Noor Sana, Aslam Fatima, Ejaz Azhar, Malik Aafia, Nasir Hafsa, Awan Nabila, Khattak Imran Qadir, Shah Mustaqeem
Community Medicine, Avicenna Medical and Dental College and Hospital, Lahore, PAK.
Medical Education, University of Health Sciences, Lahore, PAK.
Cureus. 2024 Oct 27;16(10):e72461. doi: 10.7759/cureus.72461. eCollection 2024 Oct.
Professionalism in healthcare is crucial for maintaining patient trust and delivering high-quality care. Unprofessional behaviors among house officers (recent medical graduates undergoing training) raise concerns about their impact on healthcare outcomes. This study aims to assess the prevalence and perceptions of unprofessional behavior, as well as participation in it, among house officers in both public and private hospitals in Pakistan.
A cross-sectional survey was conducted among 212 house officers from seven hospitals across Pakistan. The hospitals included both public and private institutions: 57% were private (Avicenna Medical College, Rashid Latif Medical College, Amna Inayat Medical College, Nawaz Sharif Medical College) and 43% were public (Quaid-e-Azam Medical College, Gujranwala Medical College, Khyber Medical College). A pre-validated and pre-tested questionnaire was used, covering demographic data and 29 questions related to unprofessional behaviors, including perceptions, observations, and self-reported participation. Data were collected through an online platform and analyzed using IBM SPSS Statistics for Windows, version 22 (IBM Corp., Armonk, NY, USA). Descriptive statistics were used to summarize variables, and Chi-square tests for independence were applied to compare proportions between groups (graduates from private and public universities) for each variable. Associations between demographic factors and knowledge of professionalism were analyzed, with a significance level set at p ≤ 0.05.
Out of 212 participants, almost all (99.1%, n=210) were familiar with the concept of professionalism, but over half (53.8%, n=114) had not completed a formal medical ethics course, while 52.4% (n=111) engaged in self-directed study. Although 78.3% (n=166) had completed additional professional ethics training, Chi-square analysis revealed no significant associations between ethics training and changes in unprofessional behaviors, nor between gender, department, or type of institution, and the likelihood of observing or participating in unprofessional behavior (p > 0.05). However, certain unprofessional behaviors were significantly associated with previous ethics training (p < 0.05).
While house officers demonstrated a strong awareness of professionalism, unprofessional behavior persisted regardless of gender or type of institution. These findings emphasize the need for enhanced ethical training and stricter monitoring to address and mitigate unprofessional behaviors in healthcare settings. Policymakers should consider mandatory integration of comprehensive ethical training in medical curricula to ensure better alignment between ethical knowledge and practice.
医疗行业的职业素养对于维持患者信任和提供高质量医疗服务至关重要。住院医师（正在接受培训的新晋医学毕业生）的不专业行为引发了人们对其对医疗结果影响的担忧。本研究旨在评估巴基斯坦公立医院和私立医院住院医师中不专业行为的发生率、认知情况以及参与程度。
对来自巴基斯坦七家医院的212名住院医师进行了横断面调查。这些医院包括公立和私立机构：57%为私立医院（阿维森纳医学院、拉希德·拉蒂夫医学院、阿姆娜·伊纳亚特医学院、纳瓦兹·谢里夫医学院），43%为公立医院（真纳医学院、古杰兰瓦拉医学院、开伯尔医学院）。使用了一份经过预验证和预测试的问卷，涵盖人口统计学数据以及29个与不专业行为相关的问题，包括认知、观察和自我报告的参与情况。数据通过在线平台收集，并使用IBM SPSS Statistics for Windows 22版（IBM公司，美国纽约州阿蒙克）进行分析。描述性统计用于总结变量，卡方独立性检验用于比较各变量组（私立和公立大学毕业生）之间的比例。分析了人口统计学因素与职业素养知识之间的关联，显著性水平设定为p≤0.05。
在212名参与者中，几乎所有人（99.1%，n = 210）都熟悉职业素养的概念，但超过一半（53.8%，n = 114）没有完成正式的医学伦理学课程，而52.4%（n = 111）进行了自主学习。尽管78.3%（n = 166）完成了额外的职业道德培训，但卡方分析显示，伦理学培训与不专业行为的改变之间、性别、科室或机构类型与观察或参与不专业行为的可能性之间均无显著关联（p>0.05）。然而，某些不专业行为与之前的伦理学培训显著相关（p<0.05）。
虽然住院医师表现出对职业素养的强烈认知，但无论性别或机构类型如何，不专业行为仍然存在。这些发现强调需要加强伦理培训和更严格的监督，以解决和减轻医疗环境中的不专业行为。政策制定者应考虑在医学课程中强制纳入全面的伦理培训，以确保伦理知识与实践更好地结合。
