PROFESSIONALISM IN CONTEMPORARY PRACTICE:

The Professionalism in Contemporary Practice (PCP) program was offered from 2003 to 2007. Each year six medical faculty were selected for training as seminar facilitators. The one-month, facilitator-training course provided participants with the background knowledge and seminar leadership skills needed to deliver a series of eight 90-minute seminars to faculty and residents.

CURRICULUM:

Updated Curricular Materials
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The curriculum covers key concepts and issues pertinent to 21st century medicine. The curriculum is geared for the physician-educatcor and consists of eight 90-minute modules covering the following topics:

Defining & Teaching Professionalism
Provides an introduction to the curriculum as a whole. Examines what evolving
definitions of professionalism imply for expanding roles in contemporary practice.
Participants reflect on their own professional responsibilities as "physician citizens" and
then identify areas in which they would like to take a more active role.
Reflective Practice: Concepts & Application
Reviews a framework for reflective practice and strategies to teach reflection. After
discussing tools and key components of reflective practice, participants understand the
value of reflection and its relevance to professionalism through application in several
group exercises.
Patient-Centered Care: Effective Communication & Shared Decision Making
Examines the importance of patient-centered communication and shared decision making
(SDM), as well as patient expectations around various decision-making styles. Explains
what elements motivate SDM and how beneficence and respect for autonomy form the
ethical basis for SDM. Presents two models of SDM, which participants practice via a
group role-play exercise.
Patient-Centered Care: Cultural Competence
Part two of the patient-centered communication theme offers a framework for
understanding the patient's cultural perspective. Describes how communication is related
to health disparities, and reviews evidence and explanations for health disparities and
outcomes. Participants explore the patient's perspective by applying tools to
improve cross-cultural communication through role-play exercises, followed by
information on how to work effectively with interpreters.
Evidence-Based Care: Concepts & Tools
Covers strategies on using and interpreting clinical guidelines to answer clinical questions
quickly and efficiently. Considers new ideas for teaching evidence-based
medicine concepts and skills, specifically how to facilitate the use and implementation of
clinical practice guidelines.
Patient Safety
Illustrates types of errors that occur in hospital systems and examines what to do when an
error occurs. By practicing error disclosure, participants understand why errors transpire
and then analyze ways to improve safety and prevent future errors.
Quality Improvement
Connects concepts from patient safety and error prevention to concepts within system
improvement. Provides an overview of the steps for a quality improvement project, as
well as how to create an effective mission statement and select an appropriate project team.
Working Effectively in Teams
This capstone module recognizes the importance of team work to the "physician citizen."
Assesses what characteristics are beneficial to the team by outlining roles in interdisciplinary
project teams. Considers the relationship between successful quality improvement projects
and skillful negotiation with stakeholders. Before learning tools for negotiation, participants
discover their own conflict management style through a self-assessment tool.

Program Faculty: Clarence Braddock III, MD, MPH, Kambria M Hooper, MEd, Peter Rudd, MD, Merlynn Bergen, PhD, and program alumni.

List of Trained PCP Facilitators:

25 Institutions	30 Facilitators	Program

Alameda County Medical Center, Oakland, CA	Thaddeus Bordofsky	PCP 04
Duke University, Durham, NC	Sylvestre Quevedo	PCP 07
Georgetown University, Washington, DC	Eileen Moore	PCP 05
Howard University, Washington, DC	Jerome Herbers	PCP 02
Kanazawa University Hospital, Ishikawa, JAPAN	Hideki Nomura	PCP 05
Kansai Medical University, Osaka, JAPAN	Keiko Komoto	PCP 07
Keio University, Tokyo, JAPAN	Yohei Ohno	PCP 07
Kettering Medical Center, Kettering, OH	Stephen McDonald	PCP 02
Khon Kaen University, Khon Kaen, THAILAND	Srivieng Pairojkul	PCP 07
Louisiana State University Health Sciences, Shreveport, LA	Pat Bass, III	PCP 05
Mayo Clinic, Rochester, MN	John Bachman	PCP 04
Mount Sinai Medical School, City University of New York, NY	Helen Fernandez	PCP 04
National Yang-Ming University, Taipei, TAIWAN	Benjamin Kuo	PCP 02
Northern Ontario Medical School, Sudbury,Ontario, CANADA	Sarah Strasser	PCP 04
Northwestern University, Chicago, IL	Robert Golub	PCP 02
North Shore University Hospital, Manhasset, NY	Erica Kreismann	PCP 07
Stanford University, Stanford, CA	Anne Dembitzer Jon Fuller Preetha Basaviah Laura Meinke	PCP 02 PCP 04 PCP 06 PCP 06
Taipei Medical University, Taipei, TAIWAN	Cliff Chiehfeng Chen	PCP 05
Tohuko University, Sendai, JAPAN	Yutaka Nagasaki	PCP 06
Uniformed Services Univ. of the Health Sciences, Bethesda, MD	Jeffrey Jackson	PCP 02
University of Alabama, Birmingham, AL	Stuart Cohen	PCP 02
University of California, Davis, CA	Sonia Sutherland	PCP 02
University of California, San Diego, CA	Timothy Dresselhaus Simerjot Jassal	PCP 02 PCP 06
University of North Carolina, Carolinas Med Ctr, Charlotte, NC	Wesley Hofferbert	PCP 05
University of Oklahoma College of Medicine-Tulsa, Tulsa, OK	Erik Wallace	PCP 05
University of Iowa, Iowa City, IA	Ellen Gordon	PCP 02

