Chang Hyung-Joo, Lee Young-Mee, Lee Young-Hee, Kwon Hyo-Jin
a Department of Medical Humanities , Korea University College of Medicine , Seoul , Korea.
Med Teach. 2017 Mar;39(3):278-284. doi: 10.1080/0142159X.2017.1270432. Epub 2016 Dec 25.
The residency is a critical period for doctors to establish their professional identity and ethical standards, and yet during this time, residents are susceptible to engage in a diverse range of unprofessional behaviors. To prevent the misconduct of residents, it is critical to have a thorough understanding of the contributing factors or circumstances.
We conducted a qualitative study on 20 residents at one Korean university-affiliated tertiary hospital. During in-depth interviews, residents were asked to reveal their experiences or observations of misconduct, and describe their perceptions on the attributes of professional lapses.
Diverse unethical and unprofessional behaviors were extracted from the transcripts and reported in a previous paper. In the current paper, the attributes that residents regarded as the causes of their unprofessional behaviors were identified within four categories: (1) inadequate systems within training hospitals; (2) lack of professionalism education; (3) strong hierarchical structure; and (4) poor character of individuals. The residents tended to perceive their misconduct as situation-sensitive, and emphasized the importance of systematic and cultural changes.
To enhance medical professionalism among residents, the results of this study suggest the need of systematic and structured training programs, adequate professionalism education with clear codes of conduct, and active monitoring and feedback systems.
住院医师培训阶段是医生确立职业身份和道德标准的关键时期，然而在此期间，住院医师容易出现各种不专业行为。为防止住院医师的不当行为，深入了解其促成因素或相关情况至关重要。
我们对韩国一所大学附属医院的20名住院医师进行了定性研究。在深入访谈中，要求住院医师透露他们对不当行为的经历或观察，并描述他们对职业失误属性的看法。
从访谈记录中提取了各种不道德和不专业行为，并在之前的一篇论文中进行了报道。在本文中，住院医师认为导致其不专业行为的属性被归纳为四类：（1）培训医院内部系统不完善；（2）缺乏职业素养教育；（3）等级结构森严；（4）个人品德不佳。住院医师倾向于认为他们的不当行为与具体情境有关，并强调了系统和文化变革的重要性。
为提高住院医师的医学职业素养，本研究结果表明需要系统且结构化的培训项目、具备明确行为准则的充分职业素养教育，以及积极的监督和反馈系统。
