Department of Anesthesiology, The Ottawa Hospital, University of Ottawa, General Campus, Suite CCW1401, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
Can J Anaesth. 2011 Nov;58(11):1039-50. doi: 10.1007/s12630-011-9579-2. Epub 2011 Aug 25.
In this review, we examine the association between physician professional behaviour and indicators measuring patient outcomes and satisfaction with care as well the potential for complaints, discipline, and litigation against physicians. We also review issues related to the structured teaching of professionalism to anesthesia residents, including resident evaluation.
A search of the OVID Medline and PubMed databases was carried out using keywords relevant to the topics under consideration. Program directors of Canadian anesthesiology training programs were also surveyed to assess the current state of professionalism training and evaluation in their programs.
Unprofessional behaviour is frequently manifested in practice by medical students, residents, and physicians, and it is associated with personality characteristics that are evident early in training. There is a correlation between unprofessional physician behaviours and patient dissatisfaction, complaints, and lawsuits as well as adverse outcomes of care. Physician health and workplace relationships are negatively impacted by such behaviours. Canadian program directors recognize the need to approach the teaching of professionalism in an organized fashion during physician training.
A framework is provided for defining behavioural expectations, and mechanisms are offered for teaching and evaluating behaviours and responding to individuals with behaviours that persistently breach defined expectations. There is a need to define explicitly not only the expectations for behaviour but also the processes by which the behaviours will be assessed and documented. In addition, emphasis is placed on the nature, order, and magnitude of the responses to behaviours that do not meet expectations.
在这篇综述中，我们考察了医生的专业行为与衡量患者治疗效果和满意度的指标之间的关联，以及由此产生投诉、纪律处分和法律诉讼的可能性。我们还回顾了与向麻醉住院医师传授专业精神相关的问题，包括对住院医师的评估。
使用与所考虑主题相关的关键词，在 OVID Medline 和 PubMed 数据库中进行了搜索。还对加拿大麻醉学培训计划的项目主任进行了调查，以评估其计划中专业精神培训和评估的现状。
不专业的行为在实践中经常由医学生、住院医师和医生表现出来，并且与在培训早期就明显存在的人格特征有关。不专业的医生行为与患者不满意、投诉和诉讼以及护理不良后果有关。医生的健康和工作场所关系受到此类行为的负面影响。加拿大项目主任认识到需要在医生培训期间以有组织的方式来教授专业精神。
为定义行为期望提供了一个框架，并提供了用于教授和评估行为以及对持续违反规定期望的个人做出反应的机制。不仅需要明确规定行为的期望，还需要明确规定评估和记录行为的流程。此外，重点还放在不符合期望的行为的性质、顺序和程度上的反应。
