Professionalism In Medical Education

Introduction

Professionalism has been described by the American Board of Internal Medicine as “constituting those attitudes and behaviors that serve to maintain patient interest above physician self-interest.”(1)

The word profession is derived from profess which means 'to proclaim something publicly'. Physicians profess two things: to be competent to help the patients and to have the patient’s best interests in mind. Such commitment invites trust from their patients. (1)

Professionalism is critical for physicians in order to provide optimum care and achieve better health outcomes. (2)

Professionalism is based on the principles of primacy of patient welfare, patient autonomy, and social justice. It involves the following professional responsibilities

Learners who are not assessed with regard to professionalism will logically assume that educators care less about this domain than knowledge or skill domains, which are assessed more thoroughly.(6)

Although assessing professionalism poses many challenges, gauging and ascertaining growth in professionalism is impossible without measurement. The review of approaches to assess professionalism in medical education is that without solid assessment tools, questions about the efficacy of approaches to educating learners about professional behavior will not be effectively answered’’ (5)

The Accreditation Council for Graduate Medical Education (ACGME) lists 6 general competencies that physicians-in-training must possess before graduating from residency and fellowship training programs, one of which is “professionalism.” In addition in defining professionalism, the ACGME lists attributes of professionalism including respect, compassion, integrity, re-sponsiveness, altruism, accountability, commitment to excellence, sound ethics, and sensitivity to diversity. The American Board of Internal Medicine (ABIM), the American College of Physicians, and the European Federation of Internal Medicine, in the “Physician Charter,” describe professionalism as “a foundation of the social contract for medicine” and lists 3 ethics principles and 10 “commitments,”

The tool is a Scale to Measure Professional Attitudes and Behaviors in Medical Education. The Scale to Measure Professional Attitudes and Behaviors in Medical Education (SMPABME) consists of 12 items; each rated on a 4-item scale (Mostly-Often –Sometimes-Rarely).

The SMPABME obtains respondents’ opinions about professionalism in their educational environment. Since the items ask the respondent to report on the behaviors of others (versus the respondent’s own behavior) it can be used to obtain information about sensitive professionalism areas (e.g., deception) that respondents may be unwilling to report about themselves, thus it can give information about program -wide behaviors. The SMPABME may be used to gauge the effect of program-wide interventions that address professionalism areas.

Respondents used a four-point Likert type scale (mostly=4-often=3-sometimes=2-rarely=1) to answer the items. Items addressed unprofessional behaviors were reversed in their scoring so that high scores reflected more positive behaviors (rarely=4-sometimes=3–often=2-mostly=1).(11)

The peer assessment of Professionalism Questionnaire encompasses three