title: Emergency Medicine Resident Perceptions of Medical Professionalism.
abstract: BACKGROUND
  Medical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees' perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism.
  
  
  METHODS
  We performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions.
  
  
  RESULTS
  Of the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the "respect for others" and "honor and integrity" valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the "duty and service" domain (p<0.05). Among different residencies, significant differences were found with attributes within the "altruism" and "duty and service" domains (p<0.05).
  
  
  CONCLUSIONS
  Residents perceive differences in the relative importance of traditionally defined professional attributes and this may be useful to educators. Explanations for these differences are hypothesized, as are the potential implications for professionalism education. Because teaching professional behavior is taught most effectively via behavior modeling, faculty awareness of resident values and faculty development to address potential gaps may improve professionalism education.
authors.affiliation: University of Washington, Department of Emergency Medicine, Seattle, Washington.
authors.forename: Joshua
authors.initials: J
authors.lastname: Jauregui
authors.affiliation: University of Washington, Department of Emergency Medicine, Seattle, Washington.
authors.forename: Medley O
authors.initials: MO
authors.lastname: Gatewood
authors.affiliation: University of Washington, Department of Emergency Medicine, Seattle, Washington.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Ilgen
authors.affiliation: University of Cincinnati, Department of Emergency Medicine, Cincinnati, Ohio.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Schaninger
authors.affiliation: University of Cincinnati, Department of Emergency Medicine, Cincinnati, Ohio.
authors.forename: Jared
authors.initials: J
authors.lastname: Strote
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003162:Competency-Based Education; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000193:education* / Q000592:standards; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D024382:Professional Role; D011369:Professional-Patient Relations; D000068616:Professionalism; D013337:Students, Medical / Q000523:psychology*; D014481:United States