PPID MED1 Introduction to Resilience Professionalism Leadership 2024 PDF

Introduction to Professionalism, and Personal and Professional Identity (PPId) Formation Dr Sally Doherty & Ms Luma Bashmi Resilience & Professionalism Dr Anthony Friel Leadership Learning Objectives By the end of the lecture, learners will be able to: 1. Describe Medical Professionalis...

Introduction to Professionalism, and Personal and Professional Identity (PPId) Formation Dr Sally Doherty & Ms Luma Bashmi Resilience & Professionalism Dr Anthony Friel Leadership Learning Objectives By the end of the lecture, learners will be able to: 1. Describe Medical Professionalism 2. Describe Resilience 3. Describe Leadership 4. Define Professional Identity Formation 5. Discuss the relationship between Personal and Professional Identity 6. Describe the RCSI Professional Code of Conduct and its importance for students  ALL MED1 STUDENTS MUST COMPLETE THE ACADEMIC INTEGRITY COURSE PLEASE DO THIS EVEN IF YOU HAVE COMPLETED IT IN MCP OR FY ALL STUDENTS MUST HAVE A CERTIFICATE OF COMPLETION SAVED IN THEIR LAPTOP Course: Academic Integrity Course 20 24/25 (MUB) | RCSI VLE https://vle.rcsi.com/course/view.php? id=7608 Ancient Origins of Professionalism The Oath of Hippocrates I swear by Apollo the physician… that… According to my ability and judgement For the benefit of my patients Abstain from… deleterious and mischievous All such should be kept Secret Keep this Oath… enjoy life… respected by all, Violate this Oath… may the reverse be my lot! The Oath of Hippocrates. From The Genuine Works of Hippocrates translated from the Greek by Francis Adams, Surgeon, volume 2, London, 1849. Professionalism in the Modern Era Thomas Percival’s Medical Ethics In 1789 Manchester. the urbanised centre of the Industrial Revolution, and epidemic of typhus, puts enormous pressure on hospitals. Personal causes and internal quarrels (between medicine, surgery and pharmacy), meant by 1791, the epidemic persisted, and led to the closure of the fever ward. The subsequent scandal forces the managers to designate one of the hospital’s most authoritative members, Thomas Percival, to work out a code of conduct with the aim of disciplining the behaviours of the staff. Thomas Percival’s Medical Jurisprudence (Medical Ethics in 1803) Percival T. Strand, London, Manchester: S. Russell for J. Johnson, St. Paul’s Church Yard and R. Bickerstaff; 1803. Medical Ethics; or, a Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians and Surgeons; In Hospital Practice. In private, or general Practice. III. In relation to Apothecaries. In Cases which may require a knowledge of Law. To which is added an Appendix; containing a discourse on Hospital duties; also notes and illustrations. Ethics Ethics may be defined as “the normative science (standards) of the conduct of human beings living in societies – a science which judges this conduct to be right or wrong, to be good or bad…” Autono JUSTIC beneficenc Non- E my William Lille, An Introduction to Ethics, London, Methuen and Co Ltd, 1971, p.1-2 Maleficence Beneficence Beneficence, refers to actions or rules aimed at benefitting others. Acts or personal qualities of mercy, kindness, generosity and charity. David Hume’s “moral-sentiment” theory, where benevolence is the central “principle” of human nature. John Stuart Mill’s utilitarian “greatest happiness” principle, e.g. it is right if it leads to the greatest possible balance of beneficial consequences. Kant argues that everyone has a duty to be beneficent. Exceptional Beneficence is commonly categorized as supererogatory, beyond what is obligatory or doing more than is required. Oxford English Dictionary. Second edition. Oxford, UK: Clarendon Press; 1989. Cullity, Garrett, 2007, “Beneficence.” In R. E. Ashcroft, A. Dawson, H. Draper, and J. R. McMillan (eds.), Principles of Health Care Ethics (2nd ed.), pp. 19–26, Chichester, West Sussex, UK; Hoboken, NJ: John Wiley and Sons. Nonmaleficence Nonmaleficence, refers to the ethical principle of doing no harm, based on the Hippocratic maxim: Primum non nocere First, do no harm Gert’s theory of moral obligation makes nonmaleficence central, whilst denying that beneficence has a place in the theory of obligation Oxford English Dictionary. Second edition. Oxford, UK: