The Professionalism Library

The Library includes peer-reviewed publications, commentaries/blogs, and issue briefs/reports relating to professionalism. The database will be periodically reviewed and updated.

Special thanks to Dr. Therese Zink, Brown University, for her work creating the extensive literature review that formed the starting point for this searchable resource on Professionalism, found here.

The Professionalism Library

The Library includes peer-reviewed publications, commentaries/blogs, and issue briefs/reports relating to professionalism. The database will be periodically reviewed and updated.

Special thanks to Dr. Therese Zink, Brown University, for her work creating the extensive literature review that formed the starting point for this searchable resource on Professionalism, found here.

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Study Design
Category of Professionalism
Date Published

Please note: There are no articles available prior to 1998.

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Date Published:
September,
2025
Study Design:
Category:
Resource Type:

Reclaiming Medical Professionalism In An Era Of Corporate Healthcare

Annie Koempel, Frederick Chen, Bradley Barth, Robert L. Phillips, Jr.

Medicine’s increasing corporatization has fundamentally altered how physicians practice, yet discussions of medical professionalism often remain anchored in frameworks from decades past. The surge in health care consolidation and sixfold growth in private equity ownership of practices has transformed physicians’ daily operations and decision-making. Any meaningful discussion of professionalism must now address these material and environmental contexts. How does consolidation affect professional daily decisions?

Date Published:
December,
2023
Study Design:
Category:
Professionalism
Resource Type:
Peer Review

"Should I Say Something?": A Simulation Curriculum on Addressing Lapses in Professionalism to Improve Patient Safety

Lydia A Flier, Jeremy B Richards , Michele R Hacker, Alexandra Hovaguimian , Anita Vanka , Amy Sullivan , Celeste S Royce

Medical students may witness lapses in professionalism but lack tools to effectively address such episodes. Current professionalism curricula lack opportunities to practice communication skills in addressing professionalism lapses. We designed a simulation curriculum to introduce professionalism expectations, provide communication tools using elements of the Agency for Healthcare Research and Quality TeamSTEPPS program, and address observed professionalism lapses involving patient safety in hierarchical patient care teams. Students were surveyed on knowledge, skills, and attitude regarding professionalism before, immediately after, and 6 months after participation. Of 253 students, 70 (28%) completed baseline and immediate postsurveys, and 39 (15%) completed all surveys. In immediate postsurveys, knowledge of communication tools (82% to 94%, p = .003) and empowerment to address residents (19% to 44%, p = .001) and attendings (15% to 39%, p < .001) increased. At 6 months, 96% of students reported witnessing a professionalism lapse.The curriculum was successful in reported gains in knowledge of communication tools and empowerment to address professionalism lapses, but few students reported using the techniques to address witnessed lapses in real life.

Date Published:
December,
2023
Study Design:
Category:
Professionalism
Resource Type:
Peer Review

Experiences of Physicians Investigated for Professionalism Concerns: a Narrative Review

David S Im , Carrie M Tamarelli , Mary R Shen

Growing attention is being paid to physician health and behavior, including the occurrence of mental health issues and burnout in medical providers, physician impairment, and alleged disruptive behavior in physicians. In any of these areas, a physician may become the subject of an investigation. Studying the experience of investigated physicians is important to identify and mitigate any potential adverse personal and practice impacts, which in turn can hinder patient care. The purpose of this review is to (1) summarize the published scientific literature to date regarding the experiences of physicians who have been investigated, and (2) based on these findings consider strategies to mitigate any adverse effects of the investigatory process for physicians. A search of the databases PubMed and Ovid MEDLINE was conducted in June 2023 using relevant search terms. After reviewing titles, abstracts, full-length articles, and reference lists, 16 articles were identified and reviewed. Physicians in multiple countries who had been investigated commonly described short-term (feelings of anger, depression, anxiety, shame, powerlessness, isolation, being betrayed, less confidence in clinical decision-making) and long-term (increase in defensive practice, retiring early) impacts of the investigatory process. Physicians found the most difficult aspects of the investigation process to be the length of time involved, lack of transparency/communication regarding the process, feelings of isolation, and dealing with vexatious complaints. While complaints about physicians have the potential to portend constructive individual practice and systemic changes, research suggests that the investigatory process for physicians is associated with negative short- and long-term emotional and practice impacts. Strategies to mitigate the unintended adverse effects of investigatory processes are proposed. Further research is warranted to clarify the investigation experience for physicians, including physicians underrepresented in medicine, and to systematically assess the effectiveness of strategies to mitigate unhealthy or disruptive components of the investigatory process.

Date Published:
November,
2023
Study Design:
Category:
Professionalism/Medical Education
Resource Type:
Peer Review

Contradictions and Opportunities: Reconciling Professional Identity Formation and Competency-Based Medical Education

Robert Sternszus, Natasha Khursigara Slattery, Richard L Cruess, Olle Ten Cate , Stanley J Hamstra, Yvonne Steinert

The widespread adoption of Competency-Based Medical Education (CBME) has resulted in a more explicit focus on learners' abilities to effectively demonstrate achievement of the competencies required for safe and unsupervised practice. While CBME implementation has yielded many benefits, by focusing explicitly on what learners are doing, curricula may be unintentionally overlooking who learners are becoming (i.e., the formation of their professional identities). Integrating professional identity formation (PIF) into curricula has the potential to positively influence professionalism, well-being, and inclusivity; however, issues related to the definition, assessment, and operationalization of PIF have made it difficult to embed this curricular imperative into CBME. This paper aims to outline a path towards the reconciliation of PIF and CBME to better support the development of physicians that are best suited to meet the needs of society. To begin to reconcile CBME and PIF, this paper defines three contradictions that must and can be resolved, namely: (1) CBME attends to behavioral outcomes whereas PIF attends to developmental processes; (2) CBME emphasizes standardization whereas PIF emphasizes individualization; (3) CBME organizes assessment around observed competence whereas the assessment of PIF is inherently more holistic. Subsequently, the authors identify curricular opportunities to address these contradictions, such as incorporating process-based outcomes into curricula, recognizing the individualized and contextualized nature of competence, and incorporating guided self-assessment into coaching and mentorship programs. In addition, the authors highlight future research directions related to each contradiction with the goal of reconciling 'doing' and 'being' in medical education.

Date Published:
November,
2023
Study Design:
Category:
Professionalism
Resource Type:
Peer Review

Drivers of unprofessional behaviour between staff in acute care hospitals: a realist review

Justin Avery Aunger, Jill Maben, Ruth Abrams , Judy M Wright, Russell Mannion, Mark Pearson, Aled Jones, Johanna I Westbrook

Unprofessional behaviours (UB) between healthcare staff are rife in global healthcare systems, negatively impacting staff wellbeing, patient safety and care quality. Drivers of UBs include organisational, situational, team, and leadership issues which interact in complex ways. An improved understanding of these factors and their interactions would enable future interventions to better target these drivers of UB.