Health care professionals' perceptions of unprofessional behaviour in the clinical workplace.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2023
Historique:
received: 25 07 2021
accepted: 30 12 2022
entrez: 19 1 2023
pubmed: 20 1 2023
medline: 24 1 2023
Statut: epublish

Résumé

Unprofessional behaviour undermines organizational trust and negatively affects patient safety, the clinical learning environment, and clinician well-being. Improving professionalism in healthcare organizations requires insight into the frequency, types, sources, and targets of unprofessional behaviour in order to refine organizational programs and strategies to prevent and address unprofessional behaviours. To investigate the types and frequency of perceived unprofessional behaviours among health care professionals and to identify the sources and targets of these behaviours. Data was collected from 2017-2019 based on a convenience sample survey administered to all participants at the start of a mandatory professionalism course for health care professionals including attending physicians, residents and advanced practice providers (APPs) working at one academic hospital in the United States. Out of the 388 participants in this study, 63% experienced unprofessional behaviour at least once a month, including failing to respond to calls/pages/requests (44.3%), exclusion from decision-making (43.0%) and blaming behaviour (39.9%). Other monthly experienced subtypes ranged from 31.7% for dismissive behaviour to 4.6% for sexual harassment. Residents were more than twice as likely (OR 2.25, p<0.001)) the targets of unprofessional behaviour compared to attending physicians. Female respondents experienced more discriminating behaviours (OR 2.52, p<0.01). Nurses were identified as the most common source of unprofessional behaviours (28.1%), followed by residents from other departments (21%). Unprofessional behaviour was experienced frequently by all groups, mostly inflicted on these groups by those outside of the own discipline or department. Residents were most frequently identified to be the target and nurses the source of the behaviours. This study highlights that unprofessional behaviour is varied, both regarding types of behaviours as well as targets and sources of such behaviours. This data is instrumental in developing training and remediation initiatives attuned to specific professional roles and specific types of professionalism lapses.

Sections du résumé

BACKGROUND
Unprofessional behaviour undermines organizational trust and negatively affects patient safety, the clinical learning environment, and clinician well-being. Improving professionalism in healthcare organizations requires insight into the frequency, types, sources, and targets of unprofessional behaviour in order to refine organizational programs and strategies to prevent and address unprofessional behaviours.
OBJECTIVE
To investigate the types and frequency of perceived unprofessional behaviours among health care professionals and to identify the sources and targets of these behaviours.
METHODS
Data was collected from 2017-2019 based on a convenience sample survey administered to all participants at the start of a mandatory professionalism course for health care professionals including attending physicians, residents and advanced practice providers (APPs) working at one academic hospital in the United States.
RESULTS
Out of the 388 participants in this study, 63% experienced unprofessional behaviour at least once a month, including failing to respond to calls/pages/requests (44.3%), exclusion from decision-making (43.0%) and blaming behaviour (39.9%). Other monthly experienced subtypes ranged from 31.7% for dismissive behaviour to 4.6% for sexual harassment. Residents were more than twice as likely (OR 2.25, p<0.001)) the targets of unprofessional behaviour compared to attending physicians. Female respondents experienced more discriminating behaviours (OR 2.52, p<0.01). Nurses were identified as the most common source of unprofessional behaviours (28.1%), followed by residents from other departments (21%).
CONCLUSIONS
Unprofessional behaviour was experienced frequently by all groups, mostly inflicted on these groups by those outside of the own discipline or department. Residents were most frequently identified to be the target and nurses the source of the behaviours. This study highlights that unprofessional behaviour is varied, both regarding types of behaviours as well as targets and sources of such behaviours. This data is instrumental in developing training and remediation initiatives attuned to specific professional roles and specific types of professionalism lapses.

