Not all unprofessional behaviors are equal: The creation of a checklist of bad behaviors.
BACKGROUND
Professionalism is a key component of medical education and training. However, there are few tools to aid educators in diagnosing unprofessional behavior at an early stage. The purpose of this study was to employ policy capturing methodology to develop two empirically validated checklists for identifying professionalism issues in early-career physicians.


METHODS
In a series of workshops, a professionalism competency model containing 74 positive and 70 negative professionalism behaviors was developed and validated. Subsequently, 23 subject matter experts indicated their level of concern if each negative behavior occurred 1, 2, 3, 4, or 5 or more times during a six-month period. These ratings were used to create a "brief" and "extended" professionalism checklist for monitoring physician misconduct.


RESULTS
This study confirmed the subjective impression that some unprofessional behaviors are more egregious than others. Fourteen negative behaviors (e.g. displaying obvious signs of substance abuse) were judged to be concerning if they occurred only once, whereas many others (e.g. arriving late for conferences) were judged to be concerning only when they occurred repeatedly.


CONCLUSIONS
Medical educators can use the professionalism checklists developed in this study to aid in the early identification and subsequent remediation of unprofessional behavior in medical students and residents.
a Graduate Medical Education , University of Minnesota , Minneapolis , MN , USA.
Michael J
MJ
Cullen
b Department of Anesthesiology , University of Minnesota , Minneapolis , MN , USA.
Mojca R
MR
Konia
c Department of Pediatrics , University of Minnesota , Minneapolis , MN , USA.
Emily C
EC
Borman-Shoap
d Department of Orthopaedic Surgery , University of Minnesota , Minneapolis , MN , USA.
Jonathan P
JP
Braman
e Minneapolis VA Health Care System , Minneapolis , MN , USA.|f Department of Neurology, University of Minnesota , Minneapolis , MN , USA.
Ezgi
E
Tiryaki
a Graduate Medical Education , University of Minnesota , Minneapolis , MN , USA.
Brittany
B
Marcus-Blank
a Graduate Medical Education , University of Minnesota , Minneapolis , MN , USA.
John S
JS
Andrews
D001291:Attitude of Health Personnel; D001519:Behavior; D057189:Checklist; D006801:Humans; D010820:Physicians / Q000592:standards*; D011361:Professional Competence; D028743:Professional Misconduct; D000068616:Professionalism / Q000592:standards*; D015203:Reproducibility of Results