title: The professionalism curriculum as a cultural change agent in surgical residency education.
abstract: BACKGROUND
  Teaching professionalism effectively to fully engaged residents is a significant challenge. A key question is whether the integration of professionalism into residency education leads to a change in resident culture.
  
  
  METHODS
  The goal of this study was to assess whether professionalism has taken root in the surgical resident culture 3 years after implementing our professionalism curriculum. Evidence was derived from 3 studies: (1) annual self-assessments of the residents' perceived professionalism abilities to perform 20 defined tasks representing core Accrediting Council on Graduate Medical Education professionalism domains, (2) objective metrics of their demonstrated professionalism skills as rated by standardized patients annually using the objective structure clinical examination tool, and (3) a national survey of the Surgical Professionalism and Interpersonal Communications Education Study Group.
  
  
  RESULTS
  Study 1: aggregate perceived professionalism among surgical residents shows a statistically significant positive trend over time (P = .016). Improvements were seen in all 6 domains: accountability, ethics, altruism, excellence, patient sensitivity, and respect. Study 2: the cohort of residents followed up over 3 years showed a marked improvement in their professionalism skills as rated by standardized patients using the objective structure clinical examination tool. Study 3: 41 members of the national Surgical Professionalism and Interpersonal Communications Education Study Group rated their residents' skills in admitting mistakes, delivering bad news, communication, interdisciplinary respect, cultural competence, and handling stress. Twenty-nine of the 41 responses rated their residents as "slightly better" or "much better" compared with 5 years ago (P = .001). Thirty-four of the 41 programs characterized their department's leadership view toward professionalism as "much better" compared with 5 years ago.
  
  
  CONCLUSIONS
  All 3 assessment methods suggest that residents feel increasingly prepared to effectively deal with the professionalism challenges they face. Although professionalism seminars may have seemed like an oddity several years ago, residents today recognize their importance and value their professionalism skills. As importantly, department chairpersons report that formal professionalism education for residents is viewed more favorably compared with 5 years ago.
authors: Department of Surgery, New York University Medical Center, 550 First Ave., NBV 15 N1, New York, NY 10016, USA. mark.hochberg@nyumc.org
authors: Mark S
authors: MS
authors: Hochberg
authors: Russell S
authors: RS
authors: Berman
authors: Adina L
authors: AL
authors: Kalet
authors: Sondra R
authors: SR
authors: Zabar
authors: Colleen
authors: C
authors: Gillespie
authors: H Leon
authors: HL
authors: Pachter
mesh_terms: D000328:Adult; D000533:Altruism; D001291:Attitude of Health Personnel; D003142:Communication; D016265:Conflict of Interest; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D004992:Ethics, Medical; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D007400:Interprofessional Relations; D008297:Male; D009519:New York City; D016544:Patient Simulation; D010817:Physician-Patient Relations; D018907:Privacy; D011361:Professional Competence; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D014342:Truth Disclosure