Recommended Citation
Delfinado L, Simpson D, Caudle S, Bidwell J. Trust Matters: Rethinking Professionalism in Academic Medicine. Poster presentation at: NADIO (National Association of Designated Institutional Officials); December 6-8, 2026; Las Vegas, NV.
Presentation Notes
Poster presentation at: NADIO (National Association of Designated Institutional Officials); December 6-8, 2026; Las Vegas, NV.
Abstract
Background: Professionalism concerns are often dismissed as subjective, although unprofessional behavior can harm learning, teamwork, patient safety and experience, and professional development. End-of-residency professionalism ratings have been associated with more patient complaints in early practice. Reframing professionalism as trustworthiness shifts attention from traits to observable behaviors.
Objective: To develop and evaluate a framework that reframes professionalism as trust, determine whether diverse stakeholders agree on behaviors that undermine professional trust, and identify practical remediation strategies.
Methods: Medical education stakeholders across multiple regions—including learners, faculty, education leaders, coordinators, managers, and staff—submitted brief, de-identified examples of observed or experienced unprofessional behavior. Behaviors were mapped to four workplace trust domains: sincerity/integrity, reliability, competence with humility, and caring. Five behaviors per domain formed a 20-item needs assessment rating each behavior’s effect on professional trust. Findings informed interactive sessions featuring evidence reviews, behavior-based vignettes, small-group analysis of consequences for patients, teams, and individuals, large-group debriefing, and remediation planning.
Results: The needs assessment included 265 respondents and showed strong internal consistency (Cronbach’s alpha = 0.84). At a 75% agreement threshold, stakeholders consistently identified behaviors that undermined trust, with no meaningful differences by role or region. Three sessions reached 143 participants; 110 completed evaluations (77%). Respondents reported improved ability to analyze unprofessional behavior (94%), greater awareness of effects on care and teamwork (91%), recognition that such perceptions have real consequences (98%), and willingness to recommend the session (88%). Remediation strategies emphasized expectations, accountability, feedback, reflection, perspective-taking, and follow-through.
Recommendations: Academic medicine leaders should frame professionalism around observable behavior, its effects on patients and teams, and four actionable trust domains. The framework can support feedback, remediation, faculty development, and competency committee decisions while reducing labels and character judgments. Implementation should use authentic vignettes, mixed-role discussion, reflection, perspective-taking, and longitudinal assessment of behavior change and outcomes. Egregious conduct should remain subject to institutional policy.
References:
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Godschalx-Dekker JA, Gerritse FL, Pronk SA, Duvivier RJ, van Mook WN. Is insufficient introspection a reason to terminate residency training?–Scrutinising introspection among residents who disputed dismissal. Medical Teacher. 2025 Jan 2;47(1):143-50.
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Type
Poster
Affiliations
Advocate Health Care, Aurora Health Care, Atrium Health