ABSTRACT TITLE: Professionalism at the Howard University ...The task force on professionalism (the second group formed) was selected by the Dean and consisted of faculty and medical

ABSTRACT

TITLE: Professionalism at the Howard University Health Sciences

Center (HUHSC)

This presentation will describe the mechanisms by which we plan to rekindle “A Culture of Professionalism” at the Howard University Health Science Center. We will share our definition of professionalism and our plan to move “Professionalism” from its current position as an afterthought to become a showcase priority item for faculty, house staff and medical students. Our goal will be to replace the “Hidden Curriculum” by one curriculum which is based upon the participation of the full cycle of academic – the Faculty, House staff and Medical Students utilizing, the Honor Council, the Alpha Omega alpha Honor Fraternity (AOA), the Gold Humanism Honor Society, the Faculty Hand Book and Professionalism groups along with a new faculty house staff and medical student work group over a 4-6 year period.

Formation of Professionalism Groups

In response to several unprofessional events exhibited by some medical

students, then Dean Robert Taylor organized during the summer of 2010, three

groups composed of faculty and medical students of years 1-4 (1) Honor

Council (HC); (2) Task Force on Professionalism (TFOP) and (3) The Howard

University Gold Humanism Honor Society (GHHS) workgroup which was

chartered in 2010.

Formation of Professionalism Groups (Continued)

The formation of the Honor Council (the first group formed) was facilitated by

the adoption of the code of honor and the honor council in May of 2010 by the

Howard University Board of Trustees. All three activities were instituted in an

effort to identify and develop a culture of professionalism and ethical behavior

(HC and TFOP) as well as a mechanism by which medical students with the

highest professional skills and ethical behavior would be honored (GHHS).


When unprofessional behavior or other violations of this code of honor were

identified, the violators would be subjected to disciplinary action or sanction

by the honor council and recommendations for remediation or other

disciplinary actions forwarded to the Dean of the College of Medicine. The

Council deliberates alone and makes the decision on the presence or absence

of violations of the honor code and unprofessional behavior. However the

Dean makes the final decision on the remediation or other appropriate

disciplinary action that was appropriate.


The task force on professionalism (the second group formed) was selected by

the Dean and consisted of faculty and medical student representation from

Classes 1-4 who were committed to developing a Howard University College

of Medicine (HUCOM) culture of professionalism and a curriculum for

professionalism throughout the academic cycle from year 1– 4 for medical

students, the house staff and faculty members.


This group reviewed the American Medical Association (AMA), the American

Association of Medical Colleges (AAMC) and the American Board on Internal

Medicine (ABIM) goals and objectives for professionalism. These were

reviewed at numerous other colleges and universities in the USA and other

countries to find systems in place as well as codes for medical student

standards of professionalism.


This was done in an effort to allow the HUCOM to codify acceptable behavior

and standards in place to foster the development of the atmosphere and culture

of the highest standards of professionalism. The TFOP has met at least

monthly since September of 2010 and reviewed published materials on

professionalism and model systems and curriculum development.


The Dean identified Dr. Clive Callender as its chair and sent him to the Mayo

Symposium on Professionalism in November 11-13, 2010, to attend the

Whitney and Betty McMillan Symposium on Professionalism in Health Care:

and A Call to Action – sponsored by the Mayo School of Continuous

Professional Development in Florida. This set the tone for the rest of their

activities, which has culminated in the development of a curriculum and other

action plans .


These groups of faculty and medical students (Honor Council and Task Force)

met as often as necessary but at least monthly to ensure that the appropriate

standards of professional behavior and attitudes were followed. These groups

report to the Curriculum Committee, the Executive Committee, the Faculty of

the College of Medicine and medical students periodically.


In 2010, the Gold Humanism Honor Society (GHHS) (third group formed)

was initiated to reward and positively reinforce those medical student

behaviors (Senior and Junior medical students) whose humanistic practices

were role models for professionalism as identified by their peers (fellow

medical students). Its first induction ceremony was held in March of 2012 for

those senior medical students selected in 2011. Thirteen students were

inducted after selection by their classmates (peers). This year, the selection

process was completed by the students in May 2012 and will be completed by

the Assistant Dean and Dean before the end of June 2012 so this honor can be

included in the Dean’s letter.

