The Surgeon
Volume 8, Issue 1 , Pages 20-27 , February 2010

Assessing professionalism in surgeons

  • J.S. Dreyer

      Affiliations

    • Corresponding Author InformationCorresponding author. Tel.: +44 1387 241021; fax: +44 1387 241088.

Received 14 October 2009 ,Accepted 22 October 2009.

References 

  1. ISCP. Intercollegiate Surgical Curriculum Project. ISCP. [cited 2007 Mar 24]; Available from: http://www.iscp.ac.uk/About/Philosophy.aspx2007;
  2. GMC . Good medical practice. London: General Medical Council; 2001;
  3. CanMEDS . [cited 2008 Nov 12]; Available from: http://rcpsc.medical.org/canmeds/index.php2007;
  4. Williamson J, Webb R, Sellen A, Runciman W, van der Walt J. Human failure: an analysis of 2000 incident reports. Anaesthesia and Intensive Care. 1993;21:678–683
  5. Papadakis M, Hodgson C, Teherani A, Kohatsu N. Unprofessional behaviour in medical school is associated with subsequent disciplinary action by a state medical board. Academic Medicine. 2004;79:244–249
  6. Jacobellis V. Ohio, Judge Stewart P. (1964) 378 U.S. 184, 197.
  7. Lloyd GER. Hippocratic writings. Middlesex, England: Penguin; 1978;
  8. DeRosa GP. Professionalism and virtues. Clinical Orthopaedic and Related Research. 2006 Aug;449:28–33
  9. Freidson E. Professionalism: the third logic. 1st edn. Cambridge, UK: Polity Press; 2001;
  10. Freidson E. Profession of medicine: a study in the sociology of applied knowledge. Chicago: Chicago University Press; 1970;
  11. Freidson E. Professional dominance: the social structure of medical care. New York: Atherton Press; 1970;
  12. Freidson E. Professionalism reborn: theory, prophecy & policy. Cambridge UK: Polity Press; 1994;
  13. Barry D, Cyran E, Anderson RJ. Common issues in medical professionalism: room to grow. The American Journal of Medicine. 2000 Feb;108(2):136–142
  14. Rowley BD, Baldwin DCJ, Bay RC, Karpman RR. Professionalism and professional values in orthopaedics. Clinical Orthopaedic and Related Research. 2000;378:90–96
  15. van de Camp K, Vernooij-Dassen M, Grol R, Bottema B. How to conceptualize professionalism: a qualitative study. Medical Teacher. 2004;26(8):696–702
  16. Duff P. Teaching and assessing professionalism in medicine. Obstetrics & Gynecology. 2004 Dec;104(6):1362–1365
  17. Arnold L, Stern DT. What is medical professionalism. In:  Stern DT editors. Measuring medical professionalism. New York: Oxford University Press; 2006;p. 15–37
  18. Cohen JJ. Linking professionalism to humanism: what it means, why it matters. Academic Medicine. 2007 Nov;82(11):1029–1032
  19. Jha V, Bekker HL, Duffy SR, Roberts TE. Perceptions of professionalism in medicine: a qualitative study. Medical Education. 2006;40:1027–1036
  20. Golby M. Educational research in educational research: trick or treat?. Exeter Society for Curriculum Studies. 1993;15(3):5–8
  21. Schon D. Educating the reflective practitioner. New York: Jossy Bass; 1987;
  22. Fish D, Twinn S. Quality clinical supervision in the health care professions: principled approaches to practice. Oxford: Butterworth Heinemann; 1997;
  23. de Cossart L. A question of professionalism: leading forward the surgical team. Annals of the Royal College of Surgeons of England. 2005;87(238):241
  24. Wear DP, Castellani BP. The development of professionalism: curriculum matters. [Article] Academic Medicine. 2000 Jun;75(6):602–611
  25. Frank AW. The wounded storyteller: body, illness and ethics. Chicago: University of Chicago Press; 1995;
  26. Wear D, Aultman J. Professionalism in medicine: critical perspectives. New York: Springer; 2006;
  27. Jha V, Bekker HL, Duffy SR, Roberts TE. A systematic review of studies assessing and facilitating attitudes towards professionalism in medicine. Medical Education. 2007;41:822–829
