Lockman Justin L, Schwartz Alan Jay, Cronholm Peter F
Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA.
Department of Family Medicine and Community Health, Center for Public Health Initiatives, Leonard Davis Institute of Health Economics, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA.
Paediatr Anaesth. 2017 Feb;27(2):137-146. doi: 10.1111/pan.13071.
Unprofessional behavior is a significant problem throughout graduate medical education programs and medical centers. Some authors have suggested that professionalism curricula should be focused toward faculty, not trainees, to interrupt the modeling of unprofessionalism. Developing such curricula requires a needs assessment and is challenging given data indicating that the definition of professionalism varies based on medical specialty. Thus, a specialty-specific definition of professionalism is needed as a first step in any curriculum development.
The aim of this study was to define professionalism in pediatric anesthesiology.
This is a qualitative study using focus groups for data collection and a grounded theory approach for analysis. Four relevant stakeholder groups, pediatric surgeons and endoscopists, perioperative nurses, pediatric anesthesiologists, and parents of children who had undergone surgery at our facility, were recruited for participation. De-identified transcripts were analyzed and coded to derive major domains and component themes relevant to the definition of professionalism for pediatric anesthesiology. Member checking with participants from our stakeholder groups was used to validate thematic development and increase the trustworthiness of our findings.
Focus group participants included 20 individuals, 14 of whom were female. Analysis of transcripts identified 11 major domains across the four groups: Patient Ownership, Specialty Expertise, Continuous Team Improvement, Expressive Communication, Active Listening, Care Coordination, Medical Hierarchy, Leadership, Teamwork, Personality Traits, and Physical Image. The data uncovered several controversies for future study.
A composite of these 11 domains may give a more complete image of what surgical and nursing colleagues, patient families, and anesthesiologist partners expect of the pediatric anesthesiologist. Despite some overlap and interdependence between domains, this research may contribute to the creation of future educational curricula and provides domains for evaluation of professionalism in pediatric anesthesiology.
不专业行为是整个毕业后医学教育项目和医疗中心的一个重大问题。一些作者建议，职业素养课程应针对教职员工而非学员，以打断不专业行为的示范。开发此类课程需要进行需求评估，鉴于有数据表明职业素养的定义因医学专业而异，这具有挑战性。因此，作为任何课程开发的第一步，需要一个特定专业的职业素养定义。
本研究的目的是界定小儿麻醉学中的职业素养。
这是一项定性研究，使用焦点小组收集数据，并采用扎根理论方法进行分析。招募了四个相关利益相关者群体参与，即小儿外科医生和内镜医师、围手术期护士、小儿麻醉医师以及在我们机构接受过手术的患儿家长。对去识别化的转录本进行分析和编码，以得出与小儿麻醉学职业素养定义相关的主要领域和组成主题。通过与我们利益相关者群体的参与者进行成员核对，来验证主题发展并提高我们研究结果的可信度。
焦点小组参与者包括20人，其中14人为女性。对转录本的分析确定了四组中的11个主要领域：患者主导权、专业知识、团队持续改进、表达性沟通、积极倾听、护理协调、医疗层级、领导力、团队合作、性格特质和外在形象。数据揭示了一些有待未来研究的争议点。
这11个领域的综合可能会更完整地呈现外科和护理同事、患者家属以及麻醉医师伙伴对小儿麻醉医师的期望。尽管各领域之间存在一些重叠和相互依存关系，但这项研究可能有助于创建未来的教育课程，并为评估小儿麻醉学中的职业素养提供领域。
