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ECONOMICS, EDUCATION, AND POLICY

The Teaching of Professionalism During Residency: Why It Is Failing and a Suggestion to Improve Its Success

From the Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.

Address correspondence and reprint requests to Robert R. Gaiser, MD, Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104. Address e-mail to gaiserr{at}uphs.upenn.edu.

Abstract

Professionalism is one of the core competencies to be taught and evaluated during residency. A review of the literature suggests that professionalism is not completely understood or practiced. The teaching of professionalism has been incorporated into the educational programs for residents. However, residents learn from two curriculums: the stated curriculum and a hidden curriculum. The hidden curriculum represents the actions observed by the resident of the faculty in the hospital. The impact of this hidden curriculum upon professional behavior by the resident is significant. Due to the hidden curriculum, a possible means of improving professionalism involves the development of a program for faculty. This program must include not only topics but time for personal reflection of one’s knowledge and actions. Self-reflection allows for the development of a true understanding and practice of professionalism and may improve professional behavior.