Clarendon Press; 1989. Gert, Bernard, 2007, Common Morality: Deciding What to Do, New York: Oxford University Press. American Board Internal Medicine Foundation Medical Professionalism in the new millennium: a Physician Charter The primacy of patient welfare This principle focuses on altruism, trust, and patient interest Patient autonomy This principle incorporates honesty with patients and the need to educate and empower patients to make appropriate medical decisions. Social justice This principle addresses physicians’ societal contract and distributive justice. That is, considering the available resources and the needs of all patients while taking care of an individual patient. American Board of Internal Medicine Foundation. American College of Physicians–American Society of Internal Medicine Foundation. European Federation of Internal Medicine Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136(3):243–246. American Board Internal Medicine Foundation The 10 Commitments, to: Professional competence Honesty with patients Patient confidentiality Maintaining appropriate relations with patients Improving quality of care Improving access to care Just distribution of finite resources Scientific knowledge Maintaining trust by managing conflicts of interest Professional responsibilities American Board of Internal Medicine Foundation. American College of Physicians–American Society of Internal Medicine Foundation. European Federation of Internal Medicine Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136(3):243–246. Royal College of Physicians (UK) Definition “A set of Values, Behaviours and Relationships that underpins the Trust the public has in doctors” TRUST Medical Professionalism: Integrity ME Compassion Altruism I’M Continuous improvement A Excellence Working in partnership (Team and Patients) DOCTOR Working Party of the Royal College of Physicians. Doctors in Society: Medical Professionalism in a Changing World (2005). Clin Med (Lond). 2005 Nov-Dec;5(6 Suppl 1):S5-40. Integrity Integrity is the quality of being honest and showing consistent and uncompromising adherence to strong moral and ethical principles. To do the right thing, even when no one is looking, even when it comes at a personal cost. Oxford English Dictionary. Second edition. Oxford, UK: Clarendon Press; 1989. Compassion Compassion is the feeling or emotion, when a person is moved by the suffering or distress of another, and by the desire to relieve it; pity that inclines one to spare or to succour. To have compassion is to have fellow-feeling, sympathy, or to pity and take pity. Oxford English Dictionary. Second edition. Oxford, UK: Clarendon Press; 1989. Altruism Altruism, is “a disinterested and selfless concern for the well-being of others”, derives from the French word “autrui”, meaning “other people”. Egoism, is “an ethical theory that treats self-interest as the foundation of morality”, derives from the Latin term “ego”, for “I”. Psychological Altruism “a motivational state, goal of increasing another's welfare". Psychological Egoism “a motivation state, goal of increasing one's own welfare” Oxford English Dictionary. Second edition. Oxford, UK: Clarendon Press; 1989. Darity, Jr., William A., ed. (2008). "Altruism". International Encyclopedia of the Social Sciences. 1 (2nd ed.). Detroit: Macmillan Reference USA. pp. 87–88. Unprofessional ism Unprofessionalism Not pertaining to the characteristic of a profession. Behaviour or conduct, adversely affects the ideal functioning of teams: SEX Passive aggressive LATENE Uncooperati offensivve RUD SS DemandiCritica l e Sexual harassmentIntimidation or ngbullying Protected Grounds It is against the law to DISCRIMINATE against someone because of: Civil Status GENDE Religio AG R Family Status n disabili E RACE ty Sexual orientation Traveller 1.2000/78/EC of 27 November 2000 establishing a general framework for equal treatment in employment and occupation. Behaviours that undermine a culture of safety The Joint Commission Sentinel Event Alert (2008) Intimidating and disruptive behaviours can foster medical errors ………………………………..