title: Transformative learning in a professional development course aimed at addressing disruptive physician behavior:  a composite case study.
abstract: Disruptive physician behavior presents a challenge to the academic medical center. Such behaviors threaten the learning environment through increasing staff conflict, role modeling poor behaviors to trainees, and, ultimately, posing a risk to patient safety. Given that these physicians are often respected and valued for their clinical skills, many institutions struggle with how to best manage their behaviors. The authors present a composite case study of an academic physician referred to a professional development program for his disruptive behavior. They outline how transformative learning was applied to the development of concrete learning objectives, activities, and assessments for a curriculum aimed at promoting behavior change. Important themes include a safe group process in which the physician's assumptions are critically examined so that through experiential exercises and reflection, new roles, skills, and behaviors are learned, explored, and practiced. Timely feedback to the physician from the institution, colleagues, and administrators is critical to the physician's understanding of the impact of his or her behavior. Ultimately, the physician returns to practice demonstrating more professional behavior. Implications for medical education, prevention, and other professional development programs are discussed.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine, Washington, DC, USA.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Samenow
authors.forename: Linda L M
authors.initials: LL
authors.lastname: Worley
authors.forename: Ron
authors.initials: R
authors.lastname: Neufeld
authors.forename: Tobi
authors.initials: T
authors.lastname: Fishel
authors.forename: William H
authors.initials: WH
authors.lastname: Swiggart
mesh_terms: D000046:Academic Medical Centers; D000378:Agonistic Behavior; D001291:Attitude of Health Personnel; D003479:Curriculum; D034462:Dissent and Disputes; D004502:Education, Medical, Continuing; D006801:Humans; D007400:Interprofessional Relations; D010815:Physician Impairment; D028743:Professional Misconduct; D012073:Remedial Teaching