Clive O. Callender, M.D.

PROFESSIONALISM

The ability to understand the nature of, and demonstrate Courtesy

(Politeness)and ethical behavior in, the act of medical care. This includes

respect, responsibility and accountability, excellence and scholarship, honor

and integrity, altruism, leadership, cultural competency, caring and

compassion, and confidentiality.

Courtesy

Courtesy is kindness and consideration expressed in a sophisticated and elegant

way.

Politeness

Politeness is best expressed as the practical application of good manners or

etiquette.

PROFESSIONALISM

For each of the professionalism objectives below, students should be at a

proficient level by the time they complete the clerkships. Patient experiences

in the clerkship will then enable further skill development, such as providing

opportunities for students to advocate for the individual needs of the patient.

PROFESSIONALISM

The student will be able to demonstrate:

*Competency Goals Skills Objectives

Respect Define respect

Demonstrate respect by exhibiting behaviors such

as:

1. Defending patients’ dignity by using the

patient’s proper form of address and by paying

attention to the patient’s comfort and modesty in

every encounter

2. Choosing to appropriately groom and dress

oneself whenever working in a professional

environment

3. Identifying and supporting all individuals’

choices.

PROFESSIONALISM


Responsibility &

Accountability Define responsibility

Define accountability

Demonstrate responsibility and accountability by

exhibiting behaviors such as:

1. Managing emotions in order to maintain

personal control amidst adverse and trying

circumstances

2. Recognizing impairments in peers and reporting

them to the appropriate entities

PROFESSIONALISM


Responsibility &

Accountability Cont’d. Define responsibility

Define accountability

Demonstrate responsibility and accountability by


3. Intervening on behalf of patients, colleagues, or

co-workers when others behave

unprofessionally, confronting all unprofessional

behavior

4. Attending and being punctual at all required

educational sessions

PROFESSIONALISM


Excellence & Scholarship

Define excellence

Define scholarship

Demonstrate excellence and scholarship by


1. Choosing to be thorough in all assignments

including reading about patients’ problems

2. Recognizing and managing uncertainty

3. Practicing self-reflection as a tool for life-long

learning

PROFESSIONALISM


Honor & Integrity

Define honor

Define integrity

Demonstrate honor and integrity by exhibiting

behaviors such as:

1. Being honest about student identity/role and

experience level in all encounters with patients,

colleagues and co-workers

2. Recognizing and respecting personal, emotional,

and physical boundaries with patients,

teachers, and peers

3. Accurately reporting only data that has been

personally verified

PROFESSIONALISM


Honor & Integrity Cont’d.

Define honor

Define integrity

Demonstrate honor and integrity by exhibiting

behaviors such as:

4. Making appropriate attribute on to sources of

ideas and data

5. Admitting mistakes and errors

6. Evaluating own performance and being honest

about shortcomings

PROFESSIONALISM


Altruism

Define altruism

Demonstrate altruism by exhibiting behaviors such

as:

1. Identifying when patients’ needs supersede the

student’s

2. Advocating for the individual patient’s needs

when they arise

3. Recognizing the social issues that impact the

health of patients

4. Know the importance of patient advocacy

PROFESSIONALISM


Leadership

Define leadership

Demonstrate leadership by exhibiting behaviors

such as:

1. Sharing responsibility for group learning,

feedback and discussion

2. Supporting colleagues by creating a collegial

learning environment

3. Allowing others to demonstrate excellence when

appropriate

PROFESSIONALISM


Cultural Competency

Demonstrates cultural competency through:

1. The ability to adapt communication style to the

patient’s language and cultural background

2. The ability to recognize and respond to

culturally-based challenges during the clinical

encounter

PROFESSIONALISM


Caring & Compassion

Define caring

Define compassion

Demonstrates caring and compassion by exhibiting

behaviors such as:

1. Expressing sensitivity to others’ circumstances

such as emotional state, care expectations and

socioeconomic perspective

2. Recognizing when to listen, when to talk, and

when to be silently present

PROFESSIONALISM


Confidentiality

Define confidentiality

Protect patient confidentiality at all times

Demonstrate awareness of mandated privacy

regulations. e.g., HIPPA

Adapted from Embedding Professionalism in Medical Education: Assessment

as a Tool for Implementation. Report from an Invitational Conference

Cosponsored by the Association of American Medical Colleges and the

National Board of Medical Examiners. Copyright 2002. University of

Washington SOM College Faculty Professionalism Benchmark – Early

Clinical Stage (2007 – 08)

Behaviors Reflecting Professionalism

Altruism

• Offers to help team members who are busy

• Contributes to the profession; active in local and national organizations such as the

AMC – Organization of Student Representatives

• Does not use altruism as an excuse to misprioritize or to rationalize certain

behaviors (“I can’t be with my family because my patients need me.”)

Behaviors Reflecting Professionalism (Continued)

Honor and Integrity

• Forthcoming with information; does not withhold and/or use information for power

• Admits errors

• Deals with confidential information discreetly and appropriately

• Does not misuse resources (e.g., school computers and patient’s food)


Caring and Compassion

• Treats the patient as an individual, taking into account lifestyle, beliefs, personal

idiosyncrasies, support system

• Communicates bad news with sincerity and compassion

• Deals with sickness, death, and dying in a professional manner with patient and

family members

• Supports a balance in personal and professional activities for peers and

subordinates


Respect

• Respects institutional staff and representatives; respects faculty during teaching

sessions

• Respects patient rights/dignity (privacy/confidentiality, consent); knocks on door,

introduces self, drapes patients appropriately, and shows respect for patient privacy

needs

• Demonstrates tolerance to a range of behaviors and beliefs

• Does not disturb small group sessions


Responsibility and Accountability

• Demonstrates awareness of own limitations, and identifies developmental needs

and approaches for improvements

• Care for self appropriately and presents self in a professional manner (i.e.,

demeanor, dress, hygiene)

• Recognizes and reports errors/poor behavior in peers

• Informs others when not available to fulfill responsibilities and secures replacement


Responsibility and Accountability Cont’d.

• Takes responsibility for appropriate share of team work

• Arrives on time

• Accountable for deadlines; completes assignments and responsibilities on time

• Answers letters, pages, e-mail, and phone calls in a timely manner


Excellence and Scholarship

• Masters techniques and technologies of learning

• Is self-critical and able to identify own areas for learning/practice improvement

• Has internal focus and direction, setting own goals

• Takes initiative in organizing, participating, and collaborating in peer study groups


Leadership

• Teaches others

• Helps build and maintain a culture that facilitates professionalism

• Does not provide disruptive leadership (e.g., organizing pranks, inappropriately

confronting authority figures

Howard University Honor Council - Activity

The Honor Council Committee which oversees the Code of Honor,

Professionalism and Ethics was created in 2010. Since its inception the

Council has heard several cases brought against students. There are some

serious consequences that can come if brought before the Honor Council.

Such penalties include temporary or permanent letters in you student file,

remediation, suspension or expulsion from the College of Medicine. It is our

hope that by providing a brief synopsis on the cases we have tried to date, that

it reminds you to act in a professional manner in all aspects of your life.

Howard University Honor Council – Activity (Continued)

To date cases have been brought to the council by fellow students, basic

sciences faculty, attendings and deans. Although all suspected violations of

the Honor Code may be brought to the Council, it is up to the Council to

decide if the violation is worthy of a hearing.


Below is a synopsis of cases brought before the Honor Council Committee:

I. Cheating

a. Bringing unauthorized materials into a testing session, including clinical

skills exams, quizzes and shelf exams

b. Unauthorized use of multiple scantron and exam materials

c. Unauthorized use of laptops to search for answers during an exam

d. Possession of unauthorized old exam materials and distributing them

amongst other students.

II. Plagiarism both intentional and unintentional

a. Incorrectly citing sources or not citing sources at all


Below is a synopsis of cases brought before the Honor Council Committee:

III. Fabrication

a. Using one’s work and crediting as own

b. Taking an exam for another student

IV. Unauthorized absences from clinical rotations

a. Not completing the proper procedure of requesting time away from a rotation

b. Requesting time off from a resident but not the clerkship director and dean

c. Unresponsive towards an attendings request to contact the student

V. Harassment

a. Sexual harassment

b. Verbal harassment, including threats and profanity toward another student

VI. Inappropriate use of social media

a. Unprofessional behavior on social media websites, including Facebook, Twitter, etc.


We would like remind and encourage students to read the Code of Honor,

Professionalism and Ethics received in the Policies Booklet. You may refer to this

for other examples of violations of the Honor Code. Howard University College of

Medicine is committee to producing a community of knowledgeable,

compassionate and culturally competent health care professionals of high ethical

standards.

Faculty Hand Book - 1993

Terms and Conditions of Faculty Employment

Professional Ethics

As members of a learned profession and as officers of an educational

institution, the special position of faculty in this community imposes special

ethical obligations. These ethical standards are the repository of what

experience has revealed as to how scholars can live together to the best

advantage.

Faculty Hand Book Committee – Recommendation on Professionalism

WHEREAS, the Howard University Sciences Center and the Howard

University Board of Trustees (BOT) expects the highest degree of professional

behavior to be modeled by Residency Program Directors and Faculty, and;

WHEREAS, the Howard University Board of Trustees has endorsed standards

of Resident professionalism in the core competencies for decades, and

therefore;

Faculty Hand Book Committee – Recommendation on Professionalism (Continued)

The Howard University Health Sciences Center and the Howard University

Board of Trustees reaffirms its expectation that Deans, Designated

Institutional Officials, Program Directors, Faculty, and Residents in the Health

Science Centers (HSC) must demonstrate the core elements of professional

behavior in all aspects of their clinical and educational activities;

RESOLVED, that it directs the Howard University Health Sciences Center to

review its standards, and recommends any modifications of these standards

and their enforcement required to assure that these expectations are met.

We have the following hospital/medical school committees that exist to foster an

appropriate learning environment:

(1) Alpha Omega Alpha (AOA) – the National Honor Medical Fraternity

(2) The Gold Humanism Honor Society

(3) The Sub-Committee on Professionalism of the Curriculum Committee

(4) The Honor Council

(5) The Faculty Senate

(6) The Executive Committee of the Faculty Senate

(7) The Promotions Committee

(8) The Social Networking Policy Committee

(9) The Office of Faculty Development

(10) The Faculty Hand Book

(11) The Faculty House Staff and Student Affairs Committee (FHSAC)

(12) Curriculum Committee

(13) Credentials Committee of the Medical Staff

(14) Committee on Professionalism of the Medical Staff

(15) Professional Affairs Committee of the Faculty Practice Plan

Complaint is Registered

FHSAC

Mailbox

Chair of FHSAC’s

Mailbox

Any Member of

FHSAC

The Chair of FHSAC determines:

•If the complaint is appropriate for FHSAC

This entails verifying that this complaint is not also being addressed by Academic Affairs,

Graduate Medical Education, or Medical Student Affairs.

•If the complaint is appropriate for FHSAC, the Chair of FHSAC assigns it to a Rapid Response

Team

Rapid Response Team:

•Meets with the individual who registered the complaint to clarify the situation

•Meets with the person against whom the complaint was registered to understand his/her side of

the situation

•Brings their findings to the entire FHSAC

FHSAC discusses the RRT findings & develops a recommendation. The Chair of FHSAC

provides a detailed summary letter to the Senior Vice President of Health Sciences.

The Chair of FHSAC sends a letter to:

•The individual who registered the complaint

•The person against whom the complaint was registered

The Senior Vice President considers the FHSAC recommendation and determines the appropriate

action to be taken. The Senior Vice President then communicates that in writing or in person to

the individual.

Faculty, Housestaff and Student Affairs Committee

Documents

ABSTRACT TITLE: Professionalism at the Howard University ...The task force on professionalism (the second group formed) was selected by the Dean and consisted of faculty and medical