Original Publication
Open Access

Fostering an Atmosphere of Professionalism in a Residency Program: Learning How to Address the Unprofessional Behavior of Colleagues Through OSCEs

Published: May 2, 2012 | 10.15766/mep_2374-8265.9168

Included in this publication:

  • Instructor's Guide.doc
  • Colleague.wmv
  • Pediasure.wmv
  • Professionalism Communication with Colleague Case.doc
  • Professionalism Educational Value of Communication with Colleague.doc
  • Professionalism Educational Value of Pediasure Please.doc
  • Professionalism Level of Comfort Survey.doc
  • Professionalism Pediasure Please Case.doc
  • Professionalism Unprofessional Events Witnessed Part 1.doc
  • Professionalism Unprofessional Events Witnessed Part 2.ppt

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Professionalism training and assessment have received much attention. Multiple strategies have been devised to help educational programs deal with unprofessional behavior, which is not always detected by attending staff. Trainees are in a unique position to address unprofessional behavior in their colleagues because of their supervisory role and overlapping working hours. To underline the importance of addressing unprofessional behavior, we created two professionalism objective structured clinical exam (OSCE) stations that focused on confronting a junior level trainee’s unprofessional behavior. These two activities are termed the Communications OSCE, for first-year pediatric residents, and the Culture OSCE, for second-year pediatric residents. Methods: Prior to the encounter, participants read an instruction sheet and view a short video. In the “Communication with a Colleague” OSCE, participants must confront a junior colleague who treated an ambulance driver disrespectfully. In the “Pediasure Please!” OSCE they have to address a junior colleague who made racist comments about a patient to a medical student. OSCE participants have 10 minutes to complete the task and receive immediate feedback from an observing faculty member and the standardized resident. Post-OSCE group debriefing reinforces the teaching objectives. Following the completion of the OSCE, residents were surveyed anonymously and again 6 to 10 months later to evaluate the effects of the OSCE learning experience. Results: The residents were surveyed immediately after the completion of the OSCE. The educational value of the stations was rated moderate to high by 100% and 96% of the first- and second-year students (N = 96), respectively. Six to 10 months after the completion of the exercise, 88% and 76% of the residents still felt that they were to some degree comfortable in dealing with a similar unprofessional encounter as depicted in the OSCE and 88% and 65% in a dissimilar unprofessional encounter. Discussion: Our professionalism OSCE station only addresses residents confronting junior residents’ unprofessional behaviour. It does not deal with unprofessional behaviour in senior residents, attending staff, or ancillary staff. Our hope is that as the residents graduate to become attending staff, they will take the lessons learned with them and apply them at a higher level of leadership.

Educational Objectives

By the end of this session, learners will be able to:

  1. Describe the challenges in defining professionalism.
  2. Recognize professionalism as a competency.
  3. Use the Professionalism Matrix to critically analyze and think about professional and potentially unprofessional behaviors.

Author Information

  • Lita Aeder, MD: Brookdale University Hospital and Medical Center
  • Lisa Altshuler, PhD: Maimonides Infants and Children's Hospital of Brooklyn
  • Elizabeth Kachur, PhD: Maimonides Infants and Children's Hospital of Brooklyn
  • Erik Langenau, DO: National Center for Clinical Skills Testing

None to report.

None to report.

Prior Presentations
Kachur E, Altshuler L, Aeder L, Venkataraman A, Vargas I, Hilfer A, Sullivan D, Krinshpun S, Walker-Descartes I. Professionalism Stations with Standardized Healthcare Providers: Are they worth including in an Objective Structured Clinical Exam? Presented at: International Conference on Residency Education; September 2010; Ottawa, Ontario, Canada.

Aeder L, Venkataraman A, Langenau E, Kachur E, Altshuler L. Teaching Residents to Address Unprofessional Behavior in Peers. Workshop presented at: Northeast Group on Educational Affairs; June 2007; Stoneybrook, New York.

Aeder L, Venkataraman A, Langenau E, Kachur E, Altshuler L. Teaching How to Address Unprofessional Behaviors in Peers with the Help of OSCEs. Presented at: Pediatric Academic Societies (PAS); May 2007; Toronto, Ontario, Canada.

Venkataraman A, Langenau E, Aeder L, Hilfer A, Sullivan D, Vargas I, Kachur E, Altshuler L, Schaeffer H, Shelov S. Creating OSCE stations for teaching residents how to deal with unprofessional colleagues. Presented at: Mount Sinai School of Medicine Second Annual Educational Research Day; October 2006; New York, NY.


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  4. Shrank, W.H., Reed, V.A., Jernstedt, G.C. Fostering Professionalism in Medical Education: A Call for Improved Assessment and Meaningful Incentives. J Gen Intern Med. 2004;19(8):887-892. http://dx.doi.org/10.1111/j.1525-1497.2004.30635.x
  5. Hochberg, M.S., Kalet, A., Zabar, S., Kachur, E., Gillespie, C., Berman, R.S. Can professionalism be taught? Encouraging evidence. Am J Surg. 2010;199:86-93. http://dx.doi.org/10.1016/j.amjsurg.2009.10.002
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Aeder L, Altshuler L, Kachur E, Langenau E. Fostering an atmosphere of professionalism in a residency program: learning how to address the unprofessional behavior of colleagues through OSCEs. MedEdPORTAL. 2012;8:9168. https://doi.org/10.15766/mep_2374-8265.9168