“Any behaviour which impairs the health care team’s ability to function well creates risk” Disruptive behaviours often go unreported Code of conduct & Process for Managing Disruptive Behaviour. The Joint Commission (Accreditation Hospitals and Government Health Insurance Schemes in USA) https://www.jointcommission.org/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea-40-intimidating-disruptive- behaviors-final2.pdf Disruptive Behaviours Disruptive Behaviours Survey (2008) Disruptive behaviors were linked to adverse events in 4530 participants (2846 nurses, 944 physicians, 40 administrative executives and survey of hospital staff 700 Others) in 100 hospitals in USA, found: 77% witnessed disruptive behaviour by Felt that disruptive behaviours were physicians linked to medical errors 65% witnessed disruptive behaviour by nurses Felt that disruptive behaviours were (most commonly verbal abuse of staff linked to patient mortality member) High-stress specialties such as surgery, Report that they were aware of a specific adverse event that occurred obstetrics, and cardiology most prone to because of disruptive behaviour disruptive behaviour. Overall only 2–4% of health care professionals 0 20 40 60 80 10 0 at any level regularly engage in disruptive behaviour. Modified from Rosenstein AH, O'Daniel M. A survey of the impact of disruptive behaviors and communication defects on patient safety. Jt Comm J Qual Patient Saf. 2008:34;464-471. Unprofessional Behaviours and Risk Disruptive Behaviour & Patient Safety National Survey (US) Disruptive Behaviour (2008) 51% compromises in patient safety 71% compromises in quality of care Bad Behaviour can undermine a culture of safety ________________________________________ Medical Error 3rd-Leading Cause of Death USA (2016) Gray RW. Disruptive behavior now a sentinel event: pt. II. Tenn Med. 2009 Mar;102(3):30. PMID: 19354056. Rodziewicz TL, Houseman B, Hipskind JE. Medical Error Prevention. 2020 Oct 17. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan–. PMID: 29763131. Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016 May 3;353:i2139. doi: 10.1136/bmj.i2139. PMID: 27143499. The Bristol Heart Scandal The Bristol Royal Infirmary, 1990s. Babies high death rates after cardiac surgery. The Inquiry found: “staff shortages, a lack of leadership,” “[a]... unit... 'simply not up to the task’ “an old boy's culture” among doctors “a lax approach to safety, secrecy about doctors’ performance “a lack of monitoring by management“ Finding: the medical profession failed in its duty to self regulate Bristol Royal Infirmary. The Inquiry Into The Management Of Care Of Children Receiving Complex Heart Surgery At The Bristol Royal Infirmary. London: The Stationery Office, 2001. Smith R (June 1998). "All changed, changed utterly. British medicine will be transformed by the Bristol case". BMJ. 316 (7149): 1917–8. Systematic Review: Unprofessional Behaviour Systematic Review: 11,963 different studies, 46 met all inclusion criteria. Found 205 descriptions of unprofessional behaviours, coded into 30 different descriptors, and classified in four behavioural themes: failure to engage dishonest behaviour disrespectful behaviour poor self-awareness Mak-van der Vossen M, van Mook W, van der Burgt S, Kors J, Ket JCF, Croiset G, Kusurkar R. Descriptors for unprofessional behaviours of medical students: a systematic review and categorisation. BMC Med Educ. 2017 Sep 15;17(1):164. doi: 10.1186/s12909-017-0997-x. PMID: 28915870; PMCID: PMC5603020.  Student Behaviours Students who exhibited unprofessional behavior in medical school were three times more likely than those who did not to undergo disciplinary action. “severe irresponsibility” OR 8.5 “diminished capacity for improvement” OR 3.1 Apathy or poor initiative, also correlated Papadakis MA, Teherani A, Banach MA, Knettler TR, Rattner SL, Stern DT, Veloski JJ, Hodgson CS. Disciplinary action by medical boards and prior behavior in medical school. N Engl J Med. 2005;353(25):2673–2682.  