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{
    "pk": 10949,
    "title": "Self vs. Other Focus: Predicting Professionalism Remediation  of Emergency Medicine Residents",
    "subtitle": null,
    "abstract": "Introduction:\n Unprofessionalism is a major reason for resident dismissal from training. Because of the high stakes involved, residents and educators alike would benefit from information predicting whether they might experience challenges related to this competency. Our objective was to correlate the outcome of professionalism-related remedial actions during residency with the predictor variable of resident response to a standardized interview question: “Why is Medicine important to you?”  \n \nMethods: \nWe conducted a professional development quality improvement (QI) initiative to improve resident education and mentorship by achieving a better understanding of each resident’s reasons for valuing a career in medicine. This initiative entailed an interview administered to each resident beginning emergency medicine training at San Antonio Military Medical Center during 2006-2013.  The interviews uniformly began with the standardized question “Why is Medicine important to you?”  The residency program director documented a free-text summary of each response to this question, the accuracy of which was confirmed by the resident. We analyzed the text of each resident’s response after a review of the QI data suggested an association between responses and professionalism actions (retrospective cohort design). Two associate investigators blinded to all interview data, remedial actions, and resident identities categorized each text response as either self-focused (e.g., “I enjoy the challenge”) or other-focused (e.g., “I enjoy helping patients”).  Additional de-identified data collected included demographics, and expressed personal importance of politics and religion. The primary outcome was a Clinical Competency Committee professionalism remedial action.  \nResults:\n Of 114 physicians starting residency during 2006-2013, 106 (93.0%) completed the interview. There was good inter-rater reliability in associate investigator categorization of resident responses as either self-focused or other-focused (kappa coefficient 0.85). Thirteen of 50 residents (26.0%) expressed self-focus versus three of 54 (5.4%) residents expressed other-focus experienced professionalism remedial actions (p<0.01). This association held in a logistic regression model controlling for measured confounders (p=0.02).  \nConclusion: \nSelf-focused responses to the question “Why is Medicine important to you?” correlated with professionalism remedial actions during residency.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Professionalism"
        },
        {
            "word": "Graduate Medical Education"
        },
        {
            "word": "interview"
        },
        {
            "word": "Remediation"
        }
    ],
    "section": "Original Research",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/514268bq",
    "frozenauthors": [
        {
            "first_name": "Robert",
            "middle_name": "E.",
            "last_name": "Thaxton",
            "name_suffix": "",
            "institution": "San Antonio Uniformed Services Health Education Consortium, Department of Emergency Medicine, San Antonio, Texas",
            "department": "None"
        },
        {
            "first_name": "Woodson",
            "middle_name": "S.",
            "last_name": "Jones",
            "name_suffix": "",
            "institution": "San Antonio Uniformed Services Health Education Consortium, Department of Graduate Medical Education, San Antonio, Texas",
            "department": "None"
        },
        {
            "first_name": "Fred",
            "middle_name": "W.",
            "last_name": "Hafferty",
            "name_suffix": "",
            "institution": "University of Minnesota Medical School, Department of Behavioral Sciences, Minneapolis, Minnesota",
            "department": "None"
        },
        {
            "first_name": "Carolyn",
            "middle_name": "W.",
            "last_name": "April",
            "name_suffix": "",
            "institution": "University of Texas Health Sciences Center San Antonio, Department of Medicine, San Antonio Texas",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "D.",
            "last_name": "April",
            "name_suffix": "",
            "institution": "San Antonio Uniformed Services Health Education Consortium, Department of",
            "department": "None"
        }
    ],
    "date_submitted": "2017-06-14T18:44:08Z",
    "date_accepted": "2017-06-14T18:44:08Z",
    "date_published": "2017-12-14T20:16:46Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/10949/galley/5921/download/"
        }
    ]
}