ANESTHESIA & ANALGESIA - IARS

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ANESTH ANALG ABSTRACTS 2004; 98; S-1–S-282 S-66 PROGRAM ENRICHMENT - TEACHING PROFESSIONALISM: SHOULD WE? AUTHORS: T. E. Carter 1 , P. Arciaga 1 , J. S. Jahr 1 , J. Tetzlaff 2 , S. Steen 1 ; AFFILIATION: 1King Drew Medical Center, Los Angeles, CA, 2 Cleveland Clinic Foundation, Cleveland, OH. INTRODUCTION: The Accreditation Council for Graduate Medical Education and the American Board of Anesthesiology (ABA) requires compliance with six core competencies -- professionalism is one of them (1,2). The ABA 2003 manual states: “Residents must demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles and sensitivity to a diverse patient population (3)." We evaluated a teaching module that included a pre- and post-test and a didactic lecture assessing improvement. METHODS: As part of the resident education curriculum, a 30 minute presentation was scheduled to present a didactic lecture on Professionalism. No specific cases or tutorials were presented. Ten relevant questions, which were not directly addressed in the lecture, were administered as a pre- and post-test to members of the Anesthesiology Department of King/Drew Medical Center, including faculty, residents, and rotating students from UCLA. Feedback from the presentation and descriptive statistics were used to evaluate the results. RESULTS: The faculty and Dean of the Medical School, residents, and students, on validated feedback, commented favorably on the lecture, including presentation, slides, and style. However, focus and additional time allotment was suggested, including specific question-matched case examples, and interactive tutorials. Specifically, of the 6 faculty members who were pre-tested, 2 of 3 which were post-tested, demonstrated a 10% improvement. Of 11 residents who were pretested, 9 of them completed the post-test and only one showed 10% improvement. One who scored 100% on the pre-test, did not take the post-test. Of the 3 medical students who took the pre-test, one significantly improved his performance by 30%. No individuals’ scores decreased. DISCUSSION: It is important to note that the lecture did not S-67 PARTICIPANT OPINION OF MENTORSHIP TO PROMOTE PROFESSIONAL GROWTH WITHIN AN ANESTHESIOLOGY ACADEMIC DEPARTMENT AUTHORS: J. F. O'Hara, M. Hewson, B. Bierer, S. Stevens, A. Schubert; AFFILIATION: Cleveland Clinic Foundation, Cleveland, Ohio, OH. INTRODUCTION: A mentor is a person who has acquired experience and seniority; who is more than a teacher or colleague; who serves as a sponsor, advisor and role-model; who has the time to counsel and support more junior people; a person whose high standards of excellence a protégé can emulate 1,2 . This study surveyed physicians in an academic anesthesiology department with the purpose of identifying the importance of mentoring to promote professional growth within the work environment. METHODS: Fifty-two anesthesiologists in an academic, tertiary care facility with a large residency program (>100 residents) were asked to complete a survey that was compiled by the study authors (table). The items generated were perceived to include relevant and appropriate issues for these physicians. The anesthesiologists were asked to rate items using a Likert scale (1 = not important to 5 = very important). Data are presented as mean scores and standard deviations. Confidence intervals were used to check significant differences among ratings. RESULTS: The response rate of surveys completed was 86% (45/52 anesthesiologists). 71% of the respondents rated mentoring as important/very important. However, only 46% indicated that mentoring has been important/very important in their career so far. As presented in the figure below, the top five items reflecting respondents’ perceptions of the importance of mentoring for professional growth were: research skills = 4.16 ± .85, leadership strategies = 4.14 ± .79, career promotion = 4.12 ± .78, professionalism = 4.04 ± .91, and advancing in state and national anesthesiology societies = 3.97 ± .97. Maintaining a balance between career and family/personal life was rated the lowest (3.44 ± .9, p
S-68 S-69 ABSTRACTS ANESTH ANALG 2004; 98; S-1–S-282 S-68 ASSESSING FACULTY SATISFACTION WITH A FACULTY INCENTIVE PLAN AUTHORS: R. D. Kratz, F. K. Orkin, B. Mets; AFFILIATION: The Penn State Milton S. Hershey Medical Center, Hershey, PA. INTRODUCTION: This study assessed the satisfaction of anesthesiology faculty in one academic health center with the current incentive payment plan to establish a baseline for evaluating the effectiveness of a new, productivity-based incentive plan for clinical and non-clinical activities.We developed a survey to be used before and annually after the implementation of the new plan to assess its incremental effectiveness. We report the results of the survey administered before implementation of the new incentive plan. METHODS: A survey was developed using 19 statements with a fivepoint Likert scale: strongly disagree, disagree, neutral, agree, or strongly agree. Additional questions inquired about length of time in the department