Education EnLightenment The Allegory of the Cave by Plato The Allegory Of The Cave is a theory by Plato, concerning human perception. Plato claimed that knowledge gained through the senses is no more than opinion and that, in order to have real knowledge, we must gain it through philosophical reasoning. Hall, Dale. "Interpreting Plato’s cave as an allegory of the human condition." Apeiron: A Journal for Ancient Philosophy and Science 14, no. 2 (1980): 74-86. Cornelis van Haarlem, 1604, Albertina, Vienna (Picture). The Task of Medical Education “Shape the novice into the effective practitioner of medicine, to give him/her the best available knowledge and skills, and to provide him/her with a professional identity so that he/she comes to think, act, and feel like a physician” - Merton/Creuss Merton RK. Some preliminaries to a sociology of medical education. In: Merton RK, Reader LG, Kendall PL, eds. The Student Physician: Introductory Studies in the Sociology of Medical Education. Cambridge, Mass: Harvard University Press; 1957:3–79. Cruess RL, Cruess SR, Steinert Y, eds. Teaching Medical Professionalism. Cambridge, UK: Cambridge University Press; 2009. Medical Education and Professionalism “When adult learners enter medical school with the desire to exhibit the values of professionalism, they have no experience in maintaining professional behaviour under the challenging circumstances that confront practicing physicians” - Leach (2004) Simply knowing Right from Wrong is not enough, we need guidelines and guided Leach DC. Professionalism: the formation of physicians. Am J Bioeth. 2004 spring;4(2):11-12. Socialisation Socialisation is the process by which a person learns to function within a particular society or group by internalizing its values and norms. Medical Education as a locus of Occupational Socialisation and the Medical School as a setting of Deep Learning Medical education is re-socialisation; certain aspects of ones prior self are replaced with new ways of thinking, acting and valuing Moving into a new occupational role and away from old ways of being and thinking Symbiotic interface of entering-embracing and exiting-rejecting Professionalism as a form of social and self control Oxford English Dictionary. Second edition. Oxford, UK: Clarendon Press; 1989. Creus RL, Cruess S,R, Steinert Y, eds. Teaching Medical Professionalism. New York, NY: Cambridge University Press; 2009. Role Models Robert K Merton a sociologist, is credited with the term “Role Model” to describe: “a person whose behaviour, example, or success is or can be emulated by others, especially by younger people” Merton, hypothesized that individuals compare themselves with reference groups of people who occupy the social role to which the individual aspires. Merton, Robert K. (December 1936). "The Unanticipated Consequences of Purposive Social Action". American Sociological Review. 1 (6): 894–904. doi:10.2307/2084615 Clinical Learning Environment Clinical Learning Environment is defined by the Macy Foundation (2018), as: “…social interactions, organizational cultures and structures, and physical and virtual spaces that surround and shape participants’ experiences, perceptions, and learning.” Healthcare Professionals and CLE must balance: Learning in a clinical context is foundational Learni Work ng Healthcare systems require learners for Service (work) An effective and supportive CLE thus is important to the quality and safety of patient care, to the health and well-being of the medical workforce, and to trainee learning and socialization into the profession. Josiah M. Jr. Foundation. 2018. Improving environments for learning in the health professions. Recommendations from the Macy Foundation Conference. New York: Josiah Macy Jr. Foundation.. Jonas Nordquist, Jena Hall, Kelly Caverzagie, Linda Snell, Ming-Ka Chan, Brent Thoma, Saleem Razack & Ingrid Philibert (2019) The clinical learning environment, Medical Teacher, 41:4, 366-372 The Oath and White Coat Ceremony RCSI’s Oath and White Coat Ceremony Symbolizes the Transition from “Lay-student” to “Healthcare Professional in Training” for medical, pharmacy and physiotherapy students RCSI White Coat Ceremony condicted virtually during Covid-19 Pandemic. https://www.medicalindependent.ie/white-coat-ceremony/ Community of Practice A Community of Practice is: “a persistent sustaining social network of individuals who share and develop an overlapping knowledge base, set of beliefs, values, history and experiences focused on a common practice”. In belonging to a community of practice, we must acquire their: Knowledge and Skills, and adopt their Values and Behaviours Form a new Identity, like theirs’ and become a Member Joining that community of practice must be equally available regardless of race, religion, gender, sexual orientation, nationality, (the protected characteristics) Barab et al. Developing an empirical account of a community of practice: characterising the essential tensions. Journal of Learning Sciences. 