Defining Professionalism in Anesthesiology Residency

Core Components Framework

The American Board of Pediatrics established a comprehensive framework that applies across medical specialties, including anesthesiology, defining professionalism through specific behavioral standards 1, 2, 3

Honesty and integrity embody fairness, the ability to meet commitments and keep one's word, and the duty to be intellectually honest and straightforward in interactions with patients, peers, and all professional communication 1, 2, 3
Reliability and responsibility represent accountability to patients, families, other physicians, medical staff, community, and ultimately society, requiring acceptance of responsibility for errors made, including willingness to acknowledge and discuss errors, consequences, and alternatives with families and peers 1, 2, 3
Respect for others involves treating all persons with respect and regard for individual worth and dignity, including sensitivity to gender, race, and cultural differences, as well as maintenance of patient confidentiality when appropriate 1, 2, 3

Compassion and empathy require the ability to understand patients' and family members' reactions to pain, discomfort, and anxiety from their point of view, not that of the physician 1, 2, 3
Communication and collaboration involve recognition that patients' families and the health care team must work cooperatively with each other and communicate effectively to provide the best patient care 1, 2, 3
Altruism and advocacy refer to unselfish regard or devotion to the welfare of others, with patient well-being as the primary motivating factor in patient care, ahead of physicians' own interests and needs 1, 2, 3

Self-improvement involves a commitment to lifelong learning and education to maintain and enhance clinical knowledge and skills 1, 2, 3, 4
Self-awareness and knowledge of limits represent the maturity to recognize when a problem involves knowledge or technical skills beyond the experience of the provider and to ask for consultation or assistance in those situations 1, 2, 3

Faculty must model professional behavior they seek to instill in trainees, as the "hidden curriculum" (what is taught by observing daily behavior of healthcare professionals) may influence trainees more than formal ethics training 5, 4
Opportunities to model behavior occur in the clinic, at the bedside, on the telephone, and in the patient's chart, with clear documentation using the OLFACTORY principles (Original, Legible, Factual, Accurate, Consistent, Timely, Objective, Rational, and Yours) 5, 4
Clinical teachers must demonstrate how to manage difficulties in relationships with patients or colleagues, effectively communicate with interdisciplinary teams, gracefully acknowledge errors, and confront poor practice in colleagues or trainees 5
Professionalism should be viewed as a developmental process across all stages of a medical career, requiring longitudinal assessment throughout residency training 5
Stress management and coping strategies should be taught from the outset of training, as improved orientation regarding residency demands benefits resident well-being and professional development 6, 4

When physicians keep silent in the face of inappropriate behavior, the implication is that the status quo is acceptable, and the opportunity to discuss professional behavior in the clinical context is lost 5, 4
Poor documentation skills represent an area of professionalism needing improvement, with medical liability risk managers emphasizing the importance of clear, concise, and correct medical record documentation 5, 4
Physicians who attend to their own needs are better able to show compassion and empathy to patients, making self-care a professional responsibility rather than a luxury 4