Professionalism Lesson Plan FULL · 2019-02-25 · Bethany Lloyd, Year 5, University of Aberdeen...

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Bethany Lloyd, Year 5, University of Aberdeen ([email protected]) Professionalism Lesson Plan Designed to be run by any medical or allied health professional for groups of ideally less than 30 medical students to allow for whole group discussion, although can be used for larger groups. Aim: To engage medical students in a creative and fun activity, approaching professionalism from a similarly vulnerable perspective to that a patient may be in. Learning Points: 1. Professionalism is important to be a good medical student or doctor and all aspects of it should be considered. 2. What the 4 domains used in the GMC’s “Achieving good medical practice: guidance for medical students” are, and what each of these includes. 2. Begin to have an awareness of the 14 subtopics used in this guidance, and exploring potential pitfalls of neglecting any single one of these areas. Overview: As the leader of this lesson, you will guide participants through a scenario which encourages them to think through the qualities and characteristics they would like to see in any trusted professional, particularly those in high-risk situations. It is key that you initially do not relate the lesson to medical practice at all. The students will be split into teams of 4-6 individuals, and informed that they have been invited to a skydiving session. On arrival at the “skydiving centre”, the team is required to create an exhaustive list of the characteristics they would like their instructor to have, so that just the right person can be found. They are then encouraged to relate the characteristics they have come up with to the framework given in the GMC’s “Achieving good medical practice: guidance for medical students”, and consider the implication of lacking any specific aspects of professionalism, firstly in the scenario of skydiving, and secondly in medical practice. The following script can be used flexibly, with additional activities to develop this 15-minute activity into an hour-long session if required. Basic structure: 1. Introduction “story” with example from the “previous skydiving team” 2. Give 15 blank cards to write requirements of their skydiving instructor 3. Sort 15 white cards into the 4 DOMAIN headings, (if there are any blank white cards they can complete them now). 4. Relate this exercise to medicine, give the 14 SUBHEADING cards and match them to the white cards 5. For any unmatched SUBHEADING cards turn them over and ask students to read the “consequence” in their group. 6. (Optional: add up a “score” based on SUBHEADING cards they did/didn’t match) 7. Discuss the SUBHEADING cards they did not match to any white cards. What would be a possible outcome of lacking this in medical practice?

Transcript of Professionalism Lesson Plan FULL · 2019-02-25 · Bethany Lloyd, Year 5, University of Aberdeen...

Page 1: Professionalism Lesson Plan FULL · 2019-02-25 · Bethany Lloyd, Year 5, University of Aberdeen (bethanyannlloyd@gmail.com) Professionalism Lesson Plan Designed to be run by any

BethanyLloyd,Year5,UniversityofAberdeen([email protected])

ProfessionalismLessonPlanDesignedtoberunbyanymedicaloralliedhealthprofessionalforgroupsofideallylessthan30medicalstudentstoallowforwholegroupdiscussion,althoughcanbeusedforlargergroups.Aim:Toengagemedicalstudentsinacreativeandfunactivity,approachingprofessionalismfromasimilarlyvulnerableperspectivetothatapatientmaybein.LearningPoints:1.Professionalismisimportanttobeagoodmedicalstudentordoctorandallaspectsofitshouldbeconsidered.2.Whatthe4domainsusedintheGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”are,andwhateachoftheseincludes.2.Begintohaveanawarenessofthe14subtopicsusedinthisguidance,andexploringpotentialpitfallsofneglectinganysingleoneoftheseareas.Overview:Astheleaderofthislesson,youwillguideparticipantsthroughascenariowhichencouragesthemtothinkthroughthequalitiesandcharacteristicstheywouldliketoseeinanytrustedprofessional,particularlythoseinhigh-risksituations.Itiskeythatyouinitiallydonotrelatethelessontomedicalpracticeatall.Thestudentswillbesplitintoteamsof4-6individuals,andinformedthattheyhavebeeninvitedtoaskydivingsession.Onarrivalatthe“skydivingcentre”,theteamisrequiredtocreateanexhaustivelistofthecharacteristicstheywouldliketheirinstructortohave,sothatjusttherightpersoncanbefound.TheyarethenencouragedtorelatethecharacteristicstheyhavecomeupwithtotheframeworkgivenintheGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”,andconsidertheimplicationoflackinganyspecificaspectsofprofessionalism,firstlyinthescenarioofskydiving,andsecondlyinmedicalpractice.Thefollowingscriptcanbeusedflexibly,withadditionalactivitiestodevelopthis15-minuteactivityintoanhour-longsessionifrequired.