  28. Lynch DC, Surdyk PM, Eiser AR. Assessing professionalism: a review of the literature. Medical Teacher. 2004;26(4):366–373
  29. Veloski JJ, Fields SKE, Boex JRP, Blank LL. Measuring professionalism: a review of studies with instruments reported in the literature between 1982 and 2002. Academic Medicine. 2005 Apr;80(4):366–370
  30. Hundert EM, Hafferty F, Christakis D. Characteristics of the informal curriculum and trainees' ethical choices. Academic Medicine. 1996;71:624–642
  31. Ramsey P, Wenrich M, Carline J, Inui T, Larson E, LoGerfo J. Use of peer ratings to evaluate physician performance. JAMA. 1993;269:1655–1660
  32. Tate P, Foulkes J, Neighbour R, Campion P, Field S. Assessing physicians' interpersonal skills via videotaped encounters: a new approach for the Royal College of general practitioners membership examinations. Journal of Health Communication. 1999;4:143–152
  33. Roethlisberger F, Dickson W. Management and the worker: an account of a research program conducted by western electric company, hawthorne works. Chicago. Cambridge, Massachusetts: Harvard University Press; 1939;
  34. Rethans J, van Leeuwen Y, Drop R, Sturmans F. Competence and performance: two different concepts in the assessment of quality of medical care. Family Practice. 1990;7(3):168–174
  35. Rethans J, Sturmans F, Drop R, Hobus P. Does competence of general practitioners predict their performance? Comparison between examination setting and actual practice. BMJ. 1991;303(6814):1377–1380
  36. Atkinson P, Pugsley L. Making sense of ethnography and medical education. Medical Education. 2005;39:228–234
  37. Lave J, Wenger E. Situated learning: legitimate peripheral participation. Cambridge University Press; 1991;
  38. Wenger E. Communities of practice: learning, meaning and identity. Cambridge University Press; 1998;
  39. Avermaete J, Kruijsen E. NOTECHS: the evaluation of non-technical skills of multi-pilot aircrew in relation to the JAR-FCL requirements. (Final Report) Amsterdam, Netherlands: National Aerospace Laboratory; 1998;Report No.: NLR-CR-98443
  40. Flin R, O'Connor P, Mearns K. Crew resource management: improving safety in high reliability industries. Team Performance Management. 2002;8:68–78
  41. Gaba D, Fish S, Howard S. Crisis management in anaesthesiology. New York: Churchill Livingstone; 1994;
  42. Howard S, Gaba D, Fish K, Yang G, Sarnquist F. Anesthesia crisis resource management training: teaching anesthesiologists to handle critical incidents. Aviation, Space, and Environmental Medicine. 1992;63(9):763–770
  43. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Final report: development of a behavioural marker system for anaesthetists' non-technical skills (ANTS). Aberdeen: University of Aberdeen Grant Report for SCPMDE; 2001;Report No.: RDNES/991/C
  44. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists' non-technical skills (ANTS): evaluation of a behavioural marker system. British Journal of Anaesthesia. 2003;90(5):580–588
  45. Yule S, Flin R, Paterson-Brown S, Maran N. Non-technical skills for surgeons in the operating room: a review of the literature. Surgery. 2006 Feb;139(2):140–149
  46. Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D. Development of a rating system for surgeons' non-technical skills. Medical Education. 2006;40:1098–1104
  47. Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D, Youngson G. Teaching surgeons about non-technical skills. Surgeon. 2007;5(2):86–89
  48. Arnold L. Assessing professional behaviour: yesterday, today and tomorrow. Academic Medicine. 2002 Jun;77:502–515
  49. Veloski JJM, Fields SKE, Boex JRP, Blank LL. Measuring professionalism: a review of studies with instruments reported in the literature between 1982 and 2002. [Report] Academic Medicine. 2005 Apr;80(4):366–370
