Assessment of Resident Professionalism Using High-Fidelity Simulation of Ethical Dilemmas

This cross-sectional observational study aimed to examine the responses of emergency medicine residents (EMRs) to ethical dilemmas in high-fidelity patient simulations as a means of assessing resident professionalism. Each resident subject participated in a simulated critical patient encounter during an Emergency Medicine Crisis Resource Management course. An ethical dilemma was introduced before the end of each simulated encounter. Resident responses to that dilemma were compared with a professional performance checklist evaluation. It was observed that senior residents (second and third year) performed more checklist items than did first-year residents (p < 0.028 for each senior class). Residents performed a critical action with 100% uniformity across training years in only one ethical scenario (“Practicing Procedures on the Recently Dead”). Residents performed the fewest critical actions and overall checklist items for the “Patient Confidentiality” case.