Basicstructure:1. Introduction“story”withexamplefromthe“previousskydivingteam”2. Give15blankcardstowriterequirementsoftheirskydivinginstructor3. Sort15whitecardsintothe4DOMAINheadings,(ifthereareanyblankwhite

cardstheycancompletethemnow).4. Relatethisexercisetomedicine,givethe14SUBHEADINGcardsandmatch

themtothewhitecards5. ForanyunmatchedSUBHEADINGcardsturnthemoverandaskstudentstoread

the“consequence”intheirgroup.6. (Optional:addupa“score”basedonSUBHEADINGcardstheydid/didn’tmatch)7. DiscusstheSUBHEADINGcardstheydidnotmatchtoanywhitecards.What

wouldbeapossibleoutcomeoflackingthisinmedicalpractice?

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PREPARATION:

• ReadtheGMC’s“Achievinggoodmedicalpractice:guidanceformedicalstudents”,andensurethatyouarefamiliarwiththesummaryshownbelow.

• Preparea“pack”foreachteam,includingo 15blankwhitecards(seeAppendix1,alternativelyblankbusinesscardscanbeused)o 1singlesidedreusableinvitationcard(seeAppendix2)o 4singlesidedreusableDOMAINcards(seeAppendix3)o 14doublesidedreusableSUBHEADINGcards(seeAppendix4)

• Preparetheroomwithseparatetablesforeachgroup,largeenoughtospreadthecardsouton,andanoptional“leadershipboard”fortheteamscores.

Summaryof“Achievinggoodmedicalpractice:guidanceformedicalstudents”forthislessonNB:forthepurposesofthislessonthe4mainheadingsarereferredtoasDOMAINSandthe14categoriesbeneaththesearereferredtoasSUBHEADINGSDomain1:Knowledge,skillsandperformance(3)

a) Developandmaintainprofessionalperformanceb) Applyknowledgeandexperienceinpracticec) Recordworkclearly,legiblyandaccurately

Domain2:Safetyandquality(3)a) Contributetoandcomplywithsystemstoprotectthepatientsyouareresponsibleforb) Respondtoriskstosafetyc) Protectpatientsandcolleaguesfromanyriskposedbyyourhealth

Domain3:Communication,partnershipandteamwork(4plusconfidentiality)a) Communicateeffectivelyb) Workcollaborativelywithcolleaguesc) Continuityandco-ordinationofcared) Establishandmaintainpartnershipswithpatients

Domain4:Maintainingtrust(4)a) Showrespectforpatientsb) Treatpatientsandcolleaguesfairlyandwithoutdiscriminationc) Actwithhonestyandintegrityd) Openaboutlegal/disciplinaryproceedings

NB:Mostoftheresourcesforthislesson(excludingtheblankwhitecards)canbelaminatedandre-usedtominimizewastage.Ifre-usingthecardsisnotfeasible,anotheralternativeistoremovethebackgroundcoloursfromAppendix3andAppendix4.

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LESSONSCRIPT(anyboxesinpalegreyareadditionalexpansionactivitiesthatcanbeusedifmoretimeisavailable)Sectionslabeled“T”aretobedoneasawholegroup,eggroupdiscussions.Sectionslabeled“G”areforthesmallgroupandshouldhaveminimalinputfromthesessionleader.Time Items

neededActivity

1min Assignstudentstoteamsof4-6individualsatthestartofthelesson.Aimformixedteamsratherthangroupsoffriends.Directthemtothealreadysetouttables,eachofwhichshouldhavethe“invitation”cardonit,facedown.

Youcouldaskthewholegrouptolineupinorderofshoesize,birthday,furthestdistancetravelledthatday,etc,perhapsevenwithoutspeakingandthendivideintoteamsaccordingly.Thiswouldgivearandomselectionforeachteam,andwouldalsohelpthegroupasawholetorelaxandengagewithactivities.

(Whiteboardorflipchart)

Itmighthelpencouragegroupcommunicationatthisstagetodiscussasawholegroupwhatthestudents’expectationsareofa“lessononprofessionalism”.Ifyouhaveawhiteboard,youcouldwritedownsomewordstheywouldusetodescribeit.Trytoencouragehonestyratherthanthe“rightanswer”.Forexample,theymightsay“interesting”,“unnecessary”,“difficult”,“relevant”,“boring”or“practical”.Ifstudentsarereluctanttospeakup,youcouldtrygivingeachofthemapieceofpapertowritedownonewordtodescribetheirexpectationsandhaveallofthestudentsrevealtheircardssimultaneously.Itcouldhelprapportifyoushareyourexpectationstoo!Trytoalsoelicitwhattheythinktheyknowaboutprofessionalismsofar.AretheyawareoftheGMCguidanceformedicalstudents?Havetheyreadit?