  50. ACS Task Force on Professionalism . Code of professional conduct. Journal of the American College of Surgeons. 2003;197:605–608
  51. Barry L, Blair P, Cosgrove E, Cruess R, Cruess S, et al. One year, and counting, after publication of ACS “Code of professional conduct”. Journal of the American College of Surgeons. 2004;199(5):736–740
  52. McCulloch P. Surgical professionalism in the 21st century. The Lancet. 2006 Jan 14;367:177–181
  53. Arnold L, Willoughby T, Calkins E, Gammon L, Eberhart G. Use of peer evaluation in the assessment of medical students. Journal of Medical Education. 1981;56:35–42
  54. Arnold ELM, Blank LL, Race KEH, Cipparrone N. Can professionalism be measured? The development of a scale for use in the medical environment. [Report] Academic Medicine. 1998 Oct;73(10):1119–1121
  55. Papadakis M, Loeser H. Using critical incident reports and longitudinal assessments to assess professionalism. In:  Stern DT editors. Measuring medical professionalism. New York: Oxford University Press; 2006;p. 159–174
  56. Rhoton MF. A new method to evaluate clinical performance and critical incidents in anesthesia: quantification of daily comments by teachers. Medical Education. 1989;23:280–289
  57. Rhoton MF, Barnes A, Flashburg M, Ronai A, Springman S. Influence of anesthesiology residents' noncognitive skills on the occurrence of critical incidents and the residents' overall clinical performances. Academic Medicine. 1991;66:359–361
  58. Rhoton MF. Professionalism and clinical excellence among anesthesiology residents. [Article] Academic Medicine. 1994 Apr;69(4):313–315
  59. Papadakis M. A strategy for the detection and evaluation of unprofessional behavior in medical students. University of California, San Francisco School of Medicine Clinical Clerkships Operation Committee. Academic Medicine. 1999;74(9):980
  60. Phelan S, Obenshain S, Galey W. Evaluation of the noncognitive professional traits of medical students. Academic Medicine. 1993 Oct;68(10):799–803
  61. Wagner P, Hendrich J, Moseley G, Hudson V. Defining medical professionalism: a qualitative study. Medical Education. 2007;41:288–294
  62. Gauger PG, Gruppen LD, Minter RM, Colletti LM, Stern DT. Initial use of a novel instrument to measure professionalism in surgical residents. The American Journal of Surgery. 2005;189:479–487
  63. Klein EJM, Jackson JCM, Kratz LM, Marcuse EKM, McPhillips HAM, Shugerman RPM, et al. Teaching professionalism to residents. [Article] Academic Medicine. 2003 Jan;78(1):26–34
  64. Veloski JJ, Hojat M. Measuring specific elements of professionalism: empathy, teamwork and lifelong learning. In:  Stern DT editors. Measuring medical professionalism. New York: Oxford University Press; 2006;p. 117–146
  65. Archer J, Norcini J, Davies H. Use of SPRAT for peer review of paediatricians in training. BMJ. 2005;330:1251–1253
  66. Archer J, Norcini J, Southgate L, Heard S, Davies H. mini-Pat (Peer assessment tool): a valid component of a national assessment programme in the UK. Advances in Health Sciences Education. 2008;13:181–192
  67. Lockyer J. Multisource feedback in the assessment of physician competencies. The Journal of Continuing Education in the Health Professions. 2003;23:4–12
  68. Butterfield O, Mazzaferri E. A new rating form for use by nurses in assessing residents' humanistic behaviour. Journal of General Internal Medicine. 1991;6:155–161
  69. Ramsey P, Carline J, Blank L, Wenrich M. Feasibility of hospital-based use of peer ratings to evaluate the performances of practicing physicians. Academic Medicine. 1996;71(4):364–370
  70. Wenrich M, Carline J, Giles J, Ramsey P. Ratings of the performances of practicing internists by hospital based registered nurses. Academic Medicine. 1993;68:680–687
