title: Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents.
abstract: BACKGROUND
  Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents.
  
  
  METHODS
  As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership 'Basic Training' is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this 'Basic Training'.
  
  
  RESULTS
  Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (p<0.001) in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on 'Basic Training'. All residents responded in the post-test that the STEPP program was valuable, up from 56%.
  
  
  CONCLUSIONS
  A virtue-based approach is valued by residents as a part of leadership training during residency.
authors.affiliation: Division of Otolaryngology, Head and Neck Surgery, Duke University Medical Center, Durham, NC, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Schulz
authors.forename: Liana
authors.initials: L
authors.lastname: Puscas
authors.forename: Debara
authors.initials: D
authors.lastname: Tucci
authors.forename: Charles
authors.initials: C
authors.lastname: Woodard
authors.forename: David
authors.initials: D
authors.lastname: Witsell
authors.forename: Ramon M
authors.initials: RM
authors.lastname: Esclamado
authors.forename: Walter T
authors.initials: WT
authors.lastname: Lee
mesh_terms: D003479:Curriculum; D005260:Female; D006801:Humans; D020407:Internet; D007857:Leadership; D008297:Male; D008889:Military Personnel; D035863:Moral Development; D010036:Otolaryngology / Q000193:education* / Q000941:ethics*; D011361:Professional Competence; D011795:Surveys and Questionnaires; D028722:Virtues
keywords: character training; ethics; professionalism; residency; virtues