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1.
PLoS One ; 15(1): e0226677, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31896133

RESUMO

Overqualification has both positive and negative outcomes; however, extant literature exhibits a tilt in favor of its negative aspect against its positive side. This tilted approach results in derision of a condition which could produce positive results. We argue, through empirical evidence, that there might be some circumstances/conditions, like the intentions of employees about their current job, that may play an important role in enabling organizations to be benefitted from the surplus KSAs of the overqualified employees and overqualification can be used as a tool to mitigate the effects of its negative consequences. To empirically test this condition, a sample of 193 teachers and 193 students have been selected through cluster sampling technique. The results exhibited that if overqualified employees perceive their current job as a career job then there is a more likelihood that they will be involved in some innovative and creative behaviors instead of deviating negatively from the organization norms. The results provide some new research insights that could be used to better understand the phenomenon of overqualification. The results of the study have practical implications for HR managers.


Assuntos
Mobilidade Ocupacional , Escolaridade , Ocupações/normas , Poder Psicológico , Comportamento Problema/psicologia , Má Conduta Profissional/psicologia , Desempenho Profissional/normas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
2.
PLoS One ; 14(4): e0215067, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31022214

RESUMO

Reports of sexual harassment at medical faculties throughout the world, including the Radboud University, raised the question how prevalent this is at the Faculty of Science. We performed a survey among students to assess their experiences with harassment. This questionnaire consisted of questions from the EGERA survey, a questionnaire held among staff of multiple European Universities. We found that 9% of the respondents had observed or experienced harassment at the Faculty. Hardly any of these cases were reported to one of the institutional services. Moreover, most students did not now any of the provided services. We therefore suggest raising awareness on harassment and to make students more familiar with the trust person.


Assuntos
Docentes de Medicina/normas , Conhecimentos, Atitudes e Prática em Saúde , Relações Interpessoais , Má Conduta Profissional/estatística & dados numéricos , Assédio Sexual/estatística & dados numéricos , Estudantes/psicologia , Universidades/normas , Feminino , Humanos , Masculino , Má Conduta Profissional/psicologia , Assédio Sexual/psicologia , Inquéritos e Questionários
3.
Lakartidningen ; 1162019 01 15.
Artigo em Sueco | MEDLINE | ID: mdl-30644993

RESUMO

Patients' experience of abuse in health care (AHC) is common, and may cause long-lasting suffering. In Sweden, lifetime prevalence is estimated at 20 per cent among female patients and 8 per cent among male patients, and a background of other abuse is a risk factor. Most health care staff have experience of patients who have been abused, but the topic is surrounded by silence from both patients and caregivers. Models for training staff in groups have been evaluated and a more proactive stance can be fostered. Department heads and health care authorities are responsible for providing staff with options to counteract AHC. Caregivers need training in how to carry out consultations with patients who say they have been abused in health care, and this training should be included in efforts to increase quality of care. Changes are within reach but educational efforts are urgent.


Assuntos
Pacientes/psicologia , Má Conduta Profissional/psicologia , Atitude do Pessoal de Saúde , Feminino , Humanos , Capacitação em Serviço , Masculino , Abuso Físico , Relações Profissional-Paciente , Delitos Sexuais
4.
Acad Med ; 94(4): 570-578, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30489285

RESUMO

PURPOSE: To develop a road map for educators attending to medical students' professionalism lapses, aiming to offer an empirical base for approaching students who display such lapses. METHOD: Between October 2016 and January 2018, 23 in-depth interviews with 19 expert faculty responsible for remediation from 13 U.S. medical schools were conducted about the way they handle students' professionalism lapses. Three researchers independently completed three rounds of coding. Data collection, coding, and analysis were performed in a constant comparative process. A constructivist grounded theory approach was used to develop an explanatory model for attending to students' professionalism lapses. RESULTS: Based on participants' descriptions, the authors developed a three-phase approach for attending to professionalism lapses. In phase 1, experts enacted the role of concerned teacher, exploring the lapse from the student's perspective. In phase 2, they functioned as supportive coach, providing feedback on professionalism values, improving skills, creating reflectiveness, and offering support. In phase 3, if the student did not demonstrate reflectiveness and improvement, and especially if (future) patient care was potentially compromised, participants assumed an opposite role: gatekeeper of the profession. CONCLUSIONS: An explanatory model for attending to professionalism lapses that fits in the overarching "communities of practice" framework was created. Whereas phase 1 and 2 aim at keeping students in the medical community, phase 3 aims at guiding students out. These findings provide empirical support to earlier descriptive, opinion-based models and may offer medical educators an empirical base for attending to students who display professionalism lapses.