2-3min

Invitationcard(scoreboard)

Explainbrieflytothewholegroupthattodayyouarelookingatprofessionalismandintroducethescenario.Itisimportanttotryandavoiddirectlyrelatingittomedicineatthispoint,astheaimistoengagetheteamsinlateralthinkingaboutprofessionalism.Forexample,youmightsay:Asyouknow,overthenext20minuteswearegoingtobethinkingaboutwhatprofessionalismmeans.Wehavesplityouintoteamsfortheactivitieswewillbedoing.Iwillexplainwhattodoaswegoalong.Youwilleachneedapen,butIwillprovideeverythingelse.[ifscoringpointsfortheteams,explainatthispointthattherewillbepoints(andpossiblyprizes!)basedonhowwellyourteamdoesintheactivities]Youmighthavenoticedthatthereisacardonyourtable.Pleaseturnitover!

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[Giveafewsecondsforeveryoneintheteamtoreadit]IwouldliketoaddmycongratulationstothoseoftheNationalCommitteeforMedicalStudentAttire.Welldone!Eachofyourteamshaswontheopportunitytogoskydiving.Howexciting!UnfortunatelyIhavejustspokentothereceptionistattheskydivingcentre,andshehastoldmethatalloftheirusualinstructorsarecurrentlyunavailable.Sheismorethanhappytofindanewinstructorforyou,butneedsyoutospecifyEXACTLYwhatyouwantofthem.Sheissurethanshecanguaranteeanycharacteristicsyouaskfor,butanycharacteristicsthatyoudon’tmention,yourinstructorwon’thave.Thegroupbeforeyouaskedherforaninstructorwhowas“honestandreliable”butdidn’tsay“qualified”sosheemployedthelocalbakerandhasn’tseenthemsince.Iamgoingtogiveyou15whitecardstowritedownyourrequirementson.Youwillhave3minutestotryandthinkofasmanyasyoucan,butdon’tworryifyouhaven’tfinishedallofthewhitecards,therewillbeanopportunitytoaddtothemlater.

3-4min

15whitecards,pens

GivetheteamssometimetowritedowncharacteristicsKeepaneyeonhowmanyofthewhitecardseachteamhasfilledin.Tryandstopthemwhentheyhavedoneroughly10,orafter3-4minutes.

2-3min

4domaincards Explaintothewholegroupthatyouhavesomeheadings,which

coverdifferentareasofprofessionalismtheymightwanttothinkabout.Giveeachteamasetofthe4colouredDOMAINcards.Askthemtodividethewhitecardsbetweenthesecategories,andgivethemsometimetocompleteanyremainingwhitecards.

1-2min

Explaintothewholegroupthatwhenpeopleareskydiving,theyhavetotrusttheirinstructorwiththeirlife.Oftenwhenpeopleparticipateinactivitieslikeskydiving,theyhavelittleknowledgeofthespecificprocessesthatneedtobecompleted,althoughtheymayhavesomeideasaboutwhattoexpect.Theirideasmayprovetobecorrectorincorrect,buttheyneedtotrusttheresponsibleinstructortobehaveinasafe,professionalmanner.Thisissimilarinlotsofwaystomedicine,whereyouwillhavepatientspotentiallytrustingyouwiththeirlife,withoutnecessarilyknowingwhetherwhatyouaredoingissafeorcorrect.TheGMChaveproducedadocumentcalled“Achievinggoodmedicalpractice:guidanceformedicalstudents”,whichlaysouttheaspectsofprofessionalismtheyrequirefrommedicalstudents.Theysplitthese14aspectsinto4domains;theDOMAINcardsIgaveyouinthelastactivity.

