to moral distress is a sense of powerlessness and/or threat. This can emerge from hierarchical relationships, peer and culture pressure, and institutional policy. This module discusses the potential harms of moral distress, how to identify and address moral distress, and offers strategies for moral courage. 


10. Compassion and Resilience

with Florence Meyer, MD (University of Massachusetts Medical School) and Steven Rosenzweig, MD (Drexel University College of Medicine)

Bringing care and compassion to patients is deeply rewarding and potentially very stressful. This module focuses on building resilience and strength while providing compassionate care as a healthcare provider. It is about building inner stability, strength and resilience and also learning how to take care of oneself while taking care of others. This module discusses skills and practices to create tensile strength, bending with challenges and developing as part of the healthcare team as a community of healers helping each other to be the best.


11. Confidentiality

with Julie Agris, PhD, JD, LLM, FACHE (Stony Brook University School of Medicine) and John Spandorfer, MD (Sidney Kimmel Medical College - Thomas Jefferson University Medical College)

In a study of over 7,000 patients, trust in the physician was found to be one of the top determinants of their adherence to medical advice and their satisfaction with their physicians. A breach of confidentiality, or even the threat of a breach, can destroy trust in the relationship and may undermine trust in the clinician. This module discusses the history of confidentiality and describes commitments to keeping patient information private as stated by professional healthcare organizations, the U.S. legislation that regulates confidentiality and the ramifications of breaches in the age of electronic medical records and the internet. Using case studies, this module guides learners in navigating the confidentiality rules and exceptions.   


12. Creating Organizational Cultures that Foster Professionalism

with Anthony L. Suchman, MD, MA, FAACH, (University of Rochester School of Medicine), Kate J. Morris, RN MSN PhD (Harvard Medical School) and Leslie Laam (University of Rochester)

A large body of evidence shows that the culture of healthcare organizations – the patterns of how people interact – is associated with many dimensions of organizational performance including clinical outcomes, efficiency, financial performance, patient satisfaction, and staff satisfaction and resilience. To foster professional values of respect, compassion, understanding and engagement, healthcare professionals should experience a workplace culture that treats them in the same way they are expected to treat patients and families. This module discusses the principles of culture change and practical methods to effect those changes. At the center of change is good interpersonal communication skills. Other techniques highlighted include relational meeting practices, reflective practices, appreciative debriefing, reflective time-outs, maintaining behavioral accountability, ground rules, feedback, interdependent conversations, managing up, fair process and engagement coaching.

Faculty Development 

Professional Formation was designed to facilitate the traditional informal learning from role models, as well as teach the formal cognitive basis of professionalism. Faculty often need some guidance in becoming effective role-models for professionalism and enhanced knowledge and skills in presenting the concepts and values of professionalism to their learners.

 

This module helps educators reflect and hone their own skills. It can also help them create an effective faculty development program using the sections and videos from this module, as well as from other Professional Formation modules. This module presents a series of content and self-reflective exercises that enrich the teaching of professionalism for healthcare educators. Each teaching program has individual needs, and this module provides resource material that can be used for a series of faculty development workshops. The module describes how to use Professional Formation for small groups of faculty. This can be successfully completed in both distant and in-person learning environments.

Remediation

Professionalism has been identified as a core competency for medical school and residency training and is typically assessed during pre-clinical and clinical training. Trainees have professionalism lapses, since they have never been placed in the complex and often stressful environment of the practice of medicine. Although programs attempt to select for qualities of integrity, compassion, respect for others, altruism and commitment to social justice, there are many conditions that can cause a breech in professional behaviors in the pre-clinical and clinical realms. Trainees are likely to encounter problems, situations or dilemmas that are novel, require a high level of moral reasoning and are often in direct conflict to their own best interest, such as sacrificing time in order to place a patient’s needs above their own. This module guides faculty in helping learners achieve success in professional identify formation and progression along the life cycle from novice to expert during their training.