College of Medicine College of Medicine Florida State UniversityFlorida State UniversityCollege of Medicine College of Medicine Florida State UniversityFlorida State University

Professionalism at FSU COMProfessionalism at FSU COM

Christopher A. Leadem, Ph.D. & Robert Campbell, M.D.Christopher A. Leadem, Ph.D. & Robert Campbell, M.D.Division of Student Affairs & AdmissionsDivision of Student Affairs & Admissions

The Medical ProfessionThe Medical ProfessionAn occupation whose core element is work based upon the An occupation whose core element is work based upon the mastery of a complex body of knowledge and skills. It is a mastery of a complex body of knowledge and skills. It is a vocation in which knowledge of some department of science or vocation in which knowledge of some department of science or learning or the practice of an art founded upon it is used in the learning or the practice of an art founded upon it is used in the service of othersservice of others. Its members are governed by codes of ethics . Its members are governed by codes of ethics and profess a and profess a commitment to competence, integrity and morality, commitment to competence, integrity and morality, altruism, and the promotion of the public good altruism, and the promotion of the public good within their within their domain. These commitments form the basis of a social contract domain. These commitments form the basis of a social contract between a profession and society, which in return grants the between a profession and society, which in return grants the profession a monopoly over the use of its knowledge base, the profession a monopoly over the use of its knowledge base, the right to considerable autonomy in practice and the privilege of right to considerable autonomy in practice and the privilege of self-regulation. Professions and their members are self-regulation. Professions and their members are accountable to accountable to those served and to societythose served and to society.*.*

*, From “Profession”: A Working Definition for Medical Educators, Cruess et al., Teaching & Learning in Medicine 16:74, 2013

ProfessionalismProfessionalism

• AltruismAltruism- - serve the interests of the patient above your own self-serve the interests of the patient above your own self-interest interest

• AccountabilityAccountability- - to patients, society and the professionto patients, society and the profession

• ExcellenceExcellence- - conscientious effort to exceed ordinary expectations conscientious effort to exceed ordinary expectations and to make a commitment to life-long learningand to make a commitment to life-long learning

• DutyDuty- - free acceptance of a commitment to servicefree acceptance of a commitment to service

• Honor & IntegrityHonor & Integrity- - consistent regard for the highest standards consistent regard for the highest standards of behavior and the refusal to violate personal and professional codesof behavior and the refusal to violate personal and professional codes

• Respect for OthersRespect for Others- - (patients, families, professional colleagues) (patients, families, professional colleagues) is the essence of humanismis the essence of humanism

*, From the American Board of Internal Medicine, Project Professionalism, 1994

The key elements of professionalism in medicine*The key elements of professionalism in medicine*

Societal Contract“With great power comes great

responsibility.”You are in a guild now. It is no longer about you…it’s about

your patients

Honor CodeHonor Code

The Florida State University College The Florida State University College of Medicine expects students to be of Medicine expects students to be honest in all of their class work. In honest in all of their class work. In addition to academic honesty, we addition to academic honesty, we expect a high standard of personal expect a high standard of personal

and professional conduct in the and professional conduct in the physicians we aspire to train. physicians we aspire to train.

AAMC’s COMPACT BETWEEN TEACHERS AND LEARNERS ININ MEDICINE*

AAMC’s COMPACT BETWEEN TEACHERS AND LEARNERS ININ MEDICINE*

*, Adopted by FSU’s College of Medicine faculty in 2002

Commitments of FacultyCommitments of Faculty•• We pledge our utmost effort to ensure that all components of We pledge our utmost effort to ensure that all components of

the educational program for students are of high quality.the educational program for students are of high quality.

•• As mentors for our student colleagues, we maintain high As mentors for our student colleagues, we maintain high professional standards in all of our interactions with patients, professional standards in all of our interactions with patients, colleagues, and staff.colleagues, and staff.