Assuntos
Má Conduta Profissional/psicologia , Profissionalismo/normas , Estudantes de Medicina/psicologia , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/tendências , Teoria Fundamentada , Humanos , Entrevistas como Assunto/métodos , Má Conduta Profissional/estatística & dados numéricos , Pesquisa Qualitativa , Estudantes de Medicina/estatística & dados numéricos
5.
Adv Health Sci Educ Theory Pract ; 24(2): 215-232, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30387053

RESUMO

Standardized narratives or profiles can facilitate identification of poor professional behaviour of medical students. If unprofessional behaviour is identified, educators can help the student to improve their professional performance. In an earlier study, based on opinions of frontline teachers from one institution, the authors identified three profiles of medical students' unprofessional behaviour: (1) Poor reliability, (2) Poor reliability and poor insight, and (3) Poor reliability, poor insight and poor adaptability. The distinguishing variable was Capacity for self-reflection and adaptability. The current study used Nominal Group Technique and thematic analysis to refine these findings by synthesizing experts' opinions from different medical schools, aiming to develop a model of unprofessional behaviour profiles in medical students. Thirty-one experienced faculty, purposively sampled for knowledge and experience in teaching and evaluation of professionalism, participated in five meetings at five medical schools in the Netherlands. In each group, participants generated ideas, discussed them, and independently ranked these ideas by allocating points to them. Experts suggested ten different ideas, from which the top 3 received 60% of all ranking points: (1) Reflectiveness and adaptability are two distinct distinguishing variables (25%), (2) The term reliability is too narrow to describe unprofessional behaviour (22%), and (3) Profiles are dynamic over time (12%). Incorporating these ideas yielded a model consisting of four profiles of medical students' unprofessional behaviour (accidental behaviour, struggling behaviour, gaming-the-system behaviour and disavowing behaviour) and two distinguishing variables (reflectiveness and adaptability). The findings could advance educators' insight into students' unprofessional behaviour, and provide information for future research on professionalism remediation.


Assuntos
Má Conduta Profissional/psicologia , Estudantes de Medicina/psicologia , Docentes de Medicina/psicologia , Humanos , Modelos Teóricos , Países Baixos , Profissionalismo/normas , Reprodutibilidade dos Testes , Autoavaliação
6.
J Healthc Risk Manag ; 38(4): 32-42, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30136752

RESUMO

Medical errors are the third-leading cause of death in the United States. One of the problems is timely recognition and management of inappropriate health care worker behaviors that lead to intimidation and loss of staff focus, eventually leading to errors. The purpose of this qualitative modified Delphi study was to seek consensus among a panel of experts in hospital risk management practices on the practical methods for early detection of inappropriate behaviors among hospital staff, which may be used by hospital managers to considerably mitigate the risk of medical mishaps. High reliability theory guided the research process, utilizing the conceptual framework of the fair and just culture patient safety model. A single research question asked what level of consensus exists among hospital risk management experts as to the practical methods for early detection of inappropriate behavior among hospital staff, which managers may use to ultimately mitigate the risk of preventable medical mishaps. This study included nonprobability purposive sampling (n = 34) and three rounds of questionnaires. Consensus was reached on 8 factors: setting expectations, developing a culture of respect, holding staff accountable, enforcing a zero-tolerance policy, confidentiality of reporting, communicating expected behavior, open communication, and investigating inappropriate behaviors.


Assuntos
Administradores Hospitalares/psicologia , Erros Médicos/prevenção & controle , Erros Médicos/psicologia , Administração de Recursos Humanos em Hospitais/métodos , Recursos Humanos em Hospital/psicologia , Má Conduta Profissional/psicologia , Gestão de Riscos/métodos , Adulto , Currículo , Técnica Delfos , Educação Médica Continuada , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Inquéritos e Questionários , Estados Unidos
7.
Med Teach ; 41(3): 303-308, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29703096

