title: Perspective:  the education community must develop best practices informed by evidence-based research to remediate lapses of professionalism.
abstract: In July 2011, the Alpha Omega Alpha Honor Medical Society sponsored a think tank of experts in the field of medical professionalism to focus on interventions and remediation strategies for those-medical students, residents, faculty, and practicing physicians-who demonstrate lapses in professional performance, particularly if the lapses are repeated. Several participants have produced scholarly work on the assessment of professionalism. However, assessment has a limited purpose unless it leads to improvements at both the organizational and individual levels. The field of professionalism has matured enough to recognize that one of the contemporary issues within the self-regulation framework is the task of remediation. Yet there is a paucity of evidence to inform best practices to help those who have lapses. Ultimately, the most effective response to an individual's lapse in professionalism may not be simply to gather knowledge about remedial practices but also to understand organizational responses to the information about such practices already possessed by the institution.The authors report the think tank participants' recommendations on (1) how to use existing data on professionalism remediation and (2) what new evidence is needed to advance approaches to remediation of professional performance. Participants also recommended that the education community can focus on interventions and remediation by (1) performing studies about improving medical professionalism when lapses occur, (2) identifying best evidence-based remediation practices, (3) widely disseminating those practices, and (4) moving over time from a best-practices approach to remediation (which does not yet exist) to a best-evidence model.
authors.affiliation: Department of Medicine, University of California, San Francisco, CA 94143-054, USA. papadakm@medsch.ucsf.edu
authors.forename: Maxine A
authors.initials: MA
authors.lastname: Papadakis
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Paauw
authors.forename: Frederic W
authors.initials: FW
authors.lastname: Hafferty
authors.forename: Jo
authors.initials: J
authors.lastname: Shapiro
authors.forename: Richard L
authors.initials: RL
authors.lastname: Byyny
mesh_terms: D002983:Clinical Competence; D055317:Evidence-Based Practice; D006126:Group Processes; D006801:Humans; D007396:Internship and Residency; D028743:Professional Misconduct; D013337:Students, Medical