Homesite Seminars:

During the first year following the training at Stanford, the facilitators return to their home institutions to conduct the seminars for medical teachers. As part of the evaluation of this train-the-trainer diffusion process, the facilitators are asked to play a critical role in gathering data during the post-training year. Evaluation activities include questionnaire administration, videotape recordings of seminars, and personal record keeping during the implementation of training.

The teaching of seminars in subsequent years is based on the size and need of individual home site institutions. Trained facilitators also serve as regional and national faculty development resources for instructional improvement.

Comments from SFDC-trained Professionalism in Contemporary Practice Facilitators:

"It was a treasured experience to see different teaching styles--ranging from didactic to interactive to freeform--and to consider the inherent value of each. Now the challenge is to experiment when I return home."

"Although I felt that my teaching skills were slightly above average before starting the program, I certainly learned many new teaching skills. What helped the most was doing something that I didn't feel comfortable doing· This will help me give better presentations in the future."

"The most significant attitudinal shift for me was the realization that my goal can be to practice medicine as it should be, incorporating the new, instead of to practice medicine as I was trained."

"I am glad to have learned skills for disclosing medical errors to patients and for assessing cultural characteristics of patients."

"This month has provided me with an armamentarium of skills for practicing and teaching in the various PCP content areas. Specifically, tools for beginning reflective practice, role-modeling, evidence-based medicine strategies such as the Process Improvement Combined ApprOach (PICO) format for questions and ideas for implementing Quality Improvement projects as practice-based learning and improvement for residents in clinic."

"Overall increase in knowledge, skills, and attitudes across PCP modules impressed me. I thought I would have preferences of some topics, but was pleasantly surprised to see interest broadly. The hands on experience with role plays and tremendous feedback helped me grow tremendously as a learner and teacher."

"The opportunity to take the material we have learned and actually teach the content--this forces us to learn the content in a very different way--at a much deeper level. Also being able to teach the material and work with it is a very empowering process. I am inspired by the "train the trainer" model."

"Most significant to me was the knowledge that others found these topics important to practice of medicine and to a careers in academic medicine; a feeling/belief I had been developing during my training but that others didn't seem to realize or legitimize. I now have the realization that this could make a huge impact on my career and the way in which I treat my patients and hopefully teach students/learners."

"My skepticism regarding whether professionalism can be taught has been replaced by self efficacy, in my ability to do so."

Comments from Faculty and Resident Participants in Home-Site Seminars:

"The components of true leadership in this course made a major difference for me as a clinician-educator."
"The overall impact that was most significant to me was being able to understand quality improvement and how it affects everyone."
"Team building and dialogue with others regarding patient care was the overall impact that was most significant to me."
"The seminar experience changed my understanding of professionalism; it is broader and entails much more than I used to think about professionalism."
"Making time to establish and incorporate evidence-based practice/clinical guidelines was the overall impact that was most significant to me."
"The impact of the PCP seminars on my practice is that I have been much more conscious about evidence-based medicine, practice-based learning and improvement, patient safety and quality improvement, as well as how to involve other faculty in that process. I have started to try to explicitly teach that to residents as part of my core curriculum when I am either in clinic or on the hospital service. Just examples, we've enacted 2 new protocols to try to improve our anti-coagulation and I think in part or completely [they] are related to participation through the seminars."