PROFESSIONAL CONDUCT AND ATTITUDES

Rationale
Prerequisites
Competencies

Rationale
Knowledge, skills, clinical reasoning, and informed decision making while crucial to a physician's practice of medicine, are insufficient to guarantee successful clinical interactions. A physician must have well-developed interpersonal skills that facilitate communication, and must also demonstrate attitudes, behaviors and beliefs that serve to promote the patient's best interest. Students can learn to be professional, at least to a certain degree, in the abstract, but will acquire professional characteristics most effectively through contact with physicians chosen to serve as role models. In order to be effective role models, however, faculty must undergo training in order to be able to explain their behaviors explicitly, to foster professionalism and humanism. Clerkship Directors should assure that faculty development occurs in this area. Ethical principles, likewise, while learned in the abstract, must be applied clinically; the importance of suitable role models cannot be overemphasized.
In particular, each student must recognize that pediatrics poses unique challenges to professional conduct and attitudes. The patient constantly changes as growth and development proceed. The patient's ability to participate actively in the clinical interaction progresses, as does his or her knowledge, experience and concerns. The adolescent presents specific challenges, including such issues as privacy, risk-taking behaviors, confidentiality and personal involvement with health. The role of parents in the clinical interaction, and their knowledge, experience, and concerns also develop and change as an individual child grows and as subsequent children are born. The way a physician communicates can have a lasting effect in how parents, children and adolescents handle situations and interact with the physician. Cultural, ethnic and socioeconomic factors also affect personal and family traits and behaviors, with varying effects on child rearing practices. Recognition of and respect for difference are important, yet the student must be alert for the child or adolescent at risk in different family environments, given that the physician's primary obligation is to promote the best interest of the patient.
Professional conduct extends to the educational process: Students have a personal responsibility for their own education and for development of life-long learning skills. They must interact with all staff, including their peers and their teachers, in a manner that demonstrates respect for each individual and that promotes personal and group learning.

Prerequisites
Well-developed data gathering skills, knowledge of ethical principles, and a basic understanding of health law issues are essential foundations for the student. Students should have completed an introductory course on medical ethics providing a basic understanding of ethical principles (autonomy, beneficence, nonmaleficence, and justice) and their application in clinical medicine

Competencies

A. Humanism and Professionalism in Patient and Family Encounters:

Knowledge

1. Describe and demonstrate behaviors that respect the patient's modesty, privacy, and confidentiality. (U)
2. Describe the practical applications of the major ethical principles (i.e. justice, beneficence, non-malfeasance and respect for autonomy) (U)

Skills

1. Demonstrate communication skills with patients and families that convey respect, integrity, flexibility, sensitivity, and compassion. (U)
2. Demonstrate respect for patient, parent, and family attitudes, behaviors and lifestyles, paying particular attention to cultural, ethnic, and socioeconomic influences to include actively seeking to elicit and incorporate the patient's, parent's and family's attitudes into the health care plan. (U)
3. Demonstrate behaviors and attitudes that promote the best interest of patients and families, including showing flexibility to meet the needs of the patient and family. (U)

B. Professionalism with Members of the Health Care Team

Knowledge

1. Describe the characteristics of the impaired physician and reflect on your responsibilities to identify and report concerning behavior (M)

Skills

1. Demonstrate collegiality and respect for all members of the health care team. (U)

C. Professionalism in the Learner Role

Skills

1. Demonstrate a positive attitude and regard for education by demonstrating intellectual curiosity, initiative, honesty, responsibility, dedication to being prepared, maturity in soliciting, accepting, and acting on feedback, flexibility when differences of opinion arise, and reliability (including completing all assignments with honesty). (U)
2. Identify and explore personal strengths, weaknesses, and goals – in general and within specific patient encounters. (U)
3. Describe the impact of stress, fatigue, and personality differences on learning and performance. (U)

D. Professionalism and Society

Knowledge

1. Describe a pediatrician's role and responsibility in advocating for the needs of patients (individual and populations) within society. (M)

Skills

1. Demonstrate behaviors that enhance the experience of the entire group of learners. (M)

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