Instruction and assessment of professionalism for surgery residents.

Surgical professionalism is one of the core competencies for surgery residents. It focuses on professional responsibilities to patients and society. This report summarizes current literature on surgical professionalism to help surgical residency program directors organize appropriate instruction and assessment methods for their residents. The instructional design should be based on 14 key concepts of surgical professionalism outlined by the American College of Surgeons. The professionalism curriculum should be a mixture between faculty-identified concepts and resident input of context that those concepts apply. Surgical faculty should start the instruction with a lecture, which later leads to problem solving of cases related to surgical professionalism. Surgical faculty should integrate professionalism instruction in everyday practice in all clinical settings, using both structured and apprenticeship approaches. A comprehensive assessment of professionalism requires both a maximal and a typical performance assessment. The test of maximal performance in an Objective Structured Clinical Examination (OSCE) format is suggested for the assessment of professionalism in situations that do not occur often. The test of typical performance can be achieved with ratings from faculty, peers, nurses, and patients to evaluate professionalism competence in regular clinical services.