Findings can provide a starting point for discussion to develop a standardized competency framework.

This study highlights the complexity of the processes involved in assigning ratings to doctor-patient encounters. Greater emphasis on behavioural definitions of specific behaviours may not be a sufficient solution, as raters appear to vary in both attention to and evaluation of behaviours. Reliance on global ratings is also problematic, especially if relatively few raters are used, for similar reasons. We propose a model highlighting the multiple points where raters viewing the same encounter may diverge, resulting in different ratings of the same performance. Progress in assessment of professionalism will require further dialogue about what constitutes professional behaviour in the medical encounter, with input from multiple constituencies and multiple representatives within each constituency.

SPs' ratings were less reliable and consistent than physician or lay ratings, although the SPs rank ordered students more consistently than the other rater types.

ObjectivesTo evaluate impact a multicultural interclerkship had on students’ perception of knowledge, interview skills, and empathy towards serving culturally diverse populations and role student demographics played in learning.MethodsData extracted from students’ self-reported course evaluations and pre/post questionnaires during multiculturalism interclerkship across 11 academic years. Inquired students’ opinion about four areas: effectiveness, small group leaders, usefulness, and overall experience. Subscale and item ratings were compared using trend tests including multivariate analyses.ResultsDuring studied years, 883 students completed course evaluation with high overall mean rating of 3.08 (SD=0.45) and subscale mean scores ranging from 3.03 to 3.30. Trends in three of four subscales demonstrated clear uptrend (p<0.0001). Positive correlations between ratings of leaders and “usefulness” were observed (p<0.0001). Pre/post matched dataset (n=967) indicated majority of items (19/23) had statistically significant higher post interclerkship ratings compared to pre scores with nine of 19 having statistically significant magnitudes of change. Questionnaire had high overall reliability (Cronbach alpha=0.8), and item-to-group correlations ranged from 0.40 to 0.68 (p <0.0001).ConclusionsBy increasing students’ exposure and interaction with diverse patients, their knowledge, attitude, and skills were increased and expanded in positive manner. These findings might inform those who are interested in enhancing this important competence. This is especially true given increasing scrutiny this global topic is receiving within and across healthcare professions around the world.