Office of Professionalism improves learning environment at McGovern
The Office of Professionalism at McGovern Medical School was established in 2020 to form a cohesive and collaborative approach to professionalism that will involve and benefit various constituencies across the school. Led by John Riggs, MD, assistant dean for professionalism, the professionalism office has taken its first steps to ensuring a safe learning environment for all students, trainees, and faculty.
“Many educators conceptualize professionalism as an essential part of the educational process, because becoming a physician is really a socialization act,” Riggs said. “It’s something that we learn, more through our interactions with others in a professional, social context, than through books and lectures. It’s that socialization process in this community of practice that changes how we think about ourselves, and how we work collectively for the better good of our patients and society as a whole. Being professional isn’t a fixed trait we are born with or that we graduate medical school having mastered. It is a life-long pursuit.”
In 2019, Riggs’ and Vineeth John, MD, vice chair for education, were appointed directors of the Clinical Learning Environment. Along with Christine Ford, EdD, education specialist, they heightened the focus on the learning environment at the Medical School following concerns raised by students about how to make the clinical learning environment more welcoming and supportive. In 2020, Riggs was asked to form the Office of Professionalism to ensure that the learning environment at McGovern Medical School is a supportive environment that guides students, trainees, and faculty toward embracing the values and beliefs of our profession.
Their goal is to support work/learning environments at McGovern where students, trainees, and faculty can be inspired and challenged while also comfortably raising questions, concerns, and challenges thereby making the care for patients more effective, and meaningful.
“At the Medical School, long before my appointment, there was already a lot of work being done on professionalism, so we initially set out to curate as much as we could of the existing professionalism education efforts that were going on,” Riggs said. “These efforts weren’t all explicitly recognized as being professionalism education efforts, but upon looking at them, they were closely related.”
Riggs said that reviewing surveys of clinical medical students twice a year shows a tremendous volume of great teaching examples.
“We get pages of accolades from the students about the resident and faculty teaching but also some areas that need improvement,” Riggs said. “We create customized improvement plans with our clerkship directors twice a year based on this student input.
“After the Office of Professionalism opened, we also surveyed residency, fellowship, and clerkship directors and asked them what sort of educational initiatives they had in place already, and what their needs were regarding educational professionalism. One of the common discomforts they felt with creating a professional environment was having high-stakes conversations with trainees, peers, or their supervisors.”
Responses showed that residency, fellowship, and clerkship directors recognized they are essentially responsible for improvements to their learning and working environments but have little training in how to have difficult but necessary conversations.
“We saw a need to build confidence, comfort and feeling of safety with talking to their peers, trainees, and supervisors about difficult situations,” Riggs said.
To address these concerns, Riggs discovered a course already offered by UTHealth Houston called “Crucial Conversations.” The Office of Professionalism is adapting the course for scenarios relevant to higher medical education challenges and desire to make this available to the great majority of the clerkship and program directors.
Speaking with students at McGovern Medical School also revealed additional directions for attention. For example, it is clear that there are some more stressful learning environments where students could learn to thrive.
“When someone joins the medical profession, it is unlikely that they have been exposed to the inevitable stresses of caring for those in need. There will be times during the practice of medicine when things will be stressful,” Riggs said. “We found that those types of learning or work environments tend to be the ones with complex schedules and vocabularies, longer hours, and possibly sleep deprivation, due to the needs of our patients. These are the realities of taking care of patients in some circumstances. So, how can we use that as an opportunity to better prepare our students to thrive in those situations?”
To address this, the Office of Professionalism is working with students and clerkship directors to develop student workshops called Thriving in Stressful Environments.
As a way to ensure growth in expanding the Office of Professionalism’s vision, Riggs, along with Sasha Adams, MD, associate professor of surgery; Omonele Nwokolo, MD, associate professor of anesthesiology; and Sara Guzman-Reyes, MD, associate professor of anesthesiology; recently completed the 12-month Academy for Professionalism in Health Care Leadership Excellence in Educating for Professionalism scholars’ program. The Academy seeks to optimize patient care through professionalism education, scholarship, policy, and practice in all health-related fields.
“The four of us from McGovern along with people from across the country have been participating in this program to get a better understanding of professionalism education and ways to advance that in our institutions while working with internationally recognized leaders in this field,” Riggs said. “It’s given us a tremendous amount of insight into how to expand professionalism education.”
Through their work with the academy, the team developed a research project with perioperative clinical providers to help them reflect on their professionalism behaviors and where they personally want to grow.
To honor the many professionalism education efforts being created across McGovern Medical School, the Office of Professionalism created the Faculty Award for Professionalism Education for individuals who have established one or more successful programs promoting professionalism education for learners enrolled in undergraduate or graduate programs. The recipient of the Faculty Award for Professionalism Education will receive a $2,500 reward and will be recognized at an award ceremony where they will provide a brief presentation on their contributions.
Though still in its infancy, the Office of Professionalism at McGovern Medical School has become a vital component to enhancing the learning environment for students, trainees, and faculty. For more information on the Office of Professionalism, contact John Riggs, MD, at John.W.Riggs@uth.tmc.edu, or Vineeth John, MD, at Vineeth.P.John@uth.tmc.edu.