Structured Discussions About Professionalism as Trust: Reframing Professionalism Through Entrustment, Trust Behaviors, and Graphic Medicine

Authors

• Deborah Simpson, Advocate Health - MidwestFollow
• Tricia La Fratta, Advocate Health - MidwestFollow
• Kristin Ouweneel, Advocate Health - MidwestFollow
• Kathryn Agard, Advocate Health - MidwestFollow
• Leah Delfinado, Advocate Health - MidwestFollow
• Suzette Caudle, Advocate Health - SoutheastFollow
• Will Lehmann, Advocate Health - MidwestFollow
• Nicole Salvo, Advocate Health - MidwestFollow
• Esmeralda Santana, Advocate Health - MidwestFollow
• Jacob Bidwell, Advocate Health - MidwestFollow
• Jessica O'Brien, Advocate Health - MidwestFollow
• William Macdonald, Advocate Health - MidwestFollow
• David Irby
• Hazel Bidwell

Recommended Citation

Simpson D, La Fratta T, Ouweneel K, et al. Structured Discussions About Professionalism as Trust: Reframing Professionalism Through Entrustment, Trust Behaviors, and Graphic Medicine. Poster presented at: Alliance of Independent Academic Medical Centers (AIAMC) – National Initiative X: Meeting #3; October 9, 2026; Virtual.

Affiliations

Aurora Health Care

Presentation Notes

Poster presented at: Alliance of Independent Academic Medical Centers (AIAMC) – National Initiative X: Meeting #3; October 9, 2026; Virtual.

Abstract

Introduction

Unprofessional behavior in health professions education adversely affects patient care, team functioning, communication, and learner development. Traditional professionalism curricula often focuses on elements of professionalism (eg, integrity, respect, duty) that may fail to illuminate the relational consequences of unprofessional behaviors. We  developed an educational intervention that reframed professionalism through the lens of trust and entrustment.

Methods

The face-to-face intervention aimed to help learners analyze professional behaviors by examining their effects on patient safety, teamwork, and professional growth using a four-element trust framework. Beginning in February 2026, a multidisciplinary faculty /staff workgroup implemented a series of facilitated educational sessions across graduate medical education and undergraduate medical education settings. Sessions ranged from 30 to 90 minutes and included: (1) evidence regarding the adverse effects of unprofessional behavior; (2) facilitated small-group discussions of professionalism scenarios; (3) review of local needs-assessment data; and (4) structured debriefing and evaluation. Outcome measures included session evaluations, resident teaching evaluations, ACGME residency survey items, professionalism milestones, and a culture of safety item on respect.

Results

Seven sessions were conducted between February – August 2026:  two held during Graduate Medical Education Committee (GMEC) retreats; two during our GME wide shared noon conferences; one residency program session; one medical student session; and two at regional/national education meetings.

A total of 138 learners completed voluntary session evaluations. Participants reported favorable perceptions of the trust-based framework. Fifty-six percent indicated the framework “definitely” improved their ability to analyze unprofessional behaviors and an additional 39% responded “yes,” yielding 95% positive agreement. Similarly, 52% reported being “definitely” more aware of the adverse effects of unprofessional behavior on patient care and team functioning, with 39% responding “yes” (91% total positive agreement). Seventy percent “definitely” agreed that perceptions of unprofessional behavior can have adverse effects, while an additional 28% agreed (98% total positive agreement). Overall, 90% of participants would recommend the session to colleagues (50% definitely; 40% yes).

Other measures demonstrated modest but favorable changes. Resident ACGME survey measures showed increased sponsoring institution compliance compared to prior year on several items:  6% for comfort contacting supervisors with questions; 1% for perceptions that faculty act professionally while teaching; and 1% for perceptions that faculty act professionally while providing patient care. Faculty teaching evaluations remained high, with ratings for “Promotes and Champions Professionalism” increasing from 4.8 to 4.9 on a 5-point scale compared to last year. Comparison of current to previous year’s professionalism milestone ratings showed modest improvements of approximately 0.1 to 0.3 points.

Discussion

Preliminary findings suggest that framing professionalism as trust may provide a meaningful and engaging alternative to traditional professionalism education. Learners reported increased ability to analyze professional behavior and greater awareness of its consequences for patients and teams. Although selected  measures demonstrated only modest improvements, the consistently positive learner evaluations and high recommendation rates support continued implementation and evaluation. Future efforts will include a graphic medicine comic to replace the session’s didactic portion  of the session as it can support discussion of tacit, emotionally complex dimensions of professionalism (eg, hidden curriculum issues, hierarchy, bias).

Type

Poster