The lived understanding of professional behavior: perspectives from three levels of seniority within a single US institution

Introduction To gain a more fulsome understanding of professional behavior, as viewed through the lens of three levels of clinical seniority at Yale New Haven Hospital.   Methods Sample: This was a qualitative research study. Participants included three groups who work within one hospital environment: 7 Departmental Chairs, 12 Clerkship Directors and 15 Resident Doctors (from Departments of Neurology, Surgery, Emergency Medicine (EM), Anaesthesia, Obstetrics and Gynaecology, Internal Medicine, and Psychiatry).   Data Collection: Trained interviewers implemented semi-structured individual and focus group interviews. All interviews were recorded and transcribed.   Data Analysis: Two of the authors (JEH, JPH) analysed the transcripts, coded the data, identified themes, and recorded verbatim quotes represented within those themes.    Results The study identified four different understandings (Leadership, Communication, Reporting, and Training) of professional behavior within a single workplace culture, around a singular code of conduct policy.   Conclusions Results indicated that one’s understanding of professionalism depends on one’s position and ‘standing’ within an organization and has important implications for policy setting. Although most medical institutions have policies and definitions of what is expected of professional behavior, further research is needed to understand how faculty come to operationalize and ‘live’ these policies and whether steps can be taken to match definitions with the lived experience.