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Wednesday 29Th August 2018 WEDNESDAY 29TH AUGUST 2018 10I: Short Communications: 10I2 (378) Talking about professionalism, do we have the words? A Professionalism qualitative study to explore internal medicine residents’ Location: Rio, 2nd Floor, CCB and attending physicians' understanding of Date: Wednesday 29th August professionalism Time: 0830-1015 hrs Authors 10I1 (317) Marco Mancinetti, University and Hospital of Fribourg, What Can We Learn from the Analysis of Top-cited Switzerland Articles in Medical Professionalism? Janko Kaeser, IML, University of Bern, Switzerland Christoph Berendonk, IML, University of Bern, Switzerland Authors Samy Azer, King Saud University, Riyadh, Saudi Arabia Presenter: Marco Mancinetti, University and hospital of Fribourg, Switzerland Presenter: Samy Azer, King Saud University, College of Medicine, Riyadh, Saudi Arabia Background: Little attention has been given to the perspectives of practicing physicians on professionalism. Background: Physicians are expected to demonstrate We don’t know what residents and attending physician in professional behavior in their day-to-day practice. Citation internal medicine understand about professionalism and if counts of articles have been used by universities and they can speak about it. The aim of this study is to explore funding bodies to measure scientific outcomes and assess their discourses about it. suitability for grant applications. With the rise of social Our research questions: how residents and attending media, altmetric scores could provide an alternative physician define professionalism, what they recognize as assessment tool. Considering these two measures, it was unprofessional and how they teach it and learn it. decided to assess the highly cited articles on medical Method: The methodological framework was based on the professionalism. principles of the discourse analysis. 7 Focus groups were Method: The Web of Science was searched for most cited conducted with a total of 35 residents and attending articles on medical professionalism. The identified articles physicians from the department of internal medicine of 4 were searched for key characteristics. The altmetric different tertiary hospitals in Switzerland. All three database was searched to identify report for each article. investigators independently reviewed transcripts and A model to assess the relationship between the number of developed codes in an iterative process. citations and each of key characteristics as well as Results: Participants in our focus groups couldn’t speak altmetric scores were developed. easily about the definition of professionalism, stating that Results: No correlations were found between the number the meaning of professionalism is blurred for them. of citations and number of years since publication When speaking about the flaws of professionalism the (p=0.192), number of institutes (p=0.081), number of grey zones were difficult to determinate and lead to an authors (p=0.270), females in authorship (p=0.15), or unresolved agreement. Learning, teaching and assessing number of grants (p=0.384). The altmetric scores varied professionalism was an issue for the participants of the from zero to 155, total= 806, median=5.0, (IQR=20). interviews. Twitter (54%) and Mendeley (62%) were the most popular Analysing the discourses using the frameworks described altmetric resources. No correlation was found between by Irby we found that the participants were expressing the number of citations and the altmetric scores (p=0.661). definitions proper to either a virtue-based professionalism, Discussion & Conclusions: The top topics covered were behavior-based professionalism or professional identity learning and teaching professionalism, curriculum issues, formation. Many aspects of unprofessional behavior were professional and unprofessional behavior, defining and referring to the discourse of complexity as reported by measuring professionalism. Only the number of countries Monroux. During the conversation about teaching and correlated with the number of citations (p= 0.001). learning we observe that professionalism is forged more Countries that contributed to these articles were mainly by an empirical approach (observation and imitation) the USA, Canada, and the UK and the articles were mainly rather than by lectures and handbooks. published in Academic Medicine, Journal of the American Discussion & Conclusion: Our findings suggest that if Medical Association, Journal of General Internal Medicine, practicing physicians don’t have the basis to speak about and Annals of Internal Medicine. Future studies should professionalism they will then struggle to recognize what investigate the specific features of highly cited articles that is unprofessional. This leads to an improvised approach to contributed significantly as a resource in medical curricula, educational strategies which results in un-systematic ways research or postgraduate training. of learning, teaching and assessing professionalism. Take-home message: Top-cited articles in professionalism We must give the right words to the medical professionals offer a useful resource to students and teachers interested to speak about professionalism, this would give them a in this area. consciousness of their professional values, helping them learn, teach and assess professionalism in their everyday work. AMEE 2018 ABSTRACT BOOK 1 WEDNESDAY 29TH AUGUST 2018 10I3 (253) medical students engage with their superiors and patients, Sri Lankan and Taiwanese Students' Professionalism whether they voice concerns or seek assistance and Dilemmas: Understanding Gender and Power Imbalances affects their emotional status. Future research might through Narratives consider how such experiences impact on students’ development as future doctors and on burnout. Authors Malissa Shaw, Chang Gung Memorial Hospital, Linkou, 10I4 (1811) Taiwan The struggle for professionalization – students´ Madawa Chandratilake, University of Kelaniya, Colombo, Sri experiences of emotionally challenging situations during Lanka medical school Ming-Jung Ho, Weill Cornell Medical College, Qatar Charlotte Rees, Monash University, Clayton, Australia Authors Lynn Monrouxe, Chang Gung Memorial Hospital, Linkou, Annalena Lönn Taiwan Maria Weurlander Robert Thornberg Presenter: Lynn Monrouxe, Chang Gung Memorial Astrid Seeberger Hospital, Linkou, Taiwan Håkan Hult Annika Wernerson Background: Social constructs such as status, gender inequality and religious stratification are reproduced in Presenter: Annalena Lönn, CLINTEC, Karolinska Institutet, medical settings. Such values impact medical Stockholm, Sweden professionals’ behaviours, ethical reasoning and sense of empathy: essentially their medical professionalism. As Background: The professionalization process is an notions of medical professionalism are context-specific, important part of medical education. During clinical this study considered Sri Lankan and Taiwanese medical placements, students encounter situations that can be students’ experiences of professionalism dilemmas: emotionally challenging, such as witnessing situations in which they witnessed or participated in patents´suffering, death and a detached health culture. unprofessional practice. The aim of the study, was to investigate how medical Method: As part of a larger international research students manage situations they perceive as being programme, this qualitative study comprised 26 focus emotionally challenging and what they learn during the groups (n=136 participants) at a Sri Lankan (n=71) and process. Taiwanese (n=64) medical school. Participants described Method: Qualitative data was collected from 86 students professionalism dilemmas they had experienced during during their last semester. The students were asked to their clinical education. Audio-recorded data were describe, in writing, situations they perceived as being anonymised, transcribed and thematically analysed to emotionally challenging and also to describe if and how identify students’ professionalism dilemmas. their ability to Results: Students narrated diverse professionalism manage these situations had changed during medical dilemmas including patient safety and dignitiy breaches, school. A constructivist grounded theory approach was alternative medicine and family inteventions. Here, we used to analyze the data. focus on patient, healthcare professional (HCP) or student Results: Medical students´ main concern in situations they mistreatment. Narratives from Taiwan were embedded in perceive as being emotionally challenging, is the struggle notions of power imbalances. Those from Sri Lanka also to achieve a professional approach. This includes being included gender inequality. Mistreatment towards able to focus on the task in a demanding situation and to students and other HCPs was generally psychological. maintain the ability to show empathy. Active reflection Mistreatment of patients also occasionally compromised and debriefing with peers and close relatives are patients’ health. For example, prescribing pregnant important when reolving the main concern.Other women oxytocin to induce labour to adhere to doctors’ strategies are to actively expose themselves to stressful schedules. Some narratives emphasized patients’ situations and the search for good role models.In this mistreatment of students and HCPs, such as patients being process, students get insights about how they can relate rude to nurses but respectful toward doctors. to patients and medical staff, and learn about what their Discussion & Conclusion:
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