Professionalism in health science
Professionalism in health science
Assessing Professionalism
in the Health Sciences
John D. Mahan, MD
Program Director, Pediatric