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Based upon our experience and reflection, we offer some practical methods for integrating local cultural values and societal needs in professionalism education.

A multimodule curriculum of palliative care for medical students can significantly improve their knowledge on principles of clinical management and beliefs about ethical decision-making in palliative care. As for changes in beliefs about ethical decision-making in palliative care, continued ethical and clinical training is required.

A 1-week multimodal curriculum for preclinical medical students can improve the knowledge and beliefs about ethical decision-making in managing terminally ill patients. Clinical skills of symptom management, especially pain control, and ethical decision-making regarding artificial nutrition and hydration should be emphasized in medical education, to promote students' competence in end-of-life care.

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Measurement invariance is a prerequisite for comparing measurement scores from different groups. In medical education, multi-source feedback (MSF) is utilized to assess core competencies, including the professionalism. However, little attention has been paid to the measurement invariance of assessment instruments; that is, whether an instrument holds the same meaning across different rater groups. To examine the measurement invariance of the National Taiwan University professionalism MSF (NTU P-MSF) in order to determine whether medical students' self-rating can be compared to their peers' rating. An eight-factor model was specified for confirmatory factor analysis to examine the construct validity of the NTU P-MSF. Cronbach's alpha was computed for the items of each domain to evaluate internal consistent reliability. The same eight-factor model was used for multi-group confirmatory factor analyses. Four hierarchical models were specified to test configural (i.e., identical factor-item relationship), metric (i.e., identical factor loadings), scalar (i.e., identical intercepts), and error variance across self-rating and peer rating groups. One hundred and twenty second-year medical students from weekly discussion groups conducted as part of a medical professionalism course agreed to use the NTU P-MSF to assess themselves or their discussion group peers. NTU P-MSF assessment scores were a good fit for the eight-factor model among self group and peer group. The Cronbach's alpha coefficients of students' NTU P-MSF scores and peers' scores ranged from 0.76 to 0.89 and 0.84 to 0.91, respectively indicating that the NTU P-MSF scores also have good internal consistent reliability between both groups. In addition, same factor structure and similar factor loadings and intercepts of NTU P-MSF scores between both groups indicate that NTU P-MSF scores had configural, metric, and scalar invariance. Thus, students' self-assessments and peer assessments can be compared in terms of the constructs of NTU P-MSF scores, change in NTU P-MSF scores, and its factor scores. This study demonstrates how to investigate the measurement invariance of a professionalism MSF and contributes to the discussion on self- and peer assessment in medical education.

In adolescents with normal WBCC, BMI is significantly related to the levels of WBCC and is the earliest component of MetS to be noted in adolescents. Elevated TG and decreased HDL-C could also be important markers for future risk factors only in male subjects.