Promoting faculty professionalism: a case-based approach.

INTRODUCTION: Professionalism is a key attribute for health professionals. Yet, it is unknown how much faculty development is directed toward skills and behaviours of faculty professionalism. Faculty professionalism includes boundaries in teacher-student relationships, self-reflection, assuring one's own fitness for duty, and maintaining confidentiality when appropriate. METHODS: For five years, we have incorporated faculty professionalism as a routine agenda item for the monthly Physician Assistant Programme faculty meetings, allowing faculty members to introduce issues they are comfortable sharing or have questions about. We also have case discussions of faculty professionalism within faculty meetings every three months. RESULTS: Faculty professionalism is important in the daily work lives of faculty members and including this as part of routine agendas verifies its importance. A faculty survey showed that a majority look forward to the quarterly faculty professionalism case discussions. These have included attempted influence in the admissions process, student/faculty social boundaries, civic professionalism, students requesting medical advice, and self-disclosure. CONCLUSION: A preventive approach works better than a reactionary approach to faculty missteps in professionalism. Routine discussion of faculty professionalism normalizes the topic and is helpful to both new and experienced faculty members. We recommend incorporation of faculty professionalism as a regular agenda item in faculty meetings.

The Burden of Burnout: An Assessment of Burnout Among Internal Medicine Residents After the 2011 Duty Hour Changes.

This study sought to determine burnout prevalence and factors associated with burnout in internal medicine residents after introduction of the 2011 ACGME duty hour rules. Burnout was evaluated using an anonymized, abbreviated version of the Maslach Burnout Inventory. Surveys were collected biweekly for 48 weeks during the 2013-2014 academic year. Burnout severity was compared across subgroups and time. A score of 3 or higher signified burnout. Overall, 944 of 3936 (24%) surveys were completed. The mean burnout score across all surveys was 2.8. Categorical residents had higher burnout severity than noncategorical residents (2.9 vs 2.7, P = .005). Postgraduate year 2 residents had the highest burnout severity by year (3.1, P < .001). Residents on inpatient rotations had higher burnout severity than residents on outpatient or consultation rotations (3.1 vs 2.2 vs 2.2, P < .001). Night float rotations had the highest severity (3.8). Burnout remains a significant problem even with recent duty hour modifications.

Making Good Citizens: Policy Approaches to Increasing Civic Participation

In this dissertation, I explore the impact of several public policies on civic participation. Using a unique combination of school administrative and public–use voter files and methods for causal inference, I evaluate the impact of three new, as of yet unexplored, policies: one informational, one institutional, and one skill–based. Chapter 2 examines the causal effect of No Child Left Behind’s performance-based accountability school failure signals on turnout in school board elections and on individuals’ use of exit. I find that failure signals mobilize citizens both at the ballot box and by encouraging them to vote with their feet. However, these increases in voice and exit come primarily from citizens who already active—thus exacerbating inequalities in both forms of participation. Chapter 3 examines the causal effect of preregistration—an electoral reform that allows young citizens to enroll in the electoral system before turning 18, while also providing them with various in-school supports. Using data from the Current Population Survey and Florida Voter Files and multiple methods for causal inference, I (with my coauthor listed below) show that preregistration mobilizes and does so for a diverse set of citizens. Finally, Chapter 4 examines the impact of psychosocial or so called non-cognitive skills on voter turnout. Using information from the Fast Track intervention, I show that early– childhood investments in psychosocial skills have large, long-run spillovers on civic participation. These gains are widely distributed, being especially large for those least likely to participate. These chapters provide clear insights that reach across disciplinary boundaries and speak to current policy debates. In placing specific attention not only on whether these programs mobilize, but also on who they mobilize, I provide scholars and practitioners with new ways of thinking about how to address stubbornly low and unequal rates of citizen engagement.