Dataset Information

Assessment of medical professionalism using the Professionalism Mini Evaluation Exercise (P-MEX) in a multi-ethnic society: a Delphi study.

ABSTRACT:

Background

The importance of medical professionalism and its assessment has been well documented in the literature. However, there is currently no culturally-adapted tool to assess medical professionalism in Singapore. This study sets out to find consensus on relevance of the items from the Professionalism Mini Evaluation Exercise (P-MEX) for assessing medical professionalism in Singapore.

Methods

A two-round Delphi survey was completed by an expert panel consisting of program directors, associate designated institutional officials, and designated institutional official (n = 15) from residency programs in Singapore. Round 1 comprised of 23 items from the P-MEX rated on a 5-point scale (1 = Definitely include, 2 = Possibly include, 3 = Neutral, 4 = Possibly exclude, 5 = Definitely exclude). In round 2, the experts received feedback from the previous round, and were asked to re-rate the items which did not achieve consensus in the previous round. The threshold for consensus in the study was defined as 70% or greater agreement among experts.

Results

Completed questionnaires for both rounds were received from all 15 experts. In round 1, 18 items (78%) achieved consensus to be included. In round 2, 1 (4%) item achieved consensus to be included. However, none of the remaining items achieved consensus to be removed, and they exhibited stability in responses. A list of 19 items covering four domains of medical professionalism (Doctor-patient relationship skills, Reflective skills, Time management and Inter-professional relationship skills) was obtained during the two-rounds of Delphi survey.

Conclusions

Nineteen items in the P-MEX had garnered consensus and is suitable for assessing medical professionalism in Singapore. The findings of this study can provide guidance for faculty and institutions who want to assess medical professionalism of their medical trainees.

SUBMITTER: Fong W

PROVIDER: S-EPMC7362541 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

Assessment of medical professionalism using the Professionalism Mini Evaluation Exercise (P-MEX) in a multi-ethnic society: a Delphi study.

Fong Warren W Kwan Yu Heng YH Yoon Sungwon S Phang Jie Kie JK Thumboo Julian J Leung Ying Ying YY Ng Swee Cheng SC

BMC medical education 20200714 1

<h4>Background</h4>The importance of medical professionalism and its assessment has been well documented in the literature. However, there is currently no culturally-adapted tool to assess medical professionalism in Singapore. This study sets out to find consensus on relevance of the items from the Professionalism Mini Evaluation Exercise (P-MEX) for assessing medical professionalism in Singapore.<h4>Methods</h4>A two-round Delphi survey was completed by an expert panel consisting of program dir ...[more]

PMID: 32664983

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Project description:BackgroundDespite the established need to prioritize professionalism-training in developing future physicians, very few medical programs in the Gulf Region embed in their curricula discrete contextualized courses aimed at developing the corresponding competencies, while fostering self-directed learning. This study aims at exploring the perception of undergraduate medical students in a multi-cultural, multi-ethnic setting regarding their understanding of, and personal experience with professionalism through their engagement with the content of an innovative curriculum-based professionalism course, offered at a Medical School in Dubai, United Arab Emirates.MethodsThe study used a qualitative phenomenological research design. Out of 33 students, 29 students had submitted reflective essays. The content of these essays was inductively analyzed following a six-step framework for conducting thematic analysis. The framework's steps include familiarizing oneself with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report.FindingsThe inductive qualitative analysis generated the Professionalism Learning Journey model. This conceptual model includes four interconnected themes: Awareness, Acknowledgement, Realization, and Application. The generated model depicts the trajectory that the learners appear to experience while they are engaging with the content of the course.ConclusionIntegrating a professionalism-training course into an undergraduate medical curriculum is likely to be positively appraised by the learners. It raises their awareness, enables them to value the subject matter and the sophistication of its application, and empowers them to put into practice the taught principles, on an individual basis and collectively. This is especially true when the course is entrenched in constructivism experiential learning theory and designed to foster self-directed learning. The introduced conceptual model, in conjunction with the innovative professionalism-training course curriculum, can serve as a template for other competencies and other schools.

