Published online September 14, 2009
PEDIATRICS Vol. 124 No. 4 October 2009, pp. 1143-1151 (doi:10.1542/peds.2009-0658)
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ARTICLE

Ethics and Professionalism in the Pediatric Curriculum: A Survey of Pediatric Program Directors

Colleen Walsh Lang, BS, BAa, Peter J. Smith, MD, MAa,b,c and Lainie Friedman Ross, MD, PhDa,c,d,e

b Section of Behavioral and Developmental Pediatrics
a Department of Pediatrics, and Departments of
d Medicine
e Surgery
c MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois

OBJECTIVE: Since 1982, pediatric residency programs have been asked to evaluate trainees for ethical behavior. In 2007, the Accreditation Council for Graduate Medical Education required documenting teaching and evaluation of professionalism. Pediatric residency program directors were surveyed to ascertain what they know about the content and process of their ethics and professionalism curricula.

METHODS: From February to May 2008, 394 program directors from the Association of Pediatric Program Directors were surveyed.

RESULTS: Of 386 eligible survey respondents, 233 (60%) returned partial or complete surveys. Programs were evenly divided on whether ethics was taught as an organized curriculum or integrated. Professionalism was combined with the ethics curriculum in 27% of programs and taught independently in 38% of programs, but 35% had no professionalism curriculum. More than one third of the respondents did not answer each content and structure question. Approximately two thirds of those who responded stated that their program dedicated <10 hours per year to ethics and professionalism, respectively. Nearly three fourth of programs identified crowding of the curriculum and one third identified lack of faculty expertise as curricular constraints. Respondents expressed interest in more curricular materials from the American Board of Pediatrics or Association of Pediatric Program Directors.

CONCLUSIONS: Despite requirements to train and evaluate residents in ethics and professionalism, there is a lack of structured curriculum, faculty expertise, and evaluation methodology. Effectiveness of training curricula and evaluation tools need to be assessed if the Accreditation Council for Graduate Medical Education requirements for competencies in these areas are to be meaningfully realized.

Key Words: ethics • professionalism • residency curriculum • pediatrics • core competencies

Abbreviations: ABP—American Board of Pediatrics • RRC—Residency Review Committee • ACGME—Accreditation Council for Graduate Medical Education • AAP—American Academy of Pediatrics • APPD—Association of Pediatric Program Directors

Accepted May 28, 2009.


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