Skip to main content
Top
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 9/2012

01-09-2012 | Continuing Professional Development

Competency-based professionalism in anesthesiology: Continuing Professional Development

Authors: Jocelyne McKenna, MD, H. David Rosen, MD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 9/2012

Login to get access

Abstract

Purpose

Fulfilling the current societal expectations for professionalism in medicine requires a clear understanding of the specific skills, attitudes, and behaviours expected of practitioners. This Continuing Professional Development (CPD) module discusses professionalism as it relates to the practice of anesthesiology.

Principal findings

While many of the attributes of the professional are generic, performance expectations must be interpreted in a specialty-specific context. Anesthesiologists face challenges to their professionalism in the time-constrained, highly technical and stressful operating room environment. Ongoing shifts in the models of health care delivery require the adaptation of anesthesiology practice to meet changing demands. Consequently, anesthesiologists’ practice environment has extended into preoperative assessment units, acute pain services, and perioperative medicine. Application of principles of biomedical ethics, understanding of medico-legal and regulatory aspects of practice, and attention to personal health and career sustainability are intrinsic aspects of professional practice. More recently, focus on adverse event management and continuous quality improvement has created the need for specific skill sets, which must be included in training and continuing professional development programs. The medical education literature suggests teaching and evaluation methods suited to the development of competence in all aspects of professionalism. Finally, professionalism requires the availability of remediation programs for learners and practitioners in difficulty.

Conclusion

The attitudes, skills, and behaviours that define professionalism in anesthesiology must be taught and evaluated to establish a basic level of competence by the completion of specialty training. Throughout their careers, anesthesiologists must continue their professional development to meet current and future societal expectations and shifting norms of health care delivery.
Footnotes
1
On December 28, 2010, a Montreal Gazette headline read: “Trust in professionals is on the wane: poll”. The author describes a decline in the level of trust that patients have in their doctors and other professionals. Physicians had one of the largest declines in trust levels of all professions. This explains the serious attention this declining trust has been under from medical schools, specialty societies, and regulating bodies.
 
2
Le 28 décembre 2010, le journal The Gazette de Montréal titrait: « La confiance dans les professionnels s’effrite selon un sondage ». L’auteur décrivait dans son article le déclin du niveau de confiance que les patients accordaient à leur médecin et à d’autres professionnels. Les médecins étaient confrontés à l’une des plus grandes pertes de confiance parmi toutes les professions. Cela explique pourquoi les facultés de médecine, les sociétés savantes et les organismes de réglementation portent la plus grande attention à cette baisse de la confiance des patients.
 
Literature
1.
go back to reference Steen RG. Retractions in the scientific literature: is the incidence of research fraud increasing? J Med Ethics 2011; 37: 249-53.PubMedCrossRef Steen RG. Retractions in the scientific literature: is the incidence of research fraud increasing? J Med Ethics 2011; 37: 249-53.PubMedCrossRef
2.
go back to reference Bahaziq W , Crosby E. Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency. Can J Anesth 2011; 58: 1039-50. PubMedCrossRef Bahaziq W , Crosby E. Physician professional behaviour affects outcomes: A framework for teaching professionalism during anesthesia residency. Can J Anesth 2011; 58: 1039-50. PubMedCrossRef
3.
go back to reference Sullivan WM. Medicine under threat: professionalism and professional identity. CMAJ 2000; 162: 673-5.PubMed Sullivan WM. Medicine under threat: professionalism and professional identity. CMAJ 2000; 162: 673-5.PubMed
4.
5.
go back to reference Stern DT. Measuring Medical Professionalism. New York: Oxford University Press; 2006. p. 19. Stern DT. Measuring Medical Professionalism. New York: Oxford University Press; 2006. p. 19.
8.
go back to reference Cruess R, Cruess SR, Steinert Y. Teaching Medical Professionalism. Cambridge: Cambridge University Press; 2009. p. 126. Cruess R, Cruess SR, Steinert Y. Teaching Medical Professionalism. Cambridge: Cambridge University Press; 2009. p. 126.
9.
go back to reference Hebert PC. Doing Right: A Practical Guide to Ethics for Medical Trainees & Physicians. 2nd ed. Toronto: Oxford University Press; 2009. Hebert PC. Doing Right: A Practical Guide to Ethics for Medical Trainees & Physicians. 2nd ed. Toronto: Oxford University Press; 2009.
10.
go back to reference Wynia MK. The role of professionalism and self-regulation in detecting impaired or incompetent physicians. JAMA 2010; 304: 210-2.PubMedCrossRef Wynia MK. The role of professionalism and self-regulation in detecting impaired or incompetent physicians. JAMA 2010; 304: 210-2.PubMedCrossRef
11.
go back to reference Edelstein SB, Stevenson JM, Broad K. Teaching professionalism during anesthesiology training. J Clin Anesth 2005; 17: 392-8.PubMedCrossRef Edelstein SB, Stevenson JM, Broad K. Teaching professionalism during anesthesiology training. J Clin Anesth 2005; 17: 392-8.PubMedCrossRef
12.
go back to reference Rosenstein AH, O’Daniel M. Impact and implications of disruptive behaviour in the perioperative arena. J Am Coll Surg 2006; 203: 96-105.PubMedCrossRef Rosenstein AH, O’Daniel M. Impact and implications of disruptive behaviour in the perioperative arena. J Am Coll Surg 2006; 203: 96-105.PubMedCrossRef
14.
go back to reference Patel P, Robinson BS, Novicoff WM, Dunnington GL, Brenner MJ, Saleh KJ. The disruptive orthopaedic surgeon: implications for patient safety and malpractice liability. J Bone Joint Surg Am 2011; 93: e1261-6.PubMed Patel P, Robinson BS, Novicoff WM, Dunnington GL, Brenner MJ, Saleh KJ. The disruptive orthopaedic surgeon: implications for patient safety and malpractice liability. J Bone Joint Surg Am 2011; 93: e1261-6.PubMed
15.
go back to reference Neff KE. Understanding and managing physicians with disruptive behaviour. In: Ransom SB, Pinsky WW, Tropman JE, editors. Enhancing Physician Performance: Advanced Principles of Medical Management. Tampa, FL: American College of Healthcare Executives; 2000. p. 45-72. Neff KE. Understanding and managing physicians with disruptive behaviour. In: Ransom SB, Pinsky WW, Tropman JE, editors. Enhancing Physician Performance: Advanced Principles of Medical Management. Tampa, FL: American College of Healthcare Executives; 2000. p. 45-72.
16.
go back to reference College of Physicians and Surgeons of Ontario and the Ontario Hospital Association. Guidebook for Managing Disruptive Physician Behaviour. Toronto; 2008. College of Physicians and Surgeons of Ontario and the Ontario Hospital Association. Guidebook for Managing Disruptive Physician Behaviour. Toronto; 2008.
17.
go back to reference Kohn LT, Corrigan JM, Donaldson MS. To Err is Human-Building a Safer Health System. Committee on Quality of Health Care in America. Institute of Medicine. National Academy Press Washington, D.C., 2000. Executive summary. Available from URL: http://books.nap.edu/catalog/9728.html (accessed February 2012). Kohn LT, Corrigan JM, Donaldson MS. To Err is Human-Building a Safer Health System. Committee on Quality of Health Care in America. Institute of Medicine. National Academy Press Washington, D.C., 2000. Executive summary. Available from URL: http://​books.​nap.​edu/​catalog/​9728.​html (accessed February 2012).
18.
go back to reference Baker GR, Norton PG, Flintoft V. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ 2004; 170: 1678-86.PubMedCrossRef Baker GR, Norton PG, Flintoft V. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ 2004; 170: 1678-86.PubMedCrossRef
22.
go back to reference Brownell AK, Cote L. Senior residents’ views on the meaning of professionalism and how they learn about it. Acad Med 2001; 76: 734-7.PubMedCrossRef Brownell AK, Cote L. Senior residents’ views on the meaning of professionalism and how they learn about it. Acad Med 2001; 76: 734-7.PubMedCrossRef
24.
go back to reference Klein EJ, Jackson JC, Kratz L, et al. Teaching professionalism to residents. Acad Med 2003; 78: 26-34.PubMedCrossRef Klein EJ, Jackson JC, Kratz L, et al. Teaching professionalism to residents. Acad Med 2003; 78: 26-34.PubMedCrossRef
25.
go back to reference Gaiser RR . The teaching of professionalism during residency: why it is failing and a suggestion to improve its success. Anesth Analg 2009; 108: 948-54. PubMedCrossRef Gaiser RR . The teaching of professionalism during residency: why it is failing and a suggestion to improve its success. Anesth Analg 2009; 108: 948-54. PubMedCrossRef
26.
go back to reference White P. Medical professionalism and continuing professional development for medical specialists. Aust N Z J Obstet Gynaecol 2004; 44: 186-90.PubMedCrossRef White P. Medical professionalism and continuing professional development for medical specialists. Aust N Z J Obstet Gynaecol 2004; 44: 186-90.PubMedCrossRef
27.
go back to reference Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994; 69: 861-71.PubMedCrossRef Hafferty FW, Franks R. The hidden curriculum, ethics teaching, and the structure of medical education. Acad Med 1994; 69: 861-71.PubMedCrossRef
28.
go back to reference Papadakis MA, Teherani A, Banach MA, et al. Disciplinary action by medical boards and prior behavior in medical school. N Engl J Med 2005; 353: 2673-82.PubMedCrossRef Papadakis MA, Teherani A, Banach MA, et al. Disciplinary action by medical boards and prior behavior in medical school. N Engl J Med 2005; 353: 2673-82.PubMedCrossRef
Metadata
Title
Competency-based professionalism in anesthesiology: Continuing Professional Development
Authors
Jocelyne McKenna, MD
H. David Rosen, MD
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 9/2012
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-012-9747-z

Other articles of this Issue 9/2012

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 9/2012 Go to the issue