Showing Professionalism in the Community-Based Setting

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Whole Session 2. What is a professional?What is the confirmation for when, where, and how are proficient qualities are taught?How are qualities taught in group based settings?A contextual investigation. What is a Professional?. An expert has charge of an uncommon group of information and skills.A expert is given particular rights not for the most part gave to the public.A expert has particular responsibiliti

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´╗┐Showing Professionalism in the Community-Based Setting GIMGEL 30 November 2001 David T. Stern, MD, PhD University of Michigan VA Ann Arbor Healthcare System

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Plenary Session 2 What is an expert? What is the proof for when, where, and how are proficient qualities are educated? How are qualities instructed in group based settings? A contextual analysis

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What is a Professional? An expert has charge of an uncommon collection of information and aptitudes. An expert is given particular rights not by and large gave to general society. An expert has particular obligations or obligations not for the most part expected of the general population.

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Professionals have particular information and abilities Physicians: Therapies, surgical methods Lawyers: Details of the substance and procedure of the law (nearby, state, and government) Clergy: Religious custom and scriptural translation

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Professionals have particular rights Physicians: Asking private inquiries, endorsing opiates, performing operations Lawyers: Lawyer-Client benefit (secret discussions) Clergy: Participation, authority, and access to certain religious ceremonies

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Professionals have particular obligations Excellence Compassion Confidentiality Integrity Inter-proficient regard Responsibility Self-policing

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How Did You Learn to "Act Like a Doctor?"

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How are understudies learning Professional Behaviors? Some are found out as a youngster, and are well set up before medicinal school. Some are found out in the formal educational modules of therapeutic school. Some are found out through part displaying amid restorative school.

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Values Change in Training P = 0.02 Eron, 1967

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Attitudes Change in Training Dislike for tumor patients (Kaye) Disdain for the sincerely sick (Stoller) Hostility towards self-destructive patients (Ghodse) Alcoholics as "ethically powerless" (Fisher) Negative state of mind towards geriatric patients (Spence)

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Take-home Point Professional practices change over the span of restorative instruction. (In spite of the fact that not really in the way that we might want.)

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How are understudies learning Professional Behaviors? Some are found out as a tyke, and are well set up before therapeutic school. Some are found out in the formal educational modules of restorative school. Some are found out through part displaying amid restorative school.

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How are we showing Professional Behaviors? Formal (Explicit) Curriculum Informal (Hidden) Curriculum

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Formal Curriculum of Values Teaching White coat function ITTP course Ethics rounds Honor gathering Standardized patients Evaluation

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Finding the Hidden Curriculum An Exercise What information is being instructed? What aptitudes are being instructed? What qualities are being educated?

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The Hidden Curriculum This concealed educational modules can likewise be spoken to by the three R's yet not the natural one of perusing, 'riting, and 'rithmetic. It is, rather, the educational modules of standards, controls, and schedules, of things educators and understudies must learn on the off chance that they are to advance with least torment in the social foundation called the school. - Jackson, 1966

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When Are Values Taught? p < 0.01 p < 0.01

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Where Are Values Taught? p < 0.01

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Take-home Points Professional practices change over the span of restorative training. Polished skill is instructed in the "shrouded educational programs."

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How are understudies learning Professional Behaviors? Some are found out as a youngster, and are well set up before medicinal school. Some are found out in the formal educational programs of therapeutic school. Some are found out through part demonstrating amid restorative school.

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Role Modeling Role displaying - show without clarification. The doctor's states of mind, mentality, moral position, and the hour-by-hour choices about how to utilize one's opportunity - all these and numerous different matters, notwithstanding including how and what and the amount to feel, are seen by the understudy and imitated diligently. Indeed, even where the express message is "Do as I say, not as I do," the understood message is "Do whatever you believe is correct, yet in the event that you need to get by in this world you would be advised to resemble me." Mel Konner, Becoming a Doctor

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Demonstration with clarification: Reflective Practice Student watches Student thinks about the master's showing Student exhibits Teacher trains the understudy on how well the endeavor coordinated the educator's desire

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Using Parables to Teach In my entire vocation, I've been a nephrologist now for a long time. Uh, I've lost one kidney doing biopsies consistently. Furthermore, there was this schizophrenic patient who we biopsied, I didn't permit the kindred to do the biopsy since I knew it would have been a troublesome one. I did it without anyone's help since I know I'm quick. Also, the patient shouted right now I was in the kidney, . . . also, there was a tear in the kidney. We attempted to do angiography to stop the dying. The kidney was at long last expelled, this patient lost the kidney. This was a standout amongst the most sensational circumstances I've ever had, and it's quite uncommon to have a noteworthy entanglement, to have a nephrectomy, it's one in one thousand .

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Using Conflict to Teach Values Professionalism is once in a while educated as a basic, single articulation of qualities: "Trustworthiness is the best strategy," " Primum non nocere. " Professionalism is all the more ordinarily instructed as clashes between at least two, in some cases similarly commendable values. (Genuineness versus effectiveness)

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Values Conflict (Example) Resident: Oh, they're going to peruse [the slides] today? Understudy: I revealed to them it was critical; our patient has gotten ugly, and it's imperative that we have these perused today . . . The subintern said they do that constantly. She resembles, they're absolutely pleasant about it, simply call them and disclose to them that there's a crisis.

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Values Conflict (Example) Resident: My God, my whole group is included in a trickery! Understudy: . . . don't you abhor sitting tight for exam comes about however? Occupant: I despise sitting tight to anything. Understudy: So aren't you happy we called and instructed them to make it earnest? Occupant: No.

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Take-home Points Professional practices change over the span of medicinal instruction. Polished methodology is educated in the "shrouded educational programs." The instructing of demonstrable skill can be made more successful by discussing it.

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Which Values Are Taught in the Inpatient Setting? Interprofessional Relationships (48/182) Service and Duty (30/182) Accountability and Responsibility (25/182) Industry (21/182) Integrity (13/182)

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Interprofessional Relationships Four Positive and 44 Negative Statements Well, you comprehend what they say in regards to specialists: on the off chance that they've done one, they've obviously witnessed it; on the off chance that they've done two, they have a considerable measure of involvement with it, and in the event that they've done three, then they have a broad arrangement.

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Practicing What We Preach? Prescribed and Taught Accountability and Compassion Recommended and Not Taught Integrity and Public Service Recommended and Taught as the Opposite Value Interprofessional affront and the weight of administration

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Is people group based medication the remedy to inpatient prescription? How is the instructing of expert conduct distinctive in group based settings? What educating of polished skill do we do interestingly well and decidedly in the group based setting?

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Case Study Question 1: Would you go to the ER and see this patient on your way home? Address 2: How might you react to the medical attendant specialist who comes to you with this demand?

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Case Study (cont.) Question 3: It's currently 5:15, and in the event that you leave the workplace at this moment, you can get the most recent 10 minutes of your little girl's title soccer match. What do you do? Address 4: What does the medicinal understudy next to you gain from the way you handle this circumstance?

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Conclusions Professional qualities are regularly instructed in the concealed educational modules. A large portion of the qualities communicated in the group are profitable, commendable, and missing from the inpatient educational programs. Group based preceptors are remarkably arranged to give proficient instruction.

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