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2-4min

14attributecards

Nextgivetheteamsthe14SUBHEADINGcards,whichfitintothe4domains.WithoutturningtheseovertheyshouldmatchthewhitecardstotheSUBHEADINGcardsintheirteams.[Teamsmayneedsomehelptostartthisoff.Trytocirculatebetweentheteamstogiveextrainformationonanyofthesubheadingsifneeded.ThereissomeoverlapbetweentheSUBHEADINGcards.Theremaybesomethingstheyhavewrittendownthatdon’tfitintoanyofthesubheadingsordomains.Youmightwanttobringthisupinthediscussion]Itwilllooksomethinglikethis:(inthisexampletheyhave3unpairedSUBHEADINGcards)

1-2min

Askthegroup:DoyouhaveSUBHEADINGcardsleftoverthatyoudidn’tmatchanyofthewhitecardsto?AsktheminteamstoturnoveranyoftheSUBHEADINGcardswhichareunpairedandreadthe“consequences”oftheirinstructornotdemonstratingthataspectofprofessionalism.IftheyhavelotsofunpairedSUBHEADINGcards,theyshouldchoosejust2or3toreadtheconsequencesfor.Theconsequencesaredramaticexamplestomakeanimportantandmemorablepoint:thereispotentialforharmifANYaspectofprofessionalismisneglected.

Scoreboard,pens

Forscoring:+20pointsforanyoftheSUBHEADINGcardsthatarepaired.Forexampleifateamhaswritten“complieswithsafetyprocesses”they

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wouldget+20pointsformatchingwithSUBHEADINGCard“Contributetoandcomplywithsystemstoprotecttheskydiversyouareresponsiblefor”.Iftheyhadalsowritten,“helpsdevelopsafetysystems”onanotherwhitecardtheywouldnotgetanyextrapointsasthisisalsocoveredbythesamesubheading.PointsaredeductedforeachoftheSUBHEADINGcardsthattheydidnotmatchanythingto,accordingtothescoresontheback.Addupatotalscoreperteam.

2-3min

Together:AsktheteamstochooseoneoftheirunpairedSUBHEADINGcards.Encouragediscussionasawholegroup(orinteamsifshortontime)aroundthequestionsinAppendix5.Ifyouareshortontime,focusonthequestionslistedhere(q1,q3).Aimtokeepthediscussionpracticalratherthantheoretical.1.Whydoyouthinkyoudidn’tconsiderthisaspectofprofessionalismwhenyouwerediscussingitasateam?3.Canyouthinkofsomeimplicationsofnothavingitifyouwereamedicalstudent?NB:akeypointintheusefulnessofthislessonasalearningexperienceisinrelatingtheseattributesbacktomedicalpractice,throughthelensofconsideringthemselvesan“injuredparty”.Theaimisthatstudentswillrememberindividualcharacteristicsmorereadily,particularlywiththememorable“consequences”onthecards.

YoucanrepeatthesequestionsforoneortwomoreoftheunpairedSUBHEADINGcards.Ifyouaredoingthis,youmightwanttoencourageteamstochoosesubheadingsfromdifferentdomainswherepossible.Ifyouhavelonger,youcouldgiveteamsonefulldomainfrom“Achievinggoodmedicalpractice:guidanceformedicalstudents”tolookoveranddiscussthepoints.Aimtokeepthediscussionpractical-dotheythinkthisguidanceisthingstheydoinpracticethemselves?Ifnot,whynot?Isthereanythingtheywouldadd?

1min SummarisewhattheyhavelearntandclosethesessionIfyouareshortontimeyoucanbrieflysummarise.Otherwiseyoucouldgoroundandhaveeachstudentsay1thingthattheyhavelearnt,or1thingtheyenjoyed/1thingtheywouldimprove.Ifyouhavekeptscores,announcethewinnersatthisstageandcongratulatethem.Ifyouhaveasmallprizeitcanmakethismorefun.Thankthestudentsandclosethesession

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APPENDIX1:BLANKCARDSFORCHARACTERISTICSLISTTopreparecards-cutalongthedottedlines

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APPENDIX2:INVITATION

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APPENDIX3:DOMAINCARDSTopreparecards-cutalongthedottedlines

DOMAIN1:KNOWLEDGE,SKILLSANDPERFORMANCE

DOMAIN2:SAFETYANDQUALITY

DOMAIN3:COMMUNICATION,PARTNERSHIPANDTEAMWORK

DOMAIN4:MAINTAININGTRUST

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APPENDIX4:SUBHEADINGCARDSTopreparecards-cutalongthedottedlines,thenfoldalongthecentraldoublelinetocreateadoublesidedcard. Attribute Consequence

Domain1

Know

ledge,Skillsand

Pe

rformance

Developandmaintainprofessionalperformance

- Acquireknowledgeandskillsasastudent(goodattendance,respondingtofeedback,reflecting)

- Maintain/improveasaprofessional.

