A UCF mobile app that will be used to assess the professionalism of medical students and residents has received a prestigious grant from the Josiah Macy Jr. Foundation’s Institute on Medicine as a Profession, a national organization that works to improve healthcare and medical professionalism in the United States.
The foundation describes itself as the only national foundation dedicated to supporting projects that broaden and improve health professional education. It’s two-year, $100,000 grant to the UCF College of Medicine will allow the college to finalize the app and get it into the hands of physician educators who train medical students and residents.
Dr. Juan Cendan, the medical school’s assistant dean for simulation and professor of surgery, is the primary investigator on the grant. He developed the app with UCF’s Institute for Simulation and Training to provide real-time feedback for exemplary professionalism, behaviors that warrant a caution and actual breaches of professional conduct. The medical school’s Professionalism Task Force began the initiative by devising a list of desired character traits medical students need as they work with patients, core and volunteer faculty, and each other. The traits are under six broad categories including self-improvement, adaptability, relationships, responsibility and reliability.
The medical school is preparing to get the app onto the phones of directors at UCF’s new Internal Medicine residency program and for faculty in the Practice of Medicine module. Ultimately, with the help of the grant, the app will be expanded for use by clerkship physicians, preceptors and eventually to students who can evaluate each other and even their faculty.
The app is called Promobes – Professional Mobile Measurements of Behaviors. With it, a physician types in the student’s name or just the student’s year and gets a menu of photos. The physician selects the particular student and then clicks whether the student has earned a gold bar or reward for professionalism, a yellow bar for cautionary behavior or a red bar for a breach. Using a drop-down menu, the faculty member clicks on the specific professionalism traits that were performed well or breached. The app also includes a section for comments. When the feedback is completed, it is sent securely to an appropriate third party – the residency program director, M.D. clerkship director or even deans – for action.
Over time, the software provides a graph showing the student’s various marks in professionalism. A student who has a number of yellow warnings and breaches during a specific period may be dealing with a personal, behavioral or learning problem. By seeing patterns early, faculty can better intervene, Dr. Cendan said. To be meaningful, feedback for medical students must be immediate and directive, Dr. Cendan said. “It’s not enough to say a student ‘rubbed a patient or a faculty member the wrong way,’” he explained. “What does that mean? To learn and to improve, students must receive timely and formative feedback. This technology helps us to identify the problem early and correct it. ”
In addition to timely feedback, the app can help identify trends in student behaviors, baselines for determining if residents are meeting specific milestones and provide an overall portrait of student performance from all of his or her teachers. Once the app is perfected, the College of Medicine hopes to make it available nationwide.
“As we were talking about professionalism, we realized that no one was putting together all the feedback, whether positive or corrective,” Dr. Cendan said. “This technology allows us to specifically recognize in real time people who are doing great work and to take real time corrective, formative steps if students are not showing professionalism.”
Professionalism is becoming increasingly emphasized in healthcare, he said, noting that state medical boards are often dealing not with lack of knowledge in disciplining physicians but in lapses of judgment and inappropriate behavior. The Accreditation Council for Graduate Medical Education (ACGME), which oversees residency programs, has also developed specific milestones for evaluating residents and many milestones relate to professionalism.
Faculty also hope that by having specific traits listed in the app, traits of character and professionalism will be more clearly understood and that students will perform to those specific traits.
Dr. Deborah German, vice president for medical affairs and dean of the UCF College of Medicine, said she was “delighted” by the grant award and applauded the use of technology to create better doctors. “We use technology as a tool to do the things we can’t currently do and to improve what we already do. I can’t think of a better use of technology than helping us ensure our students exhibit the highest level of professionalism.”