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Universidad Nacional Autónoma de México

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Inv Ed Med 2017;6:136-7 - DOI: 10.1016/j.riem.2017.01.138
Promoting Professionalism through Remediation in Residency Education (Presented at ICRE 2016 Niagara Falls Top Five Session - What Works)
José Antonio Dávila Rivas, Carlos Félix Arce, Mary Ana Cordero Díaz
Escuela de Medicina. Instituto Tecnológico y de Estudios Superiores de Monterrey, México

Promoting Professionalism through Remediation in Residency Education (Presented at ICRE 2016 Niagara Falls Top Five Session - What Works) Introduction: The Professional Role in the CanMEDS 2015 Physician Competency Framework underscores physicians’ accountability to society and the privilege of physician-led regulation. Addressing unprofessional behaviors among residents promotes professionalism if remediation is embedded within the two communities of practice interacting in the academic health centers: the clinical workplace and the educational space (Kalet & Chou, 2014). We developed a strategy to address unprofessional behaviors with residents in order to achieve effective remediation to maximize healthcare and educational outcomes. Method: We implemented a 4-level strategy adapting the approach by Hickson et al (2007) to address unprofessional behaviors and a remediation process for the “difficult trainee” who typically presents with behavioral problems as “personal conduct that negatively affects or potentially affects patient care” (Kalet & Chou, 2014). Level 0 “Informal Intervention” was a dialogue between the resident and the clinical tutor or chief resident; Level 1 “Professionalism Awareness” was a formal intervention by the program director (PD); Level 2 “Leadership Intervention” was a formal intervention by the PD, medical residency programs director (MRPD) and professionalism director; and Level 3 “Disciplinary Action” was a formal intervention by the Dean of GME, MRPD, PD, professionalism director and the Dean of Students Affairs. Results: The implemented strategy during 2015 with 6 residents’ cases included clear communication and documentation, enabling remediation and disciplinary action when indicated. Conclusions: It is necessary a model for faculty development to support remediation and residents’ professionalism education with the understanding that physicians are accountable to society, to their profession, and to themselves.

Peer Review under the responsibility of Universidad Nacional Autónoma de México.

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