Everyday Mishaps and Lapses in Ethics, Professionalism, and Self-Care: A Faculty Development Workshop

Acad Psychiatry (2016) 40:97–99 DOI 10.1007/s40596-015-0319-8 COLUMN: EDUCATIONAL CASE REPORT Everyday Mishaps and Lapses in Ethics, Professionalism, and Self-Care: A Faculty Development Workshop Brenda Bursch & John Piacentini & Ian A. Cook & Margaret L. Stuber Received: 29 August 2014 / Accepted: 27 February 2015 / Published online: 21 April 2015 # Academic Psychiatry 2015 Professionalism, personal responsibility, and patient safety are inseparable [1]. As the physical and emotional health of clini- cians becomes compromised from work-related pressures, they are at higher risk for lapses in the provision of high- quality care. Such lapses can negatively impact patients, fam- ilies, and the reputation of the profession. Mandated reduced work hours have heightened debate related to the balance between altruism and self-care. We all experience everyday challenges related to ethics, professionalism, and self-care. It is easy to remember the ba- sics, but even easier to fall into patterns of small violations or lapses. Sometimes we do not realize that our actions are pos- sibly unethical or unprofessional. Sometimes smart, ethical, and highly professional people see things differently from each other. We are rewarded for high productivity, sometimes at the expense of our reflective and organizational abilities. Finally, historical and generational forces influence views on professionalism. Training programs have been charged with heightening awareness of ethics and professionalism, with recognition of the need to address the implicit curriculum in order to make genuine inroads [2]. To address this Accreditation Council for Graduate Medical Education (ACGME) requirement in a meaningful way, we developed an interactive workshop de- signed to address these important issues. Given consistently positive feedback, we have repeated this workshop annually for the past 6 years. Workshop attendance has been high, and group discussions have become more open and accepting each year. Initially required by our division chief, mandated atten- B. Bursch (*) : J. Piacentini : I. A. Cook : M. L. Stuber David Geffen School of Medicine at UCLA, Los Angeles, CA, USA e-mail: bbursch@mednet.ucla.edu dance is no longer necessary. Based on informal feedback and our own perceptions of the usefulness of this workshop, this paper describes our workshop in order to encourage others to consider a similar approach. While this format can be used in any specialty, we have used it with our multidisciplinary su- pervising faculty and staff, child psychiatry fellows, and child psychology trainees. Pre-workshop Preparation We hold the workshop each December. This scheduling pro- vides sufficient time for trainees to observe and get to know our faculty and staff but is also early enough in the year that it offers us the opportunity to respond to those observations and feedback within the training year. A key feature of our workshop is to ensure that all discussions are relevant to a current behavior. Two months prior to the workshop, we e-mail a request for examples of self-care challenges or possible lapses in ethics or professionalism directly observed within our di- vision during the past 4 months. Faculty, staff, and trainee respondents are informed of the purpose of the solicitation and are requested not to provide identifying details. Sub- missions are allowed to be made anonymously, although no one has yet utilized this option. The workshop leaders include two psychologists (one male and one female) and two psychiatrists (one male and one female). Our division chief and training directors do not serve as workshop leaders. Workshop leaders select examples from the submissions that represent the most common themes. These examples are developed into sce- narios that are slightly altered to preserve confidentiality. Several potential responses are also created. Each