RESUMO

The relatively new term "Professional Identity Formation" (PIF) complements behavior-based and attitude-based perspectives on professionalism. Unprofessional behavior and its remediation should also be addressed from this perspective. However, a framework is needed to guide discussion and remediation of unprofessional behavior, which can encompass behavior-based, attitude-based, and identity-based perspectives on professionalism. To this end, the authors propose a multi-level professionalism framework which describes, apart from professional behavior, more levels which influence professional performance: environment, competencies, beliefs, values, identity, and mission. The different levels can provide tools for educators to address and discuss unprofessional behavior with their students in a comprehensive way. By reflecting on all the different levels of the framework, educators guard themselves against narrowing the discussion to either professional behavior or professional identity. The multi-level professionalism framework can help educators and students to gain a better understanding of the root of unprofessional behavior, and of remediation strategies that would be appropriate. For despite the recent emphasis on PIF, unprofessional behavior and its remediation will remain important issues in medical education.


Assuntos
Competência Clínica/normas , Ética Clínica/educação , Má Conduta Profissional/psicologia , Profissionalismo/educação , Estudantes de Medicina/psicologia , Educação Médica , Humanos , Papel do Médico , Competência Profissional
8.
Nurs Ethics ; 26(3): 859-869, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-28901204

RESUMO

BACKGROUND: Nurses engaging in research are held to research ethics standards. RESEARCH AIM: Examine experiences, behaviors, and perceptions of nurses in Israel regarding research ethics and explore possible related factors. RESEARCH DESIGN: An original investigator-designed self-administered questionnaire measured five variables: (a) ethics in research, (b) encountered research misconduct during the course of one's studies, (c) the inclination to fabricate data, (d) the inclination to select or omit data, and (e) knowledge of research misconduct in the workplace. Additionally, demographic data were collected. PARTICIPANTS AND RESEARCH CONTEXT: The questionnaire was completed by 151 Israeli registered nurses. 10.2% hold a PhD, 34 % hold an MA, 42.2% hold a BA, and 13.6% with no academic degree. ETHICAL CONSIDERATIONS: The study was approved by the University's ethics committee; anonymity and consent of the respondents were respected. FINDINGS: Registered nurses' level of studies achieved was significantly associated with a lower inclination to fabricate data, with one exception-PhD nurses were more inclined to fabricate data than nurses with a Master's degree. A trend was found in which a higher level of studies is associated with higher knowledge of research misconduct in the workplace. DISCUSSION: Results indicate that nurses' perceptions of research ethics change throughout their academic studies, indicating a positive influence of level of studies, research experience, and work experience on ethics perceptions. Nevertheless, PhD nurses showed a greater inclination to actually select, omit, or even fabricate data than MA nurses. This may be related to pressure to publish. CONCLUSION: PhD nursing programs should include ethics training. Academic faculty members should serve as role models regarding research integrity. Research ethics deserves further emphasis on all levels of nurse education in Israel, as well as in the nurses' code of ethics and related documents. This may positively impact ethical research practices.


Assuntos
Ética em Pesquisa , Enfermeiras e Enfermeiros/psicologia , Percepção , Adulto , Idoso , Atitude do Pessoal de Saúde , Feminino , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Má Conduta Profissional/psicologia , Inquéritos e Questionários , Local de Trabalho/psicologia , Local de Trabalho/normas
9.
Saudi J Kidney Dis Transpl ; 29(6): 1358-1365, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30588967

RESUMO

In any health system, public awareness of organ donation fundamentally affects the organ transplantation programs. The aim of this study was to evaluate the knowledge and perception of the people in Morocco toward organ donation as well as to identify the reasons and determinants for refusal of organ donation. This opinion survey included a representative sample of 2000 participants in Morocco, and data related to sociodemographic characteristics, knowledge and self-opinion about organ donation, and reasons behind refusal were collected. Statistical analysis showed that 55.2% of the participants were women, the median age was 21 years, and 60.8% of included participants had secondary education. Almost two-thirds of surveyed participants (62.3%) showed a low to mid-level of knowledge about organ donation and transplantation in Morocco. About half of the interviewed participants (48.8%) refused to donate their organs. Concern about risk of medical error and the belief in trafficking of procured organs were the main reasons for refusal, seen in 66% and 62% of the interviewees, respectively. Univariate and multivariate logistic regression models showed that the older, the less educated and the less informed a person is, the less he accepted organ donation. Therefore, promotion of organ donation in Morocco should involve a regular information and awareness among the general population.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Transplante de Órgãos/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Idoso , Estudos Transversais , Escolaridade , Feminino , Educação em Saúde , Humanos , Masculino , Imperícia , Erros Médicos/psicologia , Pessoa de Meia-Idade , Marrocos , Transplante de Órgãos/efeitos adversos , Transplante de Órgãos/métodos , Má Conduta Profissional/psicologia , Medição de Risco , Inquéritos e Questionários , Doadores de Tecidos/provisão & distribução , Adulto Jovem
10.
BMC Pregnancy Childbirth ; 18(1): 392, 2018 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-30286734