2002;11(4):489-542. Guidelines Guide to Professional Conduct and Ethics Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Amended) 8th Edition 2019. https://www.medicalcouncil.ie/news-and-publications/reports/guide-to-pr ofessional-conduct-and-ethics-for-registered-medical-practitioners-amen Important policies and forms RCSI Bahrain Code of Conduct Academic integrity Student dignity and respect Ethics and behavioural standards for students Plus many more – part of professional attitude to be informed – go read the guidelines and stay within the recommendations of college https://vle.rcsi.com/course/view.php?id=4469&section=1 Irish Medical Council Definition Partnership - Good care depends on doctors working together with patients and colleagues toward shared aims and with mutual respect. Partnership relies on:  Trust 3 Pillars of Professionalism: Partnership  Patient-centred care Practice  Working together Performance  Good communication  Advocacy The Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Amended) 8th Edition 2019. https://www.medicalcouncil.ie/news-and-publications/reports/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-amended-.p df Irish Medical Council Definition Practice – This describes the behaviour and values that support good care. It relies on putting the interests and well-being of patients first. The main elements of good practice are:  Caring 3 Pillars of Professionalism: Partnership  Confidentiality Practice  Promoting patient safety Performance  Integrity  Self-care  Practice management  Use of resources  Conflicts of interest The Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Amended) 8th Edition 2019. https://www.medicalcouncil.ie/news-and-publications/reports/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-amended-.p df Irish Medical Council Definition Performance – This describes the behaviour and processes that provide the foundation for good care. It requires:  Competence  Reflective Practice 3 Pillars of Professionalism: Partnership  Acting as role models Practice  Teaching and training medical students and Performance doctors new to practice The Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Amended) 8th Edition 2019. https://www.medicalcouncil.ie/news-and-publications/reports/guide-to-professional-conduct-and-ethics-for-registered-medical-practitioners-amended-.p df Medical Professionalism at RCSI Medical Professionalism: “Values, behaviours and attitudes that promote professional relationships, public trust and patient safety”  Personal and Professional Identity (PPId) Professional Identity Formation “A representation of self, achieved in stages over time during which the characteristics, values and norms of the medical profession are internalised, resulting in an individual thinking, acting and feeling like a physician/doctor.” - Cruess & Creuss (2014) Creuss RL, Creuss SR, Boudreau JD, Snell L, Steinert Y. Reframing medical education to support professional identity formation. Acad Med. 2014;89(11):1446-51. Amending Millar’s Pyramid of Learning Consistently demonstrates the attitudes, values, and behaviours IS expected of one who has come to (Identity) “think, act, and feel like a doctor” Consciously demonstrates the DOES behaviours of a doctor Does (Action) Demonstrates the behaviours expected SHOWS HOW of a doctor under supervision Shows How (Performance) Knows when individual behaviours are Knows How / KNOWS HOW appropriate Understand (Competence) Knows the behavioural norms expected KNOWS of a doctor Knows / Knowledge (Knowledge) Modified from Miller GE. The Assessment of Clinical Skills/Competence/Performance. Acad. Med. 1990:65(9); 63-67. Amending Miller’s Pyramid to Include Professionalism Identity Formation, Cruess R & Cruess S in Ed Cruess RL, Creus SR, Steinert Y. Teaching Medical Professionalism. Cambridge University Press (2009) 2016. Professional Identity Formation Professio Personal Socialisati nal Identity on Identity Cruess, Richard L. MD; Cruess, Sylvia R. MD; Boudreau, J. Donald MD; Snell, Linda