and specialty areas. Two open-ended questions allowed faculty to share experience with other plans and express concerns that were not addressed in the survey. With IRB approval, the anonymous survey was distributed to current clinical faculty members and to those faculty who had resigned during the past year. Summary statistics and contingency tables were prepared (SPSS 11.5), with exact probabilities computed (StatXact 5); P less than 0.05 was considered to indicate statistical significance. RESULTS: Of the 26 current clinical faculty and four faculty who had left the department during the last year, 20 current and all four former faculty completed the survey. Among current faculty 80% did not understand how their most recent incentive amount was determined, 70% did not feel they had received adequate time, and 35% did not feel they had the other resources needed to make progress towards their yearly goals. Concerning the current plan, 40% felt it did not influence their productivity, and over half disagreed with statements that it motivated them to provide patient care, educational activities, research, or administrative activity. Only 35% could agree that they are highly satisfied with the current incentive plan. Faculty were more likely to be S-69 DEVELOPMENT OF A GOAL-BASED INCENTIVE PLAN FOR MOTIVATING ACADEMIC ANESTHESIOLOGY DEPARTMENTS AUTHORS: R. D. Kratz; AFFILIATION: The Penn State Milton S. Hershey Medical Center, Hershey, PA. INTRODUCTION: In the past many chairs of departments of anesthesiology have had full discretion and no formal guidelines for dispensing incentives.Our current chairman envisions the department moving to a program with more structure: one that not only rewards past effort but also looks to the future and motivates personal development. Our departmental faculty feel strongly that a goal-based program is more desirable than a value based or standards based program. No prior literature has been found relating goal-based incentive programs to anesthesiology departments. METHODS: The literature in medical, psychological, and business journals relating to goal theory was reviewed. Goal setting theory was developed in the psychological literature. It was then expanded into business practice, but only recently have applications related to medicine been documented. RESULTS: Five general rules of goals have emerged from the laboratory experiments and field studies (1,2,3,4). 1. Focused goals inspire. Three to five goals are preferable to six or more goals. 2. Specific goals generate higher performance than general goals. Specific goals are observable and measurable. 3. Difficult, achievable goals generate higher performance than easy goals or impossible goals. 4. Worker participation elicits increased commitment and motivation. 5. Specific feedback, both negative and positive, inspires increased levels of performance. DISCUSSION: The Goal Setting Model can be applied to an anesthesiology department. Goals are established individually by the chairman and faculty. Then the chair and faculty meet to determine mutually agreeable goals. At the satisfied if they felt collegiality and support (P=0.0011), were in the department longer than 5 years (P=0.0347), and felt they had adequate time (P=0.0221) and other resources (P=0.0081). Those who resigned were more likely to have their level of productivity influenced by the incentive (P=0.0349) but otherwise responded similarly. DISCUSSION: These data suggest that the current incentive plan is ineffective in motivating faculty. As we implement our new incentive plan, we must effectively communicate the details of this plan and ensure the goals set are aligned with the resources provided. These data will also provide a base from which to evaluate the success of our efforts. same time they determine measurement criteria for goal achievement. It is important to ensure that the resources necessary for goal achievement are available. Then follow up for feedback and evaluation allows for continuous improvement. Goal-based incentive plans can be developed which not only reward past effort but also encourage future growth in faculty by aligning their effort with the interests of the department (5). Good communication between the chairman and the faculty is required for success. We will be implementing a goal-based incentive plan and evaluating its effect on productivity and faculty satisfaction. REFERENCES: 1. Hellreigel D, Slocum Jr JW, Woodman RW. (2001). Motivation in the Work Setting. Organizational Behavior (ninth edition). Cincinnati: South-Western College Publishing. 2. Hughes CL, GOAL SETTING Key to Individual and Organizational Effectiveness. 1965. American Management Association. 3. Lawler III EE, Motivation in Work Organizations, 1994 by Jossey- Bass Publishers, San Francisco, CA 4. Layman EJ, and Guyden JA. (2000). Renewal versus burnout: A career blueprint. The Health Care Manager, 18(3), pp. 52-62. 5. Biebuyck JF, Mallon WT. The Successful Medical School Department Chair: A Guide to Good Institutional Practice. Module 3. 2002. AAMC Publications.
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