Wednesday, July 1, 2015

PEM Attending Perspectives on Maintaining Professionalism

Christine Cho, MD, MPH, MEd
Children's Hospital and Research Center / UCSF

Objective: To characterize the pediatric emergency medicine (PEM) attending’s perspective on maintaining professionalism during their career.
Methods: Two qualitative methods were used: field observation and semi-structured interviews. Field observations were conducted in a pediatric emergency department (ED) based on a framework for professionalism education. Semi-structured interviews were conducted with a purposive sample of PEM attendings from across the country. Interviews were transcribed and coded using constant comparative technique. The two differing methods allowed for data triangulation.
Results: 45 hours of observation and 17 interviews were conducted with PEM physicians around the country with a wide variety of demographic characteristics. Observations and interviews revealed several themes describing the PEM attending’s perspective on professionalism. Challenges to professionalism include: patient related factors (such as high volume and acuity, difficult medical situations and dissatisfied families), staff interactions (RN, ancillary, etc.), trainee education and interaction, ED environment, academic pressures, and personal factors.
Conclusions: By understanding the PEM attending perspective on professionalism, resources and education can be better targeted for professional development and interventions to solve the challenges that PEM physicians identify. Development of robust assessment tools for professionalism and investigating the impact of role models on trainee education can be studied with more insight by using the results of this study.