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Leadership & Professionalism: Practical Tools in the Workplace for Residency Training Officers. Erlyn A. Sana, PhD <erlynsana@yahoo.com.ph >. The resident’s workplace: the ward. The resident’s workplace: the OPD. The Ob-Gyn resident’s workplace. Conference Rooms Library Lecture Halls
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Leadership & Professionalism: Practical Tools in the Workplace for Residency Training Officers Erlyn A. Sana, PhD <erlynsana@yahoo.com.ph>
The Ob-Gyn resident’s workplace • Conference Rooms • Library • Lecture Halls • Classrooms with peers and/or consultants • Call room • Obstetrics Admission Section (OBAS) • Consultation Room • Labor Room • Delivery Room • Operating Room • Intensive Maternal Unit
Professional roles & general terminal competencies expected of residents Leadership & Professionalism
Professionalism • Those sets of values that sustain the interest of the patient above one’s own self-interest, • Entails a wide range of attitudes and behaviours such as altruism, humility, commitment to excellence, duty & commitment to service, honour & respect for others, integrity & compassion, and accountability to patients, colleagues and society • American Board of Internal Medicine (CPA Bulletin, 2002)
Leadership • The process through which an individual attempts to intentionally influence another individual or a group in order to accomplish a goal. • Locus of leadership: a person • Focus of leadership: other individual or groups • Most critical element: influence • Shortell and Kaluzny, 1997
Leadership traits • Personal: integrity, courage, discipline, loyalty, a sense of justice, sacrifice, honor, unselfishness, tact, decisiveness, reliability, moral character & enthusiasm • Leadership skills and techniques • Intellectual breadth • Intellectual depth • Resident Leadership Webinar
The trouble with attitudes as learning outcomes: When we follow codes of conduct or rules of decorum, we are often just play acting, acting appropriately in outer conduct, irrespective of what is in our hearts. Sherman, 2005 ; cited in Rees, & Knight, Acad Med, 2007
Characterization Organization Valuing Responding Receiving The Affective Domain of Learning(Krathwohl, et al., 1960) Consistency Compliance Identification Internalization
Practical tools to teach leadership & professionalism Workplace Approaches to teach Clinical (experiential) teaching-learning Actual clinical work Bedside teaching Rounds Endorsements Audits • Clinical environment (Accreditation Council for Graduate Medical Education, 2004) Teaching : facilitating, explaining, clarifying, closing consciously by the experiential learning cycle, inculcating, indoctrination, role modelling, and values clarification
Practical tools to teach leadership & professionalism Workplace Approaches to teach Lectures Simulations Cooperative and team learning Independent study Discussions and seminars • Classrooms and other related settings (Accreditation Council for Graduate Medical Education, 2004) Teaching : facilitating, explaining, clarifying, closing consciously by the experiential learning cycle, inculcating, indoctrination, role modelling, and values clarification
Testing implications of concepts in new situations (Behavioral) Observations & Reflections (Perceptual) Formation of abstract Concepts & generalizations (Symbolic) The experiential learning cycle (Kolb, 1984) Concrete Experience (Affective)
Values clarification(Raths, 1960) • Choosing: Asking residents about the choices they made in given circumstances • Prizing : asking residents if they are satisfied with their choices • Acting: asking and observing residents if they can publicly affirm their choices
Consultant Fellow SR Resident JR Resident Intern Nurse NA Manong Bantay Pasyente Clerks Germs Food chain in Ward X (Sana, 2001)(By order of harassment)
Facilitating learning Competence Approachability Respectability Confidence Orderliness Caring Inhibiting learning Temper/mood Inconsistency Discouraging Ingratitude Anxiety Impulsiveness Consultants’ personal attitudes and effects to residents (Morada, 2003)
Assessment(Best and Khan, 1989) • The collection of data, organizing them to measure how the learners have achieved the expected levels of competencies as a result of instruction
The Nature of Assessment Standard Constructs of leadership & professionalism Applying the Standard Measurement Collecting relevant data Constructing tests Making questionnaires Determining who accomplishes tools When and for how much (content valid)
Types of Assessment used for leadership & professionalism (Norcini & Burch, 2007)
Innovations in clinical evaluations (Norcini & Burch, 2007) Simulated /Controlled Naturalistic / Work place Case based discussion Direct Observation of Procedural Skills (DOPS) Structured Clinical Operative Test (SCOT) Mini-CEX (www.hcat.nhs.uk) • Objective Structured Clinical Examination (OSCE) • Objective Structured Assessment of Technical Skills (OSATS) • OSOE (Oral Examination) • OSPE (Practical Examination) Value of feedback The teaching-learning environment The environment for assessment