For a study entitled: "Professional Boundaries: How do family medicine residency programs teach and model an ethical framework for patient care?"

Reviewer 1:

Patient Physician Relationship seems to be the issue of interest based on your background information, which is good. At this time, however, your research question and Objectives seem to broadly address professionalism without narrowing to this specific question of Patient Physician Relationship. It is mentioned in one objective and not mentioned in many of the actual questions. I think if the background was left the same and the question/objectives were rewritten to allow the survey questions to only address the relationship part of professionalism, it might provide valuable information. At this point, it seems too broad to gather the information.

Reviewer 2:

"Doctor-patient boundaries" is a very important topic for family medicine residency programs!  Your proposal is not yet ready for prime time, but I encourage you to resubmit.  Here is my feedback.  Introduction - this is very well-argued, and your citations are spot-on.  Aims and hypotheses - These should match your survey questions perfectly, but they don't.  I note you include questions about (a) curriculum and (b) policies, so edit your research questions to address both; right now the research questions address only curriculum. Your hypotheses are merely descriptive, that is, it appears that you simply plan to "count" responses to survey questions (these types of hypotheses are considered "weak" because one cannot test them).  Can you think of correlations with these curricula or policies?  For example, what might influence a residency program to have specific policies in place? Perhaps the program director's own behavior - does he or she treat family members, friends, employees?  Are rules less stringent in small communities? Good hypotheses will predict correlations between variables.  Finally - the survey questions. As I said above, you appear to focus on curriculum and policies. I picture about 3-4 questions with "check all that apply" response. "Does your program's Professionalism curriculum address issues regarding physician-patient boundaries? (check all that apply): a. prohibiting sexual relationships between doctors and patients; b. discouraging medical care for self or family members; c. discouraging medical care for co-workers or employees; etc." You could use a parallel questions for clinic policies. Also include a question regarding the mode of teaching - didactics, mentoring, rolemodeling, etc. In general, CERA does not 'like' check-all-that-apply questions, but if your survey had only 3-4 questions, hm... maybe...  If you decide to re-apply, ask CERA for a mentor to help you with the application. We do that! 

Reviewer 3:

This is an interesting question. The hypotheses are mostly descriptive. Strongly hypotheses would result in a stronger proposal. The questions also need significant work and there is no attempt at an analysis plan.

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