•• We respect all students as individuals, without regard to We respect all students as individuals, without regard to gender, race, national origin, religion, or sexual orientation; gender, race, national origin, religion, or sexual orientation; we will not tolerate anyone who manifests disrespect or who we will not tolerate anyone who manifests disrespect or who expresses biased attitudes towards any student or resident.expresses biased attitudes towards any student or resident.

•• We pledge that students will have sufficient time to fulfill We pledge that students will have sufficient time to fulfill personal and family obligations, to enjoy recreational personal and family obligations, to enjoy recreational activities, and to obtain adequate rest; we monitor and, when activities, and to obtain adequate rest; we monitor and, when necessary, reduce the time required to fulfill educational necessary, reduce the time required to fulfill educational objectives, including time required for objectives, including time required for ““callcall”” on clinical on clinical rotations, to ensure studentsrotations, to ensure students’’ well being. well being.

Commitments of Faculty (conCommitments of Faculty (con’’t)t)•• In nurturing both the intellectual and the personal development In nurturing both the intellectual and the personal development

of students, we celebrate expressions of professional attitudes of students, we celebrate expressions of professional attitudes and behaviors, as well as achievement of academic excellence.and behaviors, as well as achievement of academic excellence.

•• We do not tolerate any abuse or exploitation of students.We do not tolerate any abuse or exploitation of students.

•• We encourage any student who experiences mistreatment or We encourage any student who experiences mistreatment or who witnesses unprofessional behavior to report the facts who witnesses unprofessional behavior to report the facts immediately to appropriate faculty or staff; we treat all such immediately to appropriate faculty or staff; we treat all such reports as confidential and do not tolerate reprisals or reports as confidential and do not tolerate reprisals or retaliations of any kind.retaliations of any kind.

Examples of inappropriate behaviors are:Examples of inappropriate behaviors are:• • Physical punishment or physical threatsPhysical punishment or physical threats

• • Sexual harassmentSexual harassment

• • Discrimination based on race, religion, sex, sexual orientation, national or Discrimination based on race, religion, sex, sexual orientation, national or ethnic origin, age, disabilityethnic origin, age, disability

• • Repeated episodes of psychological punishment of a student by a particular Repeated episodes of psychological punishment of a student by a particular superior (e.g. public humiliation, threats and intimidation, removal of superior (e.g. public humiliation, threats and intimidation, removal of privileges)privileges)

• • Grading used to punish a student rather than to evaluate objective Grading used to punish a student rather than to evaluate objective performanceperformance

• • Assigning tasks for punishment rather than to evaluate objective performanceAssigning tasks for punishment rather than to evaluate objective performance

• • Requiring the performance of personal servicesRequiring the performance of personal services

• • Taking credit for another individual’s workTaking credit for another individual’s work

• • Intentional neglect or intentional lack of communication.Intentional neglect or intentional lack of communication.

From: 2011/12 FSU COM Student Handbook

FSU Sexual Harassment PolicyFSU Sexual Harassment Policy☤ (3)(3) DEFINITION. Sexual harassment is defined as DEFINITION. Sexual harassment is defined as

unwelcome sexual advances, requests for sexual favors, and unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature directed at other verbal or physical conduct of a sexual nature directed at an employee or student by another when:an employee or student by another when:(a) submission to such conduct is made either explicitly or implicitly a term or (a) submission to such conduct is made either explicitly or implicitly a term or

condition of employment, academic status, receipt of University services, condition of employment, academic status, receipt of University services, participation in University activities and programs, or affects the measure of a participation in University activities and programs, or affects the measure of a student's academic performance; or,student's academic performance; or,

(b) submission to or rejection of such conduct is used as the basis for a decision (b) submission to or rejection of such conduct is used as the basis for a decision affecting employment, academic status, receipt of services, participation in affecting employment, academic status, receipt of services, participation in University activities and programs, or the measure of a student's academic University activities and programs, or the measure of a student's academic performance; or,performance; or,

(c) such conduct has the purpose or effect of unreasonably interfering with (c) such conduct has the purpose or effect of unreasonably interfering with employment opportunities, work or academic performance or creating an employment opportunities, work or academic performance or creating an intimidating, hostile, or offensive work or educational environment.intimidating, hostile, or offensive work or educational environment.

