Presentation on theme: "WHAT PROFESSIONALISM CAN LEARN FROM BIOCHEMISTRY Steven A"— Presentation transcript:
1WHAT PROFESSIONALISM CAN LEARN FROM BIOCHEMISTRY Steven A WHAT PROFESSIONALISM CAN LEARN FROM BIOCHEMISTRY Steven A. Wartman, MD, PhD, MACP President/CEO Association of Academic Health Centers Presented to the Professionalism Task Force of the University of South Alabama April 24, 2008
5The “Krebs Cycle” Challenge How can we ensure a common outcome in terms of progression of values for the incredibly varied group of individuals entering our education and training programs?
6The Learning Environment-1 The Strong ForcesAccreditationTestingLicensure
7Wartman SA, Littlefield JH Wartman SA, Littlefield JH. Changes in the US medical licensure examination and impact on US medical schools. Research Letter. JAMA 2005;293:
8The Learning Environment-2 The Local Philosophy and RealityResources and priorityFaculty incentivesTraditional approachCurriculum committeeDisciplinary pressure
9The Learning Environment-3 Calls for new curriculaalternative therapies, bioterrorism, cardiothoracic radiology, chronic illness, cross-cultural education, emergency psychiatry training, end-of-life care, geriatrics, medical humanities, musculoskeletal medicine, palliative care, stroke, and women’s health
10The Substrate-1 The students Variety of perspectives, attitudes, skills, motivation, personalities, beliefs, and even values
11The Substrate-2 Service versus education conflict External Regulation Faculty and other role models
12“Culture eats strategy for lunch over and over again”
13Some Questions To Consider How do our health professions programs embrace and acculturate such a varied group of individuals?
14Some Questions To Consider How do we inculcate the idea of giving oneself in the service of others while learning?
15Some Questions To Consider Are we churning out superficially similar products that are able to pass the necessary board exams and go on with their careers, but who exhibit markedly different degrees of arguably the most important goal of health professions education: professionalization?
16ProfessionalismIn the end professionalism means “acting rightly when the right path is clear before us but other pressing needs and desires pull us away… [and] taking the time and making the effort to do the right thing when the path of least resistance would be to take an easier way out…”11. Huddle TS. Teaching professionalism: is medical morality a competency? Acad Med 2005;80(10):
17What is not so apparent is the existence of a code of conduct that runs deep throughout the program and impacts the participants so that by graduation it has become part of their professional identity
18The Centrality Of Professionalism It’s what separates health professions education from a trade schoolIt’s essential for the public trustIt’s absolutely critical for the clinician-patient relationship
19So How Can Professionalism Be Taught? Not by using conventional meansIt is a long, slow and deliberate process that must be constantly reinforcedIt values the importance of personal experience and emotion in professional development
20The ChallengeIf our goal is to produce graduates deeply steeped in the ethos of professionalism, then our challenge is to find a common pathway to clinical practice that inculcates life long professionalism
21“It is indeed remarkable that all foodstuffs are burnt through a common pathway.”
22In his Nobel Lecture of December 11, 1953, Krebs pointed out his “astonishment” that, in spite of a multitude of sources of energy, the number of steps where energy is utilized is small – only seven.
23Some CaveatsThis is not something that an orientation program or seminar will solveIt requires an ongoing, constant commitmentIt starts from the top downAnd, it needs to be highly individualized and personalized
24The Seven Step Program Step 1 Model professionalism from the top down Begin with the vice president, deans, department chairs, program directors and eventually involve all the faculty
25The Seven Step Program Step 2 View professionalism as consistently important from day one to graduationBe relentless
26The Seven Step Program Step 3 Get to know the individual student and traineeWhy? Because the transformation we seek is a highly personal one
27The Seven Step Program Step 4 Build flexibility into your program Each student and trainee has different needs, strengths, weaknesses, etcEschew the “cookie cutter” approach
28The Seven Step Program Step 5 Provide regular and timely personal feedback and combine self-assessment with outside evaluation
29The Seven Step Program Step 6 Provide an ongoing safe venue to share experiences and enhance personal awareness
30The Seven Step Program Step 7 Commit your program to the provision of community service above and beyond the regular educational experiences
31“To have results you’ve never had, you must do things you’ve never done”
32“Out of the chaos of isolated reactions Krebs succeeded in extracting the basic system for the essential pathway of oxidation process within the cell.”
33“His penetrating intuition was so clear and true and his grasp of the problem so keen from the start that none of his original ideas had to be revised.”