title: Ethics and professionalism in medical physics: a survey of AAPM members.
abstract: OBJECTIVE
  To assess current education, practices, attitudes, and perceptions pertaining to ethics and professionalism in medical physics.
  
  
  METHODS
  A link to a web-based survey was distributed to the American Association of Physicists in Medicine (AAPM) e-mail membership list, with a follow-up e-mail sent two weeks later. The survey included questions about ethics/professionalism education, direct personal knowledge of ethically questionable practices in clinical care, research, education (teaching and mentoring), and professionalism, respondents' assessment of their ability to address ethical/professional dilemmas, and demographics. For analysis, reports of unethical or ethically questionable practices or behaviors by approximately 40% or more of respondents were classified as "frequent."
  
  
  RESULTS
  Partial or complete responses were received from 18% (1394/7708) of AAPM members. Overall, 60% (827/1377) of the respondents stated that they had not received ethics/professionalism education during their medical physics training. Respondents currently in training were more likely to state that they received instruction in ethics/professionalism (80%, 127/159) versus respondents who were post-training (35%, 401/1159). Respondents' preferred method of instruction in ethics/professionalism was structured periodic discussions involving both faculty and students/trainees. More than 90% (1271/1384) supported continuing education in ethics/professionalism and 75% (1043/1386) stated they would attend ethics/professionalism sessions at professional/scientific meetings. In the research setting, reports about ethically questionable authorship assignment were frequent (approximately 40%) whereas incidents of ethically questionable practices about human subjects protections were quite infrequent (5%). In the clinical setting, there was frequent recollection of incidents regarding lack of training, resources and skills, and error/incident reporting. In the educational setting, incidents of unethical or ethically questionable practices were only frequently recollected with respect to mentorship/guidance. With respect to professional conduct, favoritism, hostile work/learning environment, and maltreatment of subordinates and colleagues were frequently reported. A significantly larger proportion of women reported experiences with hostile work/learning environments, favoritism, poor mentorship, unfairness in educational settings, and concerns about student privacy and confidentiality.
  
  
  CONCLUSIONS
  The survey found broad interest in ethics/professionalism topics and revealed that these topics were being integrated into the curriculum at many institutions. The incorporation of ethics and professionalism instruction into both graduate education and postgraduate training of medical physicists, and into their subsequent lifelong continuing education is important given the nontrivial number of medical physicists who had direct personal knowledge of unethical or ethically questionable incidents in clinical practice, research, education, and professionalism.
authors.affiliation: Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois 60637, USA. nozturk@radonc.uchicago.edu
authors.forename: Naim
authors.initials: N
authors.lastname: Ozturk
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Armato
authors.forename: Maryellen L
authors.initials: ML
authors.lastname: Giger
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Serago
authors.forename: Lainie F
authors.initials: LF
authors.lastname: Ross
mesh_terms: D001290:Attitude; D003625:Data Collection; D004522:Educational Status; D006283:Health Physics / Q000193:education* / Q000941:ethics*; D011361:Professional Competence / Q000706:statistics & numerical data*; D014481:United States
references.citation: Acad Med. 2002 Dec;77(12 Pt 1):1226-34
references.pmid: 12480632
references.citation: J Appl Clin Med Phys. 2012 Jul 05;13(4):4010
references.pmid: 22766958
references.citation: Br J Radiol. 2007 Dec;80(960):955-66
references.pmid: 17971477
references.citation: J Am Coll Radiol. 2005 Feb;2(2):198-9
references.pmid: 17411794
references.citation: Acad Med. 2012 Jul;87(7):877-82
references.pmid: 22622208
references.citation: Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1590-5
references.pmid: 15817367
references.citation: Nature. 2005 Jun 9;435(7043):737-8
references.pmid: 15944677
references.citation: Int J Radiat Oncol Biol Phys. 2010 Oct 1;78(2):321-2
references.pmid: 20832662
references.citation: J Am Coll Radiol. 2012 Mar;9(3):170-3
references.pmid: 22386162
references.citation: Neurosurgery. 2006 Oct;59(4):749-55; discussion 755-8
references.pmid: 17038940
references.citation: Acad Med. 2005 Apr;80(4):400-8
references.pmid: 15793027
references.citation: PLoS One. 2009 May 29;4(5):e5738
references.pmid: 19478950
references.citation: Int J Radiat Oncol Biol Phys. 2008;71(1 Suppl):S162-5
references.pmid: 18406918
references.citation: Med Phys. 2012 Dec;39(12):7272-90
references.pmid: 23231278
references.citation: Teach Learn Med. 2007 Winter;19(1):20-9
references.pmid: 17330995
references.citation: Acad Med. 2004 Apr;79(4):319-25
references.pmid: 15044163
references.citation: JAMA. 2012 May 9;307(18):1899-901
references.pmid: 22570448
references.citation: Med Phys. 2010 Aug;37(8):4495-500
references.pmid: 20879608
references.citation: Med Phys. 2003 Dec;30(12):3049-50
references.pmid: 14713069
references.citation: Sci Eng Ethics. 2008 Sep;14(3):323-36
references.pmid: 18615274