Identifiants

pubmed: 36656827
doi: 10.1371/journal.pone.0280444
pii: PONE-D-21-24116
pmc: PMC9851503
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0280444

Informations de copyright

Copyright: © 2023 Dabekaussen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

JAMA Surg. 2020 Jun 1;155(6):524-526
pubmed: 32236505
BMJ Qual Saf. 2015 Jan;24(1):56-64
pubmed: 25380669
Ann Surg. 2020 Apr;271(4):608-613
pubmed: 30946072
Jt Comm J Qual Patient Saf. 2014 Apr;40(4):168-77
pubmed: 24864525
Acad Med. 2016 Mar;91(3):427-32
pubmed: 26579795
J Emerg Med. 2012 Jul;43(1):139-48
pubmed: 21421291
JAMA Surg. 2019 Sep 1;154(9):828-834
pubmed: 31215973
BMJ Qual Saf. 2017 Nov;26(11):869-880
pubmed: 28442609
J Patient Saf. 2009 Sep;5(3):180-3
pubmed: 19927052
BMC Med Educ. 2017 Sep 15;17(1):164
pubmed: 28915870
Jt Comm J Qual Patient Saf. 2008 Aug;34(8):464-71
pubmed: 18714748
JAMA Surg. 2021 Oct 1;156(10):942-952
pubmed: 34319377
Acad Med. 2018 Nov;93(11):1679-1685
pubmed: 29319539
BMJ Qual Saf. 2013 May;22(5):414-23
pubmed: 23293118
BMC Med Educ. 2016 Apr 27;16:127
pubmed: 27117063
N Engl J Med. 2022 Mar 31;386(13):1284-1287
pubmed: 35353969
Can J Anaesth. 2019 Jul;66(7):781-794
pubmed: 31168769
N Engl J Med. 2019 Oct 31;381(18):1741-1752
pubmed: 31657887
J Intern Med. 2018 Jun;283(6):516-529
pubmed: 29505159
J Grad Med Educ. 2020 Oct;12(5):525-528
pubmed: 33149815
BMJ. 2018 Mar 7;360:k1025
pubmed: 29514793
J Grad Med Educ. 2013 Mar;5(1):25-30
pubmed: 24404222
JAMA Intern Med. 2020 May 1;180(5):653-665
pubmed: 32091540
BMJ. 2022 Sep 14;378:e070442
pubmed: 36104064
J Am Coll Surg. 2006 Jul;203(1):96-105
pubmed: 16798492
Acad Med. 2014 May;89(5):817-27
pubmed: 24667512
BMJ Open. 2017 Jun 21;7(6):e015141
pubmed: 28637730
Surgery. 2007 Nov;142(5):658-65
pubmed: 17981185
Acad Med. 2007 Nov;82(11):1040-8
pubmed: 17971689
Can J Anaesth. 2017 Feb;64(2):128-140
pubmed: 27900669
Lancet. 2009 Nov 14;374(9702):1714-21
pubmed: 19914516
Jt Comm J Qual Patient Saf. 2016 Apr;42(4):149-64
pubmed: 27025575
PLoS One. 2013;8(2):e57570
pubmed: 23469027
JAMA. 2018 Sep 4;320(9):873-874
pubmed: 30128569
Sentinel Event Alert. 2008 Jul 9;(40):1-3
pubmed: 18686330
JAMA Intern Med. 2017 Feb 1;177(2):195-205
pubmed: 27918798
Am J Surg. 2015 Jan;209(1):65-70
pubmed: 25454961
Postgrad Med J. 2014 Mar;90(1061):149-54
pubmed: 24398594
Med Educ. 2019 Aug;53(8):799-807
pubmed: 30989682
BMJ Qual Saf. 2017 Dec;26(12):1004-1014
pubmed: 28794242
Am J Surg. 2020 Jan;219(1):21-26
pubmed: 31151660
World J Clin Cases. 2015 Nov 16;3(11):930-4
pubmed: 26601095
J Interprof Care. 2013 May;27(3):210-3
pubmed: 23082769
Front Health Serv Manage. 2009 Summer;25(4):3-11
pubmed: 19603686
J Interprof Care. 2010 Jul;24(4):350-61
pubmed: 20540614
Nurse Educ Pract. 2016 Jul;19:36-40
pubmed: 27428690

Auteurs

Kirsten F A A Dabekaussen (KFAA)

Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.

Renée A Scheepers (RA)

Erasmus School of Health Policy and Management, Rotterdam, The Netherlands.

Erik Heineman (E)

Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.

Adam L Haber (AL)

Department of Environmental Health, Harvard T. H. School of Public Health, Boston, Massachusetts, United States of America.

Kiki M J M H Lombarts (KMJMH)

Professional Performance & Compassionate Care Research Group, Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Debbie A D C Jaarsma (DADC)

Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.

Jo Shapiro (J)

Harvard Medical School, Boston, Massachusetts, United States of America.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH