Exam 2 Flashcards
Professionalism Definition
Professionalism is demonstrated through a foundation of competence,
communication skills, and ethical and legal understanding upon which is built the aspiration too and wise application of the principles of: excellence,
humanism, accountability, and altruism.”
3 fundamental principles in medical professionalism
Primacy of patient welfare
Patient autonomy
Social justice
What is Empathy?
The ability of one person to relate and
understand the situational circumstances
of another human being
Strong correlation between empathy and ______
professionalism
What is professional integrity?
One who willingly “adopts” and consistently applies the
knowledge, skills, and values of a chosen profession. Integrity may be the most appropriate word used to describe the person who willingly and consistently acts in accordance
with social standards or moral values of society. Professional integrity thus defines the professional who consistently and
willingly practices within the guidelines of the mission of a chosen profession under the obligation of a Code of Ethics and societal expectations
What is research misconduct and reporting mechanism?
Fabrication, falsification,
or plagiarism in proposing,
performing or reviewing
research or in reporting
research results
-Obligation to report
-Honest differences of
opinion are not considered
as misconduct
-Officer for Research
Standings (ORS)
-Students report to ORS,
Provost or Student Life
Moral vs. Ethical
-Similar but not the same
-Ethics > a set of rules, principles, or ways of thinking that guide
or claim authority to guide the actions of a particular group
* Has no particular religious basis or connection
* Often based on the profession you are in: medicine, business, etc.
-Morality > a doctrine or system concerned with conduct or duty;
habits of life with regard to right or wrong
* Often conflated with religion; also embedded in a society’s values
Moral Dissonance
- A clash
- Inconsistency between
the beliefs and values of
the parties to the
decision-making process
Moral Distress
- Moral distress occurs when one knows the ethically correct action
to take but feels powerless to take that action (Jameton, 1984) - Initially described in nursing profession
- Demonstrated to impact ALL healthcare professionals, including
physicians - Students are especially vulnerable due to power imbalance
Moral Distress
Constraints Involved in Moral Distress: Internal vs External
-Internal: self-doubt, fear, lack of assertiveness
-External: hierarchies in health care system, not enough staff, fear of litigation
What is the cost of moral distress? How can we fix it?
-physician burnout, moral outrage/injury, leaving the profession
-speak up, deliberate decisions, support networks, working as a team, acknowledge struggles
What is moral dilemma?
- A situation involving choice
between equally
(un)satisfactory alternatives - A problem seemingly
incapable of a satisfactory
solution
Decision making process for ethical choices
1) Gather Information
2) Define the Value Conflict
3) Identify the Decision
Makers
4) Weigh the Alternative(s)
and Decide
5) Carry Out the Decision
6) Live With the Decision
7) Learn from the Decision
What are boundary crossings and violations?
-Crossing: deviation from classical therapeutic activity that is harmless, non-exploitive, and possible supportive of the therapy
itself
* Not all boundary crossings are boundary violations
-Violation: deviation from classical therapeutic activity that is harmful (or potentially harmful) to the patient and therapy alike
b/c it constitutes exploitation of the patient, using the health care
provider-patient relationship as its vehicle
What are dual relationships?
- Two distinct types of relationship with the same person
- HCP PLUS friend, business affiliate, coworker, family member, romantic
partner,….
-Dual relationships are discouraged because: - Allow for possible conflicts of interest, May lessen clinical objectivity, Ultimately impair professional judgment
-Iowa Board of Medicine has guidelines re: romantic involvement with
patients/parents of patients: - Cannot date any patient you have ever seen for mental health problem
- Cannot date current patient (best to wait at least a year)
- Cannot date parent of a minor patient
What is Resilience?
-Process of adapting well
-A person’s capacity to resist adversity
-Capacity of a material or body to suffer stress or the imposition of
external pressure and return to its original state
What is moral courage?
Moral courage is the courage to take action for moral reasons despite the
risk of adverse consequences
5 pillars of resilience
- Physical resilience: aims to maintain and improve physical health
- Mental resilience: aims to maintain and improve emotional and cognitive state
- Social resilience: aims to maintain and improve social situation and relationships
- Financial resilience: aims to maintain and improve financial foundation
- Spiritual/existential resilience: aims to provide meaning in life/role
Stress management HALT acronym
Don’t let yourself get too
* Hungry
* Angry
* Lonely
* Tired
* (Sick)
TeamSTEPPS
-Team Strategies & Tools to Enhance Performance
& Patient Safety
-gives team a common language
bridges the divide and levels hierarchy
-includes patients as core to care
Standards of Effective
Communication
-complete
-clear
-brief
-timely
-respectful
What is SBAR
-A framework for team members to effectively communicate information to one another
-situation
-background
-assessment
-recommendation or request
What is call-out?
- A strategy used to communicate important or critical
information: - It informs all team members simultaneously during emerging
situations. - It helps team members anticipate next steps
What is a check-back?
-Confirming medication, procedure etc.
-Confirms right treatment
What is hand-off?
-shift change
-“rounds”
-patient clarity and information
-gives opportunity to ask questions about patients
-transfers responsibility of patient
What is the I-PASS handoff tool?
-I = illness severity (stability)
- P = patient summary (treatment plan, ongoing assessments etc.)
-A = action list (to-do list)
- S = situation awareness and planning (whats going on and plan for what might happen)
- S = synthesis of receiver (summary, ask questions)
Team Leader Role
- Ensure the patient’s needs and preferences are understood and prioritized.
- Define, assign, share, monitor, and modify a plan.
- Review the team’s performance.
- Establish “rules of engagement.”
- Manage and allocate resources effectively.
- Provide feedback regarding assigned responsibilities and progress toward the goal.
- Facilitate information sharing.
- Encourage team members to assist one another.
- Facilitate conflict resolution.
- Model effective teamwork
What is a team brief?
- A team brief is an effective strategy for
sharing the plan. - Briefs should help:
- Form the team.
- Designate team roles and responsibilities.
- Establish climate and goals.
- Engage team in short- and long-term
planning.
What is the huddle?
*monitoring or modifying the plan
* Hold ad hoc, “touch base” meetings to
regain situation awareness.
* Discuss critical issues and emerging
events.
* Anticipate outcomes and likely
contingencies
What is the debrief?
*fosters process improvement:
* Brief, informal information exchange and
feedback sessions
* Occur after an event or shift
* Designed to improve teamwork skills
* Designed to improve outcomes
