Residency Program
Curricula
Area - Core Competency - Professionalism
Professionalism
(2008)
A.
Inpatient Medicine (General inpatient medicine, critical
care medicine, specialty rotations)
Modeling/Mentoring
by managing attending
Demonstrate
respect and compassion for various cultures, ethnicity, and socioeconomic
status
Demonstrate
an awareness of ethical issues
Completion
of duties in a timely manner
Round table
discussions on topics such as medical ethics, marginalized patients
Initiation
of EMR-based technology to provide sign outs on patients for continuity
of care
B.
Ambulatory Medicine (Ambulatory continuity clinic, specialty
rotations, ambulatory medicine rotations)
Modeling/Mentoring
by attending physician
Demonstrate
respect and compassion for various cultures, ethnicity, and socioeconomic
status
Demonstrate
an awareness of ethical issues
Teaching and
expectation of appropriate coding
Review and
justification of appropriate pain medication use
Completion
of duties in a timely manner
C.
Being a Better Clinician
Ethics
Informed Consent
Hospital Documentation
D.
Foundational Lecture Series
Didactic and
interactive sessions are held semiannually
Behavior
Patient Safety
Risk Management
E.
Emergency Medicine
Modeling/Mentoring
by the managing attending
F.
Didactic Session
Practice issues
Health law
Job application/contracts
Medical ethics
small group discussion CCM
G.
Elective
Modeling/Mentoring
by the managing attending
Demonstration
of professional attire and demeanor in the care of patients in various
settings
Demonstrate
punctuality in interactions with attending physicians who are outside
the department of medicine
H.
Residency
Hospital committee
participation
Details:
A. In the
inpatient setting, the resident must demonstrate compassion and
respect in all patient-centered activities. The resident is expected
to carry out all duties in a professional manner, respect the patient's
rights to privacy and autonomy and display sensitivity to patients
from various socioeconomic, cultural and religious backgrounds.
The managing attending interacts closely with the resident and provides
feedback and guidance throughout most of these interactions. In
addition, multidisciplinary rounds occur during the General Inpatient
Medicine and Critical Care Medicine rotations where these topics
are further explored. Residents are evaluated by faculty, peers,
patients and ancillary staff in the area of professionalism. During
the Infectious Disease rotation, residents assist in providing care
for a diverse, multicultural population, where they come to understand
the obstacles to healthcare access and the importance of confidentiality.
B. Residents
learn to treat patients with respect and compassion, to maintain
a professional appearance and demeanor, to consider ethical and
cultural implications, and to attend to all duties in a timely manner
in the care of ambulatory patients.
C. Dr. Richard
Gibson has given a workshop in ethics in the 2007 February Being
a Better Clinician block. This did not occur in the 2008 block due
to scheduling; however, this material will be covered in February
2009. Dr. Trey Lacharite gave workshops to both the PGY-1 and PGY-2
classes about appropriate documentation so that the hospital can
code severity of illness appropriately. Respecting and holding the
system to a high standard is part of overall professionalism.
D. The University
Health System holds a full day of orientation at the beginning of
each year for all incoming residents. Lectures include: (1) using
the health care team,
(2) clinical
documentation with dating and timing notes and orders, avoiding
inappropriate abbreviations, and documenting fully, (3) the “Just
Culture” of safe patient practice, Patient Safety Net, addressing
medical errors, peer review and autopsy (4) JC, core measures and
needle stick protocols, (5) HIPAA (6) Risk Management, informed
consent, grievances, disclosure to families, critical events, state
reportables and litigation, (7) issues in anger management, difficult
patients.
In the Foundational
curriculum, lectures on professionalism and how it affects the practice
of medicine are given. Other topics include patient satisfaction
and the role residents play in achieving patients who are satisfied
with their care, resident problems and “burnout”. The State Volunteer
Mutual Insurance Company (the primary malpractice insurer in TN)
gives an annual workshop at our institution to all residents about
professional practices to help avoid malpractice.
E. Residents
are taught to demonstrate respect and compassion for patients in
the emergent care setting. They are expected to present a professional
appearance and demeanor, demonstrate an understanding of ethical
issues that arise in the provision of care in the emergency setting.
F. Please
see comments regarding lectures given in the listed areas.
G. Residents
who rotate on services outside the Department of Medicine are taught
that punctuality, professional appearance and demeanor and completion
of duties in a timely manner are expected. These experiences provide
the resident an opportunity to learn patient care from the perspective
of varied managing attendings in various settings.
H. In recent
years, residents were encouraged to participate in hospital committees.
With the July 2008 class, we will have both PGY-2 and PGY-3 residents
in hospital-based committees and reporting back to the resident
group on a regular basis.
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