Youfailtorequirethatyourinstructorisqualifiedorhasmaintainedtheirqualifications.Asaresult,thereceptionistcallsinthelocalbakerwhooncewentonaskydivein1963andthinkshecanmakeastabatit.Unfortunatelyhedoesn’treallyrememberitaswellashethoughtanddoesn’tpullthecorduntiltoolate.

Domain1

Know

ledge,Skillsand

Pe

rformance

Applyknowledgeandexperienceinpractice

- Workwithintheircompetence- Behaveprofessionallyegnotlate,

professionaldress- Gainingconsent

Youfailtorequirethatyourinstructorappliestheirknowledgeandskillsinaprofessionalmanner.Therefore,sheturnsup2hourslate,bywhichtimethepilothasleft.Shedecidestoflytheplaneherselfasalthoughnotqualifiedtodoso,sheisfriendswithapilotwhohastalkedherthroughitbefore.Itturnsoutshecantakeoff,butnotlandtheplane.

Domain1

Know

ledge,Skillsand

Pe

rformance

Recordworkclearlylegiblyandaccurately

- Goodcontinuity,goodteamwork,safehandoversfromoneprofessionaltoanother

Youfailtorequirethatyourinstructormakesarecordofanythingclearly.Assuch,althoughshecheckstheweatherreportbeforeyouleave,shewritesitdownonascrapofpapertotakewithher.Shortlybeforejumping,shelooksatitbutitunsurewhethershehaswrittenNWorNEforthewindspeed.Sheguesseswrongandyouareblown50milesoffcourse,outtosea.

Domain2

Safetyand

Quality

Contributetoandcomplywithsystemstoprotecttheskydiversyouareresponsiblefor

- complywithsystemsdiligently- seektoimprovesystems- openandhonestfollowing

significantevents

Youdonotrequirethatyourinstructorisdiligentincomplyingwithsafetysystems.Theinstructorcannotbebotheredfollowingallofthesafetychecksbeforeheleavesandsoforgetstochecktheparachute.Whenitopensonthedescentitisimmediatelyobviousthatithasalargeripinit,whichbecomesrapidlyworse.Unfortunatelyhealsodidn’treadtheinstructionsindicatingthatyoushouldalsohaveareserveparachute.

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Do

main2

Safetyand

Quality

Respondtoriskstosafety

- responsibilityofthewholeteam- includesprotectingdignityand

comfort

Youfailtorequirethatyourinstructorwillrespondtosafetyrisks.Asyoutakeoff,younoticethattheplanedoorislooseandmentionthistotheinstructor.Sheshrugsandtellsyouthatthisisthepilot’sresponsibility,whoyoucannotcontactasheisinthecockpit.Therattlingbecomesworseandat10,000ftthedoorfallsoff.

Domain2

Safetyand

Quality

Protectskydiversandcolleaguesfromanyriskposedbyyourhealth

- Seekadvicefromsuitablecolleagues

- Includesimpactofstressoranxiety

- EngagewithOccupationalHealth

Youfailtorequirethatyourinstructorisdiligentaboutprotectingyouandhiscolleaguesfromrisksposedbyhisownhealth.Asaresult,thereceptionistemploysaninstructorwhohasrecentlyreturnedfromaskydivingexpeditioninTanzaniaandhasmalariawithafeverof410C.Ontheascentintheplanehebecomesdeliriousandonthefree-falllosesconsciousness.Youdonotknowhowtoactivateorsteertheparachute.

Domain3

Commun

ication,

Partne

rship,Teamwork

Communicateeffectively

- Clearcommunicationandlistening

- Takeintoaccountlanguageandotherbarrierstocommunication

Youdon’trequirethatyourinstructorhasgoodandclearcommunication,andsothereceptionistemploysafriendlyItalian.Unluckilyhedoesn’tspeakanyEnglishandyoucan’tspeakanyItalian.Whenyouhaveopenedthedooroftheplaneyouthinkhesays“go,I’mready”;hewasactuallysaying“wait,Ineedtheparachute”

Domain3

Commun

ication,

Partne

rship,Teamwork

Workcollaborativelywithcolleagues

- Adaptbehaviorasnecessarytoimproveteamworking

- Treatallmembersoftheteamwithrespect

Yourinstructorisnotrequiredtohavegoodinter-professionalworkingrelationships.Thereceptionistcontactsanoldinstructorwhowasaskedtoleaveafterpunchingthepilot.Thepilothasnotforgivenhim,andtellshimtojumpwhentheyareflyingoveranactivesurface-to-airmissiletestsite.

