Fargen Kyle M, Drolet Brian C, Philibert Ingrid
K.M. Fargen is assistant professor, Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina. B.C. Drolet is fellow of hand and upper extremity surgery, Department of Plastic Surgery, Johns Hopkins University, Baltimore, Maryland. I. Philibert is senior vice president of field activities, Accreditation Council for Graduate Medical Education, Chicago, Illinois.
Acad Med. 2016 Jun;91(6):858-64. doi: 10.1097/ACM.0000000000001133.
Recent reports have identified concerning patterns of unprofessional and dishonest behavior by physician trainees. Despite this publicity, the prevalence and impact of these behaviors is not well described; thus, the authors aimed to review and analyze the various studies on unprofessional behavior among U.S. medical trainees.
The authors performed a literature review. They sought all reports on unprofessional and dishonest behavior among U.S. medical school students or resident physicians published in English and indexed in PubMed between January 1980 and May 2014.
A total of 51 publications met criteria for inclusion in the study. The data in these reports suggest that plagiarism, cheating on examinations, and listing fraudulent publications on residency/fellowship applications were reported in 5% to 15% of the student and resident populations that were studied. Other behaviors, such as inaccurately reporting that a medical examination was performed on a patient or falsifying duty hours, appear to be even more common (reportedly occurring among 40% to 50% of students and residents).
"Unprofessional behavior" lacks a unified definition. The data on the prevalence of unprofessional behavior in medical students and residents are limited. Unprofessional behaviors are common and appear to be occurring in various demographic groups within the medical trainee population. The relationship between unprofessional behaviors in training and future disciplinary action is poorly understood. Going forward, defining "unprofessional behavior"; developing validated instruments to evaluate such behaviors scientifically; and studying their incidence, motivations, and consequences are critical.
近期报告已发现医学生学员存在不专业和不诚实行为的相关模式。尽管有这些报道，但这些行为的发生率和影响并未得到充分描述；因此，作者旨在回顾和分析关于美国医学学员不专业行为的各类研究。
作者进行了文献综述。他们查找了1980年1月至2014年5月间发表于英文且被PubMed收录的所有关于美国医学院学生或住院医师不专业和不诚实行为的报告。
共有51篇出版物符合纳入该研究的标准。这些报告中的数据表明，在所研究的学生和住院医师群体中，5%至15%的人被报告存在抄袭、考试作弊以及在住院医师/专科医师培训申请中列出虚假出版物的情况。其他行为，如错误报告对患者进行了医学检查或伪造值班时间，似乎更为常见（据报道在40%至50%的学生和住院医师中发生）。
“不专业行为”缺乏统一的定义。关于医学生和住院医师中不专业行为发生率的数据有限。不专业行为很常见，且似乎在医学学员群体的不同人口统计学分组中都有发生。培训中的不专业行为与未来纪律处分之间的关系了解甚少。未来，定义“不专业行为”；开发经过验证的工具以科学评估此类行为；并研究其发生率、动机和后果至关重要。