Project description:BackgroundProfessionalism and communication skills constitute important components of the integral formation of physicians which has repercussion on the quality of health care and medical education. The objective of this study was to assess medical graduates' professionalism and communication skills from the patients' perspective and to examine its association with patients' socio-demographic variables.MethodsThis is a hospital based cross-sectional study. It involved 315 patients and 105 medical graduates selected by convenient sampling method. A modified and validated version of the American Board of Internal Medicine's (ABIM) Patient Assessment survey questionnaire was used for data collection through a face to face interview. Data processing and analysis were performed using the Statistical Package for Social Science (SPSS) 16.0. Mean, frequency distribution, and percentage of the variables were calculated. A non-parametric Kruskal Wallis test was applied to verify whether the patients' assessment was influenced by variables such as age, gender, education, at a level of significance, p ≤ 0.05.ResultsFemale patients constituted 46% of the sample, whereas males constituted 54%. The mean age was 36 ± 16. Patients' scoring of the graduate's skills ranged from 3.29 to 3.83 with a mean of 3.64 on a five-point Likert scale. Items assessing the "patient involvement in decision-making" were assigned the minimum mean values, while items dealing with "establishing adequate communication with patient" assigned the maximum mean values. Patients, who were older than 45 years, gave higher scores than younger ones (p < 0.001). Patients with higher education reported much lower scores than those with lower education (p = 0.003). Patients' gender did not show any statistically significant influence on the rating level.ConclusionGenerally patients rated the medical graduates' professionalism and communication skills at a good level. Patients' age and educational level were significantly associated with the rating level.

Project description:IntroductionMedical professionalism is a core competency for emergency medicine (EM) trainees; but defining professionalism remains challenging, leading to difficulties creating objectives and performing assessment. Because professionalism is dynamic, culture-specific, and often taught by modeling, an exploration of trainees' perceptions can highlight their educational baseline and elucidate the importance they place on general conventional professionalism domains. To this end, our objective was to assess the relative value EM residents place on traditional components of professionalism.MethodsWe performed a cross-sectional, multi-institutional survey of incoming and graduating EM residents at four programs. The survey was developed using the American Board of Internal Medicine's "Project Professionalism" and the Accreditation Council of Graduate Medical Education definition of professionalism competency. We identified 27 attributes within seven domains: clinical excellence, humanism, accountability, altruism, duty and service, honor and integrity, and respect for others. Residents were asked to rate each attribute on a 10-point scale. We analyzed data to assess variance across attributes as well as differences between residents at different training levels or different institutions.ResultsOf the 114 residents eligible, 100 (88%) completed the survey. The relative value assigned to different professional attributes varied considerably, with those in the altruism domain valued significantly lower and those in the "respect for others" and "honor and integrity" valued significantly higher (p<0.001). Significant differences were found between interns and seniors for five attributes primarily in the "duty and service" domain (p<0.05). Among different residencies, significant differences were found with attributes within the "altruism" and "duty and service" domains (p<0.05).ConclusionResidents perceive differences in the relative importance of traditionally defined professional attributes and this may be useful to educators. Explanations for these differences are hypothesized, as are the potential implications for professionalism education. Because teaching professional behavior is taught most effectively via behavior modeling, faculty awareness of resident values and faculty development to address potential gaps may improve professionalism education.

Project description:ObjectivesIn 2016, a national consensus conference created the National Clinical Assessment Tool for Medical Students in Emergency Medicine (NCAT-EM), a standardized end-of-shift assessment tool. We report the first large-scale analysis of professionalism concerns collected from May 2017 through December 2018 by a multisite consortium using the NCAT-EM. Our primary objective was to characterize the nature and frequency of professionalism concerns. Our secondary objective was to identify characteristics associated with giving or receiving a professionalism flag.MethodsThe consortium database includes assessments for all students on EM clerkships at participating sites. This report presents descriptive statistics about the frequency of different flags, the distribution of flags among different student categories, assessor and student characteristics, and distribution of global assessment scores on assessments citing concerns. We used Fisher's exact test to look for associations between the frequency of professionalism flags and the sex of the students and assessors and across student categories. We used logistic regression to look for relationships between professionalism concerns and global assessment scores as well as intent to apply in EM.ResultsWe screened 6,768 assessments of 784 students by 719 assessors from 13 sites. After excluding assessments without flags and assessments with apparent data entry errors, we analyzed 57 (0.8%) assessments containing 79 flags. The most frequent flags were punctuality (25/79, 31.6%) and initiative (20/79, 25.3%). Few students received flags (42/784, 5.4%). Few assessors flagged concerns (41/719, 5.7%). We detected no correlation between the frequency of flags and whether a student was applying in EM or between the sex of students and assessors. Global scores of lower one-third appeared more often in assessments with a flag (30/57, 52.6% vs. 233/6,711, 3.5%).ConclusionsOnly 5.4% of students received flags. Punctuality and initiative accounted for a majority of citations. Professionalism flags correlated strongly with lower global assessment scores.

Dataset Information

Assessment of medical professionalism using the Professionalism Mini Evaluation Exercise (P-MEX) in a multi-ethnic society: a Delphi study.

Background

Methods

Results

Conclusions

Publications

Assessment of medical professionalism using the Professionalism Mini Evaluation Exercise (P-MEX) in a multi-ethnic society: a Delphi study.

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