RESUMO

BACKGROUND: Utilization of institutional delivery services could be hampered by women's experience of disrespectful and abusive care during childbirth. However, such experiences are not well documented and taken into consideration id planning maternal health services in many developing countries. The aim of this study was to describe women's experience of disrespect and abuse during giving birth at health facilities in northern Ethiopia. METHODS: A qualitative phenomenological study was conducted in Tigray, Ethiopia. Focus group discussions (FGDs) with primipara and multipara women were conducted to collect the necessary information. All study participants had their last delivery at a health facility in the year preceding the study. A semi-structured discussion guide was used to elicit discussion. Discussions were audio recorded and transcribed verbatim in the local language and then translated to English. Data were analyzed using thematic analysis approach assisted by the Open Code qualitative data management software. RESULTS: The study participants described disrespect and abuse as serious obstacles to utilization of maternal health services. Women reported experiencing feelings of being infantilized, losing self-control, being overlooked, being informed bad news without proper preparation, repeated examination without being properly communicated/informed, disallow companions, and left unattended during labor. Facility related issues include women's perception of incompetence of professionals attending delivery, unhygienic facilities, and unavailability of basic supplies. CONCLUSION: Women consider health facilities not fully prepared to provide respectful maternal care. Sustainable increase in institutional delivery requires ensuring quality, compassionate and caring services in all health facilities.


Assuntos
Comportamento Agonístico , Parto/fisiologia , Má Conduta Profissional/psicologia , Relações Profissional-Paciente , Adulto , Atitude do Pessoal de Saúde , Parto Obstétrico/psicologia , Etiópia , Feminino , Humanos , Serviços de Saúde Materna/normas , Gravidez , Pesquisa Qualitativa , Recursos Humanos , Adulto Jovem
11.
Nurse Educ Today ; 71: 17-21, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30212706

RESUMO

OBJECTIVE: The aim of this review of the literature is to synthesis the knowledge attained about determinants of student-faculty relationships and its impact on student outcomes. While adding to the body knowledge, the researchers discuss the importance, barriers, and facilitators to student-faculty academic relationships in nursing education. DESIGN: We conducted a narrative literature review using a modified version of the framework of the Population, Intervention, Comparison, and Outcome method to develop the research question for this review. That question was: What determinants of undergraduate nursing students' relationships with faculty affect those students' academic outcomes? DATA SOURCES: To search and review the literature systematically, we entered the specific criteria into the EBSCOhost interface. The following databases were used for data sourcing: Cumulative Index to Nursing and Allied Health Literature Plus with Full Text; Teacher Reference Center; Education Resources Information Center; Medline; and Theses and Dissertations. We selected only full-text, peer-reviewed sources that were written in English for final inclusion. REVIEW METHODS: After the retrieval of 56 reports via an EBSCO host search, abstracts were reviewed and 29 were rejected based on the exclusion/inclusion criteria. The rejected reports met some or no criteria and not others; or showed little to no association with determinants of nursing student-faculty academic relationships or students' academic outcomes. An inductive method of analysis was used to review and extract emerging themes. RESULTS: Findings revealed four core determinants of student-faculty relationships: support, caring, diversity, and incivility. These determinants were interrelated and appeared to have an impact on student academic outcomes. CONCLUSIONS: Nursing institutions should be proactive to ensure that barriers such as incivility are reduced and that diversity is included and appreciated in the teaching and learning environment. Additionally, a caring and supportive climate of learning should be emphasized and enacted by nurse educators.