Domain3

Commun

ication,

Partne

rship,Teamwork

Continuityandco-ordinationofcare

- Safetransferbetweendifferentprofessionalsandsettings

- Sharerelevantinformation

Youdon’taskforaninstructorwiththeabilitytopassoninformationwell.Theinstructororganizestheparachutes,butaccidentallyleavesthembehind.HecallshisslightlydeafGrantopickthemup,whocallsherslightlyblindfriend,whopicksupthewrongbag.Youdon’trealizeuntilyouhavejumpedthatitonlyholdsdirtylaundry.

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Domain3

Commun

ication,

Partne

rship,Teamwork

Establishandmaintainpartnershipswithskydivers

- Treatthemasindividuals- Listentothemandtreatthem

fairly,withrespect- Beclearaboutroles

Youdonotaskforaninstructorwhowantstoworkwithskydivers.Thereforewheneveryouoffertohelphesays,“Iamtheinstructor,Iknowbest.”Whenyouarereadytojump,youthinkyouseesomestormyweathercoming,butdon’tfeelcomfortablespeakingup.Itturnsouttobeahurricane,whichyoumeethalfwaydown.

Domain4

MaintainingTrust

Showrespectforskydivers

- notpursuingimproperorsexualrelationshipswithskydivers

- notexpressingpersonalbeliefsindistressingways

- honestyifsomethinghasgonewrong

Youdonotaskforaninstructorwhoshowsrespectforthoseintheircare.Yourinstructorbehavesoddlyontheflightup,askingwhichgirlsareinrelationships.Whenthedoorisopenedhedeclareshimselfa“Beyonceworshipper”andstateshewilloffer“singleladyhumansacrifices”.Heforcefullyaskswhowantstogooutthedoorfirst.

Domain4

MaintainingTrust

Treatskydiversandcolleaguesfairlyandwithoutdiscrimination

- donotdelayhelpbecauseyoubelievetheskydiverhascontributedtotheproblem

- awareofunconsciousbias

Youdonotrequirethatyouinstructortreatallskydiversfairly.Hejokesthatthewomenshould“stayonthegroundandmakesandwichesforwhentheygetback”.Itturnsoutthepilotisactuallyfemaletoo,andrefusestoflytheplane.Thereforenobodycangoskydiving.

Domain4

MaintainingTrust

Actwithhonestyandintegrity

- honestinallregards.Including:experience,qualifications,plagiarism,yourownhealth,communicationwithpatientsandcolleagues,finances,insurance.

Youdonotaskforaninstructorwhobehaveswithhonestyandintegrity.Sherealizesshortlyaftertakeoffthatsheforgottopackenoughparachutesforalltheparticipantsbutdoesn’twanttoadmitthemistake,sosheputsajumperintheemptybagtopaditout.Oneofyoupullstheripcordondescent,toreleaseonlyafluffypurplefleece

Domain4

MaintainingTrust

Openaboutlegal/disciplinaryproceedings

- honestduringlegalproceedings- informsemployersofany

convictionsorcautionsimmediately

- Withinandoutsidework

Youdidn’taskforaninstructorwhowasopenaboutlegalanddisciplinaryproceedings.Itturnsoutthatheisontherunfromthepolice,andwhenyouaskhisnameherepeatedlysays“JohnSmith”inaheavilyaccentedvoice.Theplaneseemstobetakinglongerthanyouwouldexpect,andwhenyoulandafterthedive,thetreeslooksuspiciouslytropical;thesandsuspiciouslywhite.

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APPENDIX5:Questionsfordiscussion

1. Whydoyouthinkyoudidn’tconsiderthisaspectofprofessionalismwhenyouwerediscussingitasateam?

2. Canyouthinkofatimewhenyousawthisbeingneglectedinmedicalpractice,maybebyafellowmedicalstudent,aconsultant,anFY,anurseoranyoneelse?Whathappened?

3. Whatmightbetheimplicationsofdisregardingthisaspectofprofessionalismasamedicalstudent?Orapracticingdoctor?

4. Whatcouldyoudotoensurethatyouputthisintopracticenowandinthefuture?

5. Howcomfortablewouldyoufeelchallengingsomeoneelseaboutthis?Whatiftheyweresignificantlymoresenioregyourconsultantorsupervisor?Whatiftheywereanothermemberofthemulti-professionalteamegaphysiotherapist,dietician,nurse?