Massachusetts General Hospital | Psychiatry

Core Competencies  Patient care  Medical knowledge / clinical science  Interpersonal, communication skills  Practice-based learning  Professionalism  Systems-based practice  Goals for the Residency  Goals & Objectives for Year 1  Goals & Objectives for Year 2

Professionalism

The cornerstone of professionalism is responsibility for patients’ care. In addition, a goal of professionalism is acting at all times “in the best interests of the child. Child and adolescent psychiatrists must act in a professional manner. This is indicated by placing patient care above and beyond self-interests, maintaining continuity of care, responding effectively and appropriately to patient needs, acting ethically and demonstrating respect for the patient and colleagues.

Knowledge
In order to act in a professional manner, residents need a firm knowledge base in specific areas. By graduation, they must demonstrate:

• Understanding of professional codes of ethics, such as the one specified by the American Academy of Child and Adolescent Psychiatry
• Understanding of legal and ethical principles of:
  -- confidentiality
  -- rights of minors and/or guardians to refuse treatment
  -- requirements for mandated reporting of suspected abuse and/or neglect
  -- involuntary commitment
  -- assent and consent principles in research
  -- abandonment
  -- Knowledge of cultural diversity that includes:

• cultural diversity of the U.S. population and cultural differences in children’s development
• cultural influences on the identification of mental health problems and help-seeking behavior
• ethnocultural influences in biological and psychosocial interventions
• Knowledge of the impact of:

-- Excessive fatigue and sleep deprivation on patient care
-- Proper transitions of care and hand-offs
-- Proper use of the electronic medical record
• Knowledge of when to call for Direct or Indirect Supervision
• Knowledge of the proper use of digital media such as the use and misuse of internet and email; Facebook; Twitter; and other electronic media that may incur boundary violations or impact patient confidentiality.

Skills
The resident will demonstrate the skills associated with professionalism that include:

-- Responsibility for patient care, including:
-- responding to patient and caregiver communications
-- use of the medical record for appropriate documentation of the course of illness and its treatment
-- providing coverage if unavailable, e.g., out of town, on vacation
-- coordinating care with other members of the medical and/or multidisciplinary team
-- providing for appropriate transfer or referral, if this is necessary

-- The resident will respond to communications from patients, caregivers and health professionals in a timely manner. If unavailable, the resident will establish and communicate backup arrangements. The resident communicates clearly to patients about how to seek emergent and urgent care when necessary

-- Ethical behavior as defined in the American Academy Code of Ethics, or Principles of Medical Ethics with Special Annotations for Psychiatry (APA)
-- Respect for patients and colleagues as persons, including their age, culture, disabilities, ethnicity, gender and sexual orientation
-- Assurance of continuity of care for patients and when it is appropriate to terminate care, the resident will do so appropriately and not “abandon” patients
-- Use of appropriate forms and procedures for informed consent, involuntary commitment and reports of suspected abuse and/or neglect

-- Excessive fatigue and sleep deprivation on patient care
-- Proper transitions of care and hand-offs
-- Proper use of the electronic medical record

Attitudes
Professionalism requires demonstration of the following attitudes:

-- Respect, regard and integrity and a responsiveness to the needs of patients and society that supersedes self-interest
-- Holding responsibility for excellence in patient care as the highest standard
-- Commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent and business practices
-- Knowing when and how to challenge/provide procedures and practices for the patient’s benefit, consistent with ongoing research and practice development in child and adolescent psychiatry
-- Sensitivity and responsiveness to cultural differences, including awareness of their own cultural perspectives.
-- Respect and self-reflection on one’s ability to care for patients under special circumstances, including fatigue, stress, sleep deprivation, complicated clinical situations in transitions of care or hand-offs, and when needing to call for supervision and/or consultation in clinical situations.