Assuntos
Bacharelado em Enfermagem/normas , Avaliação Educacional/normas , Docentes de Enfermagem/psicologia , Má Conduta Profissional/psicologia , Estudantes de Enfermagem/psicologia , Educação em Enfermagem/normas , Bacharelado em Enfermagem/métodos , Avaliação Educacional/métodos , Humanos
12.
J Nurs Adm ; 48(10): 487-494, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30239445

RESUMO

OBJECTIVE: This study investigates the association of authentic leadership (AL) and perceived organizational support to workplace bullying among a sample of licensed practical nurses (LPNs). BACKGROUND: Workplace bullying is a serious problem in the workplace that harms nurses' physical and psychological well-being. METHODS: A cross-sectional survey design was implemented. A simple random sample of 855 was drawn from a population of 4306 LPNs in a single US Midwestern state. A total of 168 usable questionnaires were returned (19.65% response rate). RESULTS: Forty-three percent of nurses experienced at least 2 negative behaviors on a weekly/daily basis; 12% self-identified as a victim. The moral component of AL was a major determinant of overall workplace bullying (ß = -.59), person-related bullying (ß = -.70), and physical intimidation (ß = -.58). Perceived support was a major determinant of work-related bullying (ß = -.40). CONCLUSIONS: Organizational support initiatives and AL training for nurse leaders should be considered to reduce bullying.


Assuntos
Satisfação no Emprego , Recursos Humanos de Enfermagem no Hospital/psicologia , Má Conduta Profissional/psicologia , Local de Trabalho/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Recursos Humanos de Enfermagem no Hospital/organização & administração , Má Conduta Profissional/estatística & dados numéricos , Inquéritos e Questionários , Local de Trabalho/estatística & dados numéricos
14.
PLoS One ; 13(7): e0200318, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29995939

RESUMO

BACKGROUND: Disrespectful and abusive practices at health facilities during childbirth discourage many women to seek care at facilities. This may lead to maternal morbidity and mortalities. Despite severe impacts, such practices remain hidden and are rarely reported in developing countries. OBJECTIVES: The study was carried out to assess the prevalence and determinants of the disrespect and abuse (D & A) during child birth in rural Gujrat, Pakistan. METHODS: A cross sectional household based study was conducted in tehsil Kharian of district Gujrat. Data was collected using an interview based questionnaire from the women who had a live birth within the previous two months (n = 360). The D & A scale was based on standard Maternal and Child Health Integrated Programme indicators. Multiple logistic regression was used to find out the determinants of reported D & A. RESULTS: Almost all women experienced D & A (99.7%) during childbirth according to objective assessment "experienced D & A". However, only 27.2% reported subjective experience of D & A "reported D & A". The main determinant of reported D & A was facility based childbirth (OR = 13.49; 10.10-100.16) and lower socio economic strata (OR = 2.89; 1.63-5.11). The risk of reporting D & A was twice in public health facilities as compared to private. Women who had reported D & A were more likely to opt for changing the place of childbirth for next time (OR = 4.37, 95% CI = 2.41-7.90). CONCLUSION: D & A during childbirth is highly prevalent and under-recognized in Pakistan. High prevalence at facilities and particularly at public facilities can be a reason for underutilization of this sector for childbirth. Maternal health policies in Pakistan need to be revised based on the charter of respectful maternity care.


Assuntos
Parto Obstétrico , Má Conduta Profissional/estatística & dados numéricos , Respeito , Adolescente , Adulto , Parto Obstétrico/normas , Feminino , Humanos , Serviços de Saúde Materna/normas , Serviços de Saúde Materna/estatística & dados numéricos , Paquistão/epidemiologia , Abuso Físico/estatística & dados numéricos , Gravidez , Má Conduta Profissional/psicologia , Fatores Socioeconômicos , Adulto Jovem
15.
Med Educ Online ; 23(1): 1485432, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29912668

RESUMO

BACKGROUND: An early concern note (ECN) program is used by some medical schools to identify, counsel, and intervene when students exhibit unprofessional behavior. Student maturity, insight, propensity for reflection, and receptiveness to feedback have been suggested as predictors of future behavior. OBJECTIVE: We hypothesized that (a) classifying students with a first ECN based on their response to the report would identify students at risk of repeat ECNs better than the action that prompted it and (b) receipt of multiple ECNs would identify students at risk of adverse academic events. DESIGN: For this study, 459 ECNs were classified based on students' (1) recognition that their behavior was inappropriate and (2) acceptance of responsibility for the behavior. Student academic progress and receipt of subsequent ECNs were tracked. RESULTS: Students who recognized their behavior was inappropriate and accepted responsibility after an initial ECN received subsequent ECNs at lower rates (14-19%) than students who disagreed with the significance of their behavior or were resistant to accepting responsibility (36-59%). Students with limited insight and adaptability appeared to be at highest risk. Seventy-one percent of students with three or more ECNs encountered adverse academic events during enrollment. CONCLUSION: Student reactions to reports of unprofessional behavior may be useful as a tool to help assess risk of recurrent lapses. Students with diminished capacity to recognize behaviors as unprofessional or accept responsibility for them appear to be at highest risk for additional adverse academic and professionalism events while in medical school.


