Group items tagged

"The authors identify a broad range of disrespectful conduct, suggesting six categories for classifying disrespectful behavior in the health care setting: disruptive behavior; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behavior; passive disrespect; dismissive treatment of patients; and systemic disrespect."

"Central to an effective response is a code of conduct that establishes unequivocally the expectation that everyone is entitled to be treated with courtesy, honesty, respect, and dignity. The code must be enforced fairly through a clear and explicit process and applied consistently regardless of rank or station.Creating a culture of respect requires action on many fronts: modeling respectful conduct; educating students, physicians, and nonphysicians on appropriate behavior; conducting performance evaluations to identify those in need of help; providing counseling and training when needed; and supporting frontline changes that increase the sense of fairness, transparency, collaboration, and individual responsibility."

"They want you to study by yourself and become obsessed with how well you understanding the material. ergo - stop caring about whether anyone else understands it. It would be a great system to develop overconfident get-mine solo practice doctors, but everyone knows there's too much paperwork to run a solo practice these days. We're also coming upon the age of specialists when collaboration will be at a premium. A disease like diabetes is complex. You might need primary care physicians working with vascular surgeons, endocrinologists, ophthalmologists, I could list every specialty. Not to mention nutritionists, personal trainers, policy makers."

The "hidden curriculum" refers to medical education as more than simple transmission of knowledge and skills; it is also a socialization process. Wittingly or unwittingly, norms and values transmitted to future physicians often undermine the formal messages of the declared curriculum. The hidden curriculum consists of what is implicitly taught by example day to day, not the explicit teaching of lectures, grand rounds, and seminars. I am increasingly aware of how those of us engaged in family medicine education are blind to it.

"Each individual decision to speak up or remain silent, or to promote unprofessional behavior or pursue nobler alternatives, is an important part of shaping the learning environment."

"Can compassion and empathy be taught? Can it be taught by older doctors serving as models? Does this mean that older physicians should allow their emotions to show on their faces when they are distressed by a patient's suffering?"

"We are sometimes unconscious of the hidden curriculum, but even when conscious of it we are silent or reluctant to act. We need a frank dialogue with students, residents, and each other about the lived experience of a career in medicine as the struggle it often is; about the challenges of living up to our profession's stated ideals; about the dangers of technological expertise without caring human relationships; about conflicts of interest and the difficult professional challenges of dealing with unprofessional colleagues; and about behaviour that imperils patients. We need to add "Above all be not silent" (Primum non tacere)17 to "First do no harm" as tenets to live by, and we must emphasize to students that what they are like as physicians is just as important as what they know. Thus will we build resistance to the hidden curriculum and reclaim our authenticity as trusted generalists whose knowledge is attached to values we truly uphold, model, and reproduce. "