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Professional Conduct and Attitude
Rationale
Professional conduct is complex and difficult to
define, but is at the core of a physician's daily activities. Knowledge,
diagnostic skills and problem solving abilities are necessary, but not
sufficient to guarantee successful clinical interactions. The physician also
must have well developed interpersonal skills that facilitate communication and
must demonstrate attitudes, behaviors and beliefs that promote the patient's
best interest. In particular, the physician who provides medical care to
infants, children, and adolescents must remember that the patient and the
clinical interaction will change continuously under the influence of growth and
development. How the physician communicates can have a lasting effect in how the
parents handle situations and communicate with the physician. The evolving
family structure also will influence the physician's interaction with both the
patient and the family. Lastly, the physician must have a commitment to lifelong
learning to ensure that the medical care provided to patients is the most
appropriate, effective treatment available.
Learning Objectives
The attitudes, beliefs and behaviors central to the
professional conduct of all physicians will be enhanced by a student's
experience in pediatrics. Specific issues during clinical pediatrics are
highlighted here. However, interaction with children and adolescents (and their
families) during the pediatric clerkship will require students to develop their
own attitudes, beliefs, ethical and legal concepts and professional conduct.
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The patient constantly changes as growth and
development proceed, and the family, likewise, develops and changes as the
child grows and as subsequent children are born. The patient's ability to
participate in the clinical interaction progresses, as do his or her
knowledge, experience and concerns. The adolescent presents specific
challenges, including such issues as privacy, risk-taking behaviors,
confidentiality and personal involvement with health. The role of parents in
the clinical interaction and their knowledge, experience and concerns also
change. Students must work to adapt their clinical approach, as appropriate
to the developmental stage of the child or adolescent and family.
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Cultural, ethnic and socioeconomic factors
also affect personal and family traits and behaviors, with varying effects
on child rearing practices. Recognition of and respect for difference are
important. The student must still be alert for the child or adolescent at
risk in different family environments, given that the physician's primary
obligation is to promote the best interest of the patient.
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Acute and chronic illness and disability test
the physician's clinical and interpersonal skills. The student must learn
how to communicate clearly and sensitively. In such situations the health
care team plays an important role and the student must learn to work within
a team, treating each member of the team with courtesy and respect and
recognizing the contributions of each to the clinical interaction.
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There are unique ethical issues in pediatrics.
The student must have a firm foundation in basic ethical principles and must
develop an appreciation of the ethical challenges specific to clinical
interactions with children, adolescents and their families.
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At the core of the physician's professional
conduct are attitudes, skills and knowledge that evolve as the individual's
experiences grow. Intellectual curiosity, initiative and willingness to
assume responsibility for the continued development of clinical skills are
crucial for the lifelong learning demanded by a career in medicine.
Competencies
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Demonstrate the professional conduct necessary
for a
successful clinical interaction.
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Demonstrate tolerance of parent and family
differences in
attitudes, behaviors and lifestyles, but recognize when a child or
adolescent is at risk and know when and how to intervene.
Provide examples that demonstrate how child rearing practices differ across
cultural and ethnic groups and in socioeconomic situations.
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Explain in general terms how to conduct an
interview and
physical exam of an adolescent with his or her parent. In
addition, outline how the results of the examination and any
diagnostic tests should be discussed with the adolescent and
parent.
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Discuss how to relate news of a serious acute
or chronic
illness or a congenital abnormality to parents. How would your discussion
differ with the child or the adolescent?
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Demonstrate intellectual curiosity,
initiative, responsibility,
and reliability.
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