Assuntos
Má Conduta Profissional/psicologia , Má Conduta Profissional/estatística & dados numéricos , Estudantes de Medicina/psicologia , Empatia , Humanos , Motivação , Profissionalismo
17.
PLoS One ; 13(5): e0196819, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29723306

RESUMO

We addressed how individuals' power influences their judgments regarding corporate transgressions. Based on the Situated Focus Theory of Power, which theorizes that powerful people respond more in accordance to circumstantial factors, we tested the interaction of power and the type of corporate discourse offered by the accused company. Across two studies (overall N = 216), we experimentally primed power (Study 1) and manipulated participants' sense of direct control over the company (Study 2). We consistently found an interaction effect of power and corporate discourse on people's negative attitudes toward the company-particularly on the unwillingness to use the company's products. Particularly, high-power individuals were prone to strongly vary their attitudes based on the mitigative/non-mitigative nature of the discourse, while those low in power were unsusceptible to the type of discourse. The results suggest how the potential rise of consumer power in society may critically influence the consumer-corporate relationships following corporate transgressions.


Assuntos
Comportamento do Consumidor , Corporações Profissionais/ética , Má Conduta Profissional/psicologia , Atitude , Comércio , Emoções , Feminino , Humanos , Japão , Masculino , Modelos Psicológicos , Responsabilidade Social , Inquéritos e Questionários , Adulto Jovem
18.
J Hosp Med ; 13(3): 210-212, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29505621

RESUMO

Professional misconduct by physicians is a significant problem with negative implications in the healthcare environment and has been termed "disruptive physician behavior" (DPB) in the United States. In recent years, hospitals and healthcare organizations have begun to better understand and formally address DPB, including its management and repercussions. Policy statements by the Joint Commission and the American Medical Association (AMA) have acknowledged that DPB may pose a threat to patient and provider safety. The purpose of this article is to raise awareness about the etiology of disruptive behavior in physicians, describe the consequences and the need for early recognition, and discuss potential interventions.


Assuntos
Segurança do Paciente , Médicos/psicologia , Má Conduta Profissional/psicologia , Qualidade da Assistência à Saúde/normas , Atitude do Pessoal de Saúde , Humanos , Relações Interprofissionais , Estados Unidos
20.
West J Emerg Med ; 19(1): 18-22, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29383051

RESUMO

Introduction: Medical student mistreatment is a prevalent and significant challenge for medical schools across the country, associated with negative emotional and professional consequences for students. The Association of American Medical Colleges and Liaison Committee on Medical Education have increasingly emphasized the issue of mistreatment in recent years, and medical schools are tasked with creating a positive learning climate. Methods: The authors describe the efforts of an emergency department (ED) to improve its clerkship learning environment, using a multifaceted approach for collecting mistreatment data and relaying them to educators and clerkship leadership. Data are gathered through end-of-rotation evaluations, teaching evaluations, and an online reporting system available to medical students. Mistreatment data are then relayed to the ED during semi-annual meetings between clerkship leadership and medical school assistant deans, and through annual mistreatment reports provided to department chairs. Results: Over a two-year period, students submitted a total of 56 narrative comments related to mistreatment or unprofessional behavior during their emergency medicine (EM) clerkship. Of these comments, 12 were submitted in 2015-16 and 44 were submitted in 2016-17. The most frequently observed themes were students feeling ignored or marginalized by faculty (14 comments); students being prevented from speaking or working with patients and/or attending faculty (11 comments); and students being treated in an unprofessional manner by staff (other than faculty, 8 comments). Conclusion: This article details an ED's efforts to improve its EM clerkship learning environment by tracking mistreatment data and intentionally communicating the results to educators and clerkship leadership. Continued mistreatment data collection and faculty development will be necessary for these efforts to have a measurable effect on the learning environment.


Assuntos
Estágio Clínico , Medicina de Emergência/educação , Aprendizagem , Má Conduta Profissional/psicologia , Má Conduta Profissional/estatística & dados numéricos , Estudantes de Medicina/psicologia , Educação de Graduação em Medicina , Feminino , Humanos , Masculino
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