MD, MHPE; Steinert, Yvonne PhD Reframing Medical Education to Support Professional Identity Formation, Academic Medicine: November 2014 - Volume 89 - Issue 11 - p 1446-1451 doi: 10.1097/ACM.0000000000000427. Snell L, Steinert Y. Reframing medical education to support professional identity formation. Acad Med. 2014;89(11):1446-51. Personal and Professional Identity at RCSI Transforming Healthcare Education Project (THEP) Professionali sm Leadershi Resilience p Self-awareness and Professional Identity Formation Much focus of healthcare training is outward facing For students to effectively develop a professional identity, they must first be self- aware Authenticity as a practicing professional built on this solid foundation of self-awareness Lack of self-awareness is potentially career limiting Conflict with colleagues Difficult work relationships Resulting implications for patient safety Many people go through their lives not understanding or appreciating their impact Self-care and Professional Identity Formation WHO definition: Self-Care is what people do for themselves to establish and maintain health, and to prevent and deal with illness. It is a broad concept encompassing hygiene (general and personal), nutrition (type and quality of food eaten), lifestyle (sporting activities, leisure etc), environmental factors (living conditions, social habits, etc.) socio-economic factors (income level, cultural beliefs, etc.) and self-medication. -[WHO, 1998] Why is it important? Need to pay attention to own physical and emotional health in order to take care of others Maintaining physical and emotional health Resilience and core curriculum Resilience is the capacity to maintain well- being and work performance under pressure Is an Emotional Competence Can be translated to skills and behaviours to be acquired during training Is a Cognitive process that encompass 4 dimensions: Self-efficacy (confidence in ability to do something) Planning Self-regulation (self-control) RCSI Definition of Resilience The capacity to apply knowledge and skills to deal positively with adversity, and the ability to learn and grow as a result of challenging situations Resilience Curriculum Collaboration between RCSI and University of Pennsylvania Positive Psychology Centre UPenn training provided to members of RCSI faculty across Dublin, Bahrain and Malaysia Trainees are interdisciplinary across 6 Schools: Medicine, Population Health, Physiotherapy, Pharmacy, Nursing, Post- graduate Studies To be delivered in small group tutorial format, focused on development of key skills Penn Resilience Programme (PRP) What it is: What it is not: A skills programme A treatment programme designed to support and A substitute for student enhance well-being mental health support Draws on two areas in psychology Cognitive behavioural psychology Positive psychology PRP Content Overview Focused on teaching of 9 key skills to facilitate resilient responses to challenges: 1. Optimistic mindset 2. Thinking traps 3. Deliberate breathing 4. Mental cues 5. Real-time resilience 6. Put it in perspective 7. Positive emotions 8. IDEAL (maintaining relationships during difficult conversations) 9. Active constructive responding PRP Content Delivery in THEP2 PRP shown to have maximum effect when sustained over time Year 1: Module Topic Duration BMF Intro to Resilience & Well- 90 minutes being Cardio Skill 1: Optimistic Mindset 120 minutes Respiratory Skill 2: Thinking Traps 120 minutes The Importance of Resilience “by turning your worst day into your best day, you are always the author of your own story” Katie Piper, November 2020 https://www.youtube.com/watch?v=DR_DAv_kpmg Minutes 48.00 – 50.35 (2.5 minutes) Medical Leadership Competency Framework Academy of Medical Royal Colleges & NHS Institute for Innovation and Improvement, developed for Curricula. Leadership Competencies essential to a Good Doctor: Shared Leadership “Followership”, participation allows others to Lead Strong Values, Patient-at-centre, not Provider priorities Warren OJ, Carnall R. Medical leadership: why it's important, what is required, and how we develop it Postgraduate Medical Journal 2011;87:27-32. The Medical Leadership Competency Framework, The National Institute for Innovation and Improvement. http://www.institute.nhs.uk/assessment_tool/general/medical_leadership_competency_framework_-_homepage.html. Reflective Practice: Core Skill in PPId Assessment insights A cognitive process that helps us to gain and rethink our practice, learn from our experiences and help us to cope with similar situations in future. What? So what? Now What? Rolfe, G., Freshwater, D. and Jasper, M. (2001). Critical reflection in nursing and the helping professions: a user’s guide. Basingstoke: Palgrave Macmillan. Your Medical Student Identity IMC Guidelines for Medical Schools Guidelines for Medical Schools Ethical Standards Appropriate Behaviour Irish Medical Students are not subject to IMC Fitness to Practise processes. Irish Medical Students are subject to the disciplinary procedures of their University Medical School. https://www.medicalcouncil.ie/news-and-publications/reports/trust-in-profession.pdf Accessed 22 September 2020 RCSI Code of Conduct The Code is based on six core principles: 1. Your primary concern must be to maintain and improve the health, wellbeing, care and safety of patients. 2. Develop your professional competence, skills and standing so as to bring health gain and value to the community and society. 3. Be honest and trustworthy and show respect for others. 4. Conduct yourself in a manner which enhances the service provided to society and which will maintain the good name of your profession. 5. Maintain your professional knowledge and competence. 6. Be aware of your obligations under the Code of Conduct and do not do anything which constitutes a breach of the Code. If your behaviour fails to meet the standards outlined in the Code, the matter may be referred in accordance with RCSI’s relevant policies and regulations. RCSI Undergraduate Student Agreement, Joint Schools Undergraduate Code of Conduct* [Appendix B] 2022-2023. https://www-components.rcsi.ie/quercus-remote-files/student-acceptance/docs/RSA.pdf RCSI Fitness to Study Policy Fitness to Study Concerns Where students are in receipt of reasonable accommodation and fail to demonstrate the core required academic, clinical and professional competencies of their programme or elect not to engage with supports provided by the University, they may be referred for a fitness to study review under this policy. In certain cases where it is determined that a significant and immediate risk may potentially exist to the well-being of a student or to the well-being of others, including patients or clients, the University reserves the right to escalate immediately to a Level 3 response. Right of Appeal. RCSI Undergraduate Student Agreement, Fitness to Study Policy [Appendix A] 2022-2023. https://www-components.rcsi.ie/quercus-remote-files/student-acceptance/docs/RSA.pdf  TRUST ME I’M (ALMOST) A DOCTOR Conclusions At the end of this talk you will: 1. Describe Medical Professionalism 2. Describe Resilience 3. Describe Leadership 4. Define Professional Identity Formation 5. Discuss the relationship between Personal and Professional Identity 6. Describe the RCSI Professional Code of Conduct and its importance for students Thank You Bibliography 1. American Board of Internal Medicine Foundation. American College of Physicians–American Society of Internal Medicine Foundation. European Federation of Internal Medicine Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136(3):243–246. 2. Working Party of the Royal College of Physicians. Doctors in Society: Medical Professionalism in a Changing World (2005). Clin Med (Lond). 2005 Nov-Dec;5(6 Suppl 1):S5-40. 3. The Medical Council Guide to Professional Conduct and Ethics for Registered Medical Practitioners (Amended) 8 th Edition 2019. https://www.medicalcouncil.ie/news-and-publications/reports/guide-to-professional-conduct-and-ethics-for-register ed-medical-practitioners-amended-.pdf 4. The Penn Resiliency Program (PRP). https://ppc.sas.upenn.edu/prpsum.htm. 5. The Medical Leadership Competency Framework, The National Institute for Innovation and Improvement. http://www.institute.nhs.uk/assessment_tool/general/medical_leadership_competency_framework_-_homepage.ht ml. 6. RCSI Undergraduate Student Agreement, Joint Schools Undergraduate Code of Conduct* [Appendix B] 2022-2023. https://www-components.rcsi.ie/quercus-remote-files/student-acceptance/docs/RSA.pdf