Can Professionalism Be Measured? The Development of a Scale for Use in the Medical Environment

Arnold, Erin L.; Blank, Linda L.; Race, Kathryn E. H.; Cipparrone, Nancy

doi:10.1097/00001888-199810000-00025

Cited by 116 publications

(75 citation statements)

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“…We developed survey items from an extensive review of the literature, and information and measures obtained from professional organizations, such as the AAMC Assessment of Professionalism Project, 1 the ACGME Advancing Education in Medical Professionalism, 2 and the American Board of Internal Medicine Project Professionalism, 23,24 and focus groups that reviewed item content, usability, and feasibility. 25 We conducted 2 focus groups in early 2008 with 15 internal medicine residency graduates.…”

Section: Methodsmentioning

confidence: 99%

The Effect of the Hidden Curriculum on Resident Burnout and Cynicism

Billings¹,

Lazarus²,

Wenrich³

et al. 2011

Journal of Graduate Medical Education

102

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Introduction Residents learn and participate in care within hospital cultures that may tolerate unprofessional conduct and cynical attitudes, labeled the “hidden curriculum.” We hypothesized that this hidden curriculum may have deleterious effects on residents' professional development and investigated whether witnessing unprofessional behavior during residency was associated with burnout and cynicism. Methods We surveyed internal medicine residents at 2 academic centers for 3 years (2008–2010). Hidden curriculum items assessed exposure to unprofessional conduct. We used regression analyses to examine if hidden curriculum scores were associated with cynicism and the Maslach Burnout Inventory depersonalization and emotional exhaustion domain scores. Results The response rate was 48% (337 of 708). In the 284 surveys analyzed, 45% of respondents met burnout criteria and had significantly higher hidden curriculum scores (26 versus 19, P < .001) than those not meeting criteria. In cross-sectional analyses, the hidden curriculum score was significantly associated with residents' depersonalization, emotional exhaustion, and cynicism scores. Cynicism scores were also associated with burnout. Conclusions Exposure to unprofessional conduct was associated with higher burnout and cynicism scores among internal medicine residents. We also found that cynicism and burnout were significantly associated and may be measures of similar but not necessarily identical responses to the challenges posed by residency. Measuring the hidden curriculum and cynicism may provide direction for educators attempting to reform hospital culture and improve resident well-being.

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Section: Methodsmentioning

confidence: 99%

The Effect of the Hidden Curriculum on Resident Burnout and Cynicism

Billings¹,

Lazarus²,

Wenrich³

et al. 2011

Journal of Graduate Medical Education

102

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“…Using factor analysis, they identified three aspects of professionalism: excellence, honor/ integrity, and altruism/respect. They concluded that although their preliminary results were encouraging, some measurement components needed additional items (Arnold et al 1998). Following this study, DeLisa et al conducted a study, using a revised version of that questionnaire.…”

Section: Practice Pointsmentioning

confidence: 97%

“…Although a rich array of existing measuring tools can be found in the literature, few of them addresses professionalism as a comprehensive construct. Furthermore, few instruments meet the minimal criteria of content validity and reliability that would support their use for academic assessments (Veloski et al 2005;Blackall 2007); among them, a well known instrument for measuring professionalism in medical training environments is developed by Arnold et al which is a questionnaire consisting of 14 items, each of which reflects a particular component of professionalism as operationally defined by the ABIM (Arnold et al 1998;ACGME 2004). Totally 529 questionnaires filled by the medical students and residents from five institutions in the northeast region of the United States were used in their analysis.…”

Section: Practice Pointsmentioning

confidence: 99%

“…Giving an exact definition for medical professionalism, however, seems to be a challenging task (Swick 2000; American Board of Internal Medicine (ABIM) 2001; Veloski et al 2005). According to the ABIM, professionalism aspires to altruism, accountability, excellence, duty, service, honor, integrity, and respect for others (Arnold et al 1998;ABIM 2001).…”

Section: Introductionmentioning

confidence: 99%

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Measuring professionalism in residency training programs in Iran

et al. 2009

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Background and aim: To assess the Farsi (Persian) translated and modified version of the questionnaire of the American Board of Internal Medicine (ABIM) for measuring professionalism, and also, measuring the professional attitudes and behaviors associated with the medical residency training environment in Iran. Methods: After a pilot study, a 17-item questionnaire was distributed to 282 medical residents of two major universities of Iran, from December 2006 through February 2007. Results: Of the 282 distributed questionnaires, 259 (95.2%) were used in the analysis. Based on the analyses, two items were omitted and 15 items were retained for further analysis. The mean score was 106 (Standard Deviation (SD), 22.4) out of maximum 150, whereas the item mean was 6.12 (SD, 0.37) out of maximum 10. Corrected item-to-total correlations ranged from low to moderate. The internal reliability of the scale, based on Cronbach's alpha, meets Nunnally's minimal requirement. A factor analysis was performed, based on principal components and varimax rotation. The solution identified three factors (subscales) including excellence, honor/integrity and altruism/respect. Together these factors represented 58.8% of the common variance. Conclusion: This study showed the content validity and internal reliability of the Farsi version of the ABIM questionnaire. Therefore, it can be considered as an encouraging step toward developing a short, reliable and valid instrument for measuring professionalism in medical environments.

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“…It is fluid in definition and may contain as many as 3 to 7 identifiable factors. 27,28 Professionalism was viewed as evident in all the competencies and a separate scale was used for its assessment (TABLE 2). Seven professionalism factors were identified through the ACGME core competencies and the American Board of Pediatrics Program Directors guide to teaching and assessing professionalism.…”

Section: The Development Of the Rotation Rubricmentioning

confidence: 99%