  71. Woolliscroft J, Howell J, Patel B, Swanson D. Resident-patient interactions: the humanistic qualities of internal medicine residents assessed by patients, attending physicians, program supervisors and nurses. Academic Medicine. 1994;69(3):216–224
  72. Arnold L, Stern DT. Content and context of peer assessment. In:  Stern DT editors. Measuring medical professionalism. New York: Oxford University Press; 2006;p. 175–194
  73. Norcini JJ. Current perspectives in assessment: the assessment of performance at work. Medical Education. 2005;39(9):880–889
  74. Ginsburg S, Regehr G, Hatala R, McNaughton N, Frohna A, Hodges B, et al. Context, conflict, and resolution: a new conceptual framework for evaluating professionalism. Academic Medicine. 2000 Oct;75(10):S6–S11
  75. Ginsburg S, Regehr G, Lingard L. Basing the evaluation of professionalism on observable behaviours: a cautionary tale. Academic Medicine. 2004;79(Suppl. 10):S1–S4
  76. GEA of the AAMC. AAMC GEA. [cited 2008 Aug 16]; Available from: www.aamc.org2008 September 13;
  77. Coutts L, Rogers J. Humanism: is its evaluation captured in commonly used performance measures?. Teaching and Learning in Medicine. 2000;12(1):28–32
  78. Klamen D, Williams R. Using standard clinical encounters to assess physician communication. In:  Stern DT editors. Measuring medical professionalism. New York: Oxford University Press; 2006;p. 53–74
  79. Prislin M, Lie D, Shapiro J, Boker J, Radecki S. Using standardized patients to assess medical students' professionalism. Academic Medicine. 2001;76(10):S90–S92
  80. Singer P, Cohen R, Robb A, Rothman A. The ethics objective structured clinical examination. Journal of General Internal Medicine. 1993;8:23–27
  81. Pieters H, Touw-Otten F, DeMelker R. Simulated patients in assessing consultation skills of trainees in general practice vocational training: a validity study. Medical Education. 1994;38:226–233
  82. de Cossart L, Fish D. Cultivating a thinking surgeon: new perspectives on clinical teaching, learning and assessment. Harley, nr Shrewsbury: tfm Publishing Ltd; 2007;
  83. Ginsburg S, Lingard LA. Using reflection and rhetoric to understand professional behaviours. In:  Stern DT editors. Measuring medical professionalism. New York: Oxford University Press; 2006;p. 195–212
  84. Fryer-Edwards K, Pinsky LE, Robins L. The use of portfolios to assess professionalism. In:  Stern DT editors. Measuring medical professionalism. New York: Oxford University Press; 2006;p. 213–234
  85. Lee A, Beaver H, Boldt H, Olson R, Oetting T, Abramoff M, et al. Teaching and assessing professionalism in ophthalmology residency training programs. Survey of Ophthalmology. 2007 May;52(3):300–314
  86. Clark P. Values in health care professional socialization: implications for geriatric education in interdisciplinary teamwork. Gerontologist. 1997;37:441–451
  87. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002 Jan 9;287(2):226–235
  88. Misch D. Evaluating physicians' professionalism and humanism: the case for humanism “connoisseurs”. Academic Medicine. 2002 Jun;77:489–495
  89. Ephgrave K, Stansfield RB, Woodhead J, Sharp WJ, George T, Lawrence J. The resident view of professionalism behavior frequency in outstanding and “not outstanding” faculty. The American Journal of Surgery. 2006;191:701–705
  90. Brasel K, Bragg D, Simpson D, Weigelt J. Meeting the accreditation council for graduate medical education competencies using established residency training program assessment tools. The American Journal of Surgery. 2004;188:9–12
  91. Chisholm M, Cobb H, Duke L, McDuffie C, Kennedy W. Development of an instrument to measure professionalism. American Journal of Pharmaceutical Education. 2006 Aug 15;70(4):85

PII: S1479-666X(09)00009-2

doi: 10.1016/j.surge.2009.10.008

The Surgeon
Volume 8, Issue 1 , Pages 20-27 , February 2010