From: http://www.auditservices.fsu.edu/sh/policy.html

Commitments of StudentsCommitments of Students•• We pledge our utmost effort to acquire the knowledge, skills, We pledge our utmost effort to acquire the knowledge, skills,

attitudes, and behaviors required to fulfill all educational attitudes, and behaviors required to fulfill all educational objectives established by the faculty.objectives established by the faculty.

•• We cherish the professional virtues of honesty, compassion, We cherish the professional virtues of honesty, compassion, integrity, fidelity, and dependability.integrity, fidelity, and dependability.

•• We pledge to respect all faculty members and all students as We pledge to respect all faculty members and all students as individuals, without regard to gender, race, national origin, individuals, without regard to gender, race, national origin, religion, or sexual orientation.religion, or sexual orientation.

•• As physicians in training, we embrace the highest standards of As physicians in training, we embrace the highest standards of the medical profession and pledge to conduct ourselves the medical profession and pledge to conduct ourselves accordingly in all of our interactions with patients, colleagues, accordingly in all of our interactions with patients, colleagues, and staff.and staff.

•• In fulfilling our own obligations as professionals, we pledge to In fulfilling our own obligations as professionals, we pledge to assist our fellow students in meeting their professional assist our fellow students in meeting their professional obligations, as well.obligations, as well.

Grading PolicyGrading Policy☤ Years 1 & 2Years 1 & 2

• Pass-FailPass-Fail

• Must pass all required coursesMust pass all required courses

☤ Years 3 & 4Years 3 & 4• Honors-Pass-FailHonors-Pass-Fail

• Must pass all required coursesMust pass all required courses

• Narrative evaluationsNarrative evaluations

☤ Medical Student Performance EvaluationMedical Student Performance Evaluation

Evaluation & Promotion CommitteeEvaluation & Promotion Committee☤ Charged with reviewing all studentsCharged with reviewing all students’’ academic academic

progressprogress☤ Composed of facultyComposed of faculty☤ ProbationProbation

• A grade other than honors or pass in any course or A grade other than honors or pass in any course or clerkship.clerkship.

• Displaying behavior that is unacceptable or Displaying behavior that is unacceptable or unprofessional, and fails to meet the level of unprofessional, and fails to meet the level of professionalism reasonably expected of medical professionalism reasonably expected of medical students and future physicians, provided that some students and future physicians, provided that some behaviors may be so egregious as to justify immediate behaviors may be so egregious as to justify immediate dismissal of a medical student.dismissal of a medical student.

Evaluation & Promotion CommitteeEvaluation & Promotion Committee☤ The SEPC may, at its discretion, require an The SEPC may, at its discretion, require an

adjustment of academic load, repetition, dismissal adjustment of academic load, repetition, dismissal or other change of status for any of the following or other change of status for any of the following academic situations:academic situations:• Failure to pass all courses/clerkships while on Failure to pass all courses/clerkships while on

probation.probation.

• Two or more failures in required courses/clerkships.Two or more failures in required courses/clerkships.

• Displaying behavior that is unacceptable or Displaying behavior that is unacceptable or unprofessional, and fails to meet the level of unprofessional, and fails to meet the level of professionalism reasonably expected of medical professionalism reasonably expected of medical students and future physicians.students and future physicians.

Attendance PolicyAttendance Policy☤ You are responsible for attending:You are responsible for attending:

• Small groupsSmall groups

• Team-based learning sessionsTeam-based learning sessions

• LabsLabs

• Clinical experiencesClinical experiences

• ExamsExams

☤ Lecture attendance is encouraged but not Lecture attendance is encouraged but not mandatory unless:mandatory unless:• Lectures with outside speakers or patientsLectures with outside speakers or patients

• Course events may require attendanceCourse events may require attendance

AAMC Matriculating Student AAMC Matriculating Student QuestionnaireQuestionnaire

You will soon be receiving emails from the You will soon be receiving emails from the AAMC to complete the Matriculating Student AAMC to complete the Matriculating Student

Questionnaire. Questionnaire.

Please fill it out (~20 minutes to complete)Please fill it out (~20 minutes to complete)

Dr. Robert Campbell

FacebookMyspaceYammerYouTubeLinkedInBloggerTwitter

Facebook: “I peed.” (social networking)

Youtube: “Look at this pee!” (video) Twitter: “I need to pee.” (microblog) Linkedin: “I am good at peeing.”

(business networking) Foursquare: “This is where I peed.”

(location) Fluid and constantly changing based on

new technology, websites, etc. Glossary of Social Media Terms: http://www.socialbrite.org/sharing-center/glossary/

20

21

everything that’s already in the world when you’re born is just normal;

anything that gets invented between then and before you turn thirty is incredibly exciting and creative and with any luck you can make a career out of it;

anything that gets invented after you’re thirty is against the natural order of things and the beginning of the end of civilization as we know it until it’s been around for about ten years when it gradually turns out to be alright really.Douglas Adams. How to Stop Worrying and Learn to Love the Internet. 1999.

http://www.douglasadams.com/dna/19990901-00-a.html

Make connections between people Improved communication for eventsOpportunity to create a positive self-

imageSocial outletCollaborative learningShare educational experiencesEducate patients

Social Media blurs the line between your professional and personal life

Social contractSacred public trustConfidentialityHIPPAPoor social image

Birthdates Political Views Location

Sexual Preference Information

Cell Phone Numbers

Pictures

•78/130 Medical Schools Responded•60% (47/78) incidents of student unprofessional posting•Violations of patient confidentiality 13%•Profanity 52%•Discriminatory language 48%•Depiction of intoxication 39%•Sexually suggestive material 38%•Of the 45 schools that reported:

•30 (67%) gave warnings•3 reported student dismissal (7%)

Online posting of Unprofessional Content by Medical Students JAMA 2009;302:1309-1315

Looked up the names of 800 medical students and residents on facebook and found 362 profiles (44.5%) Only 37% made private 6% revealed home address Over 50 percent included sexual orientation and

political positions Randomly selected 10 students

7 had picture of drinking alcohol and inferences to excessive drinking

3 had joined groups that could be interpreted as sexist (Physicians looking for trophy wives in training) or racially charged (I should have gone to a blacker college)

The Intersection of Online Social Networking with Medical Professionalism – Journal of General Internal Medicine Volume 23, Number 7, July 2008

338 doctors in University of Otago in 2006

65% had facebook 27% had no privacy Half the photos showed

alcohol with 10% showing evidence of intoxication

Belonged to groups such as:

Perverts united’ ‘F*** medicine - I want to be a

ninja’, which was ‘dedicated to medics who are sick and tired of the prospect of a hideously long training time, lack of respect, poor hours and rectal exams on elderly gentlemen’.

MEDICAL EDUCATION 2010; 44: 805–813

Robert Lindeman, M.D. Malpractice suit involving a 12-year-old patient Anonymous blog

Ridiculed the plaintiff's case Ridiculed the plaintiff's lawyer Revealed the defense strategy Accused members of the jury for dozing

Asked of he was Dr. Flea – settled the next day

Patients on social mediaProfessors on social mediaSelection of applicants to college and

to residencyThe social contract with society

Use social media Understand the implications and your

duty Think before you post Once you post content, you relinquish

control of its proliferation forever Even the strictest privacy settings do

not ensure total security Never reveal confidential or exclusive

information on the Internet

Respect copyrighted material and post only with consent of the owner

References to staff, faculty, students, or any person or organization associated with FSU (including competitors) must be truthful and respectful

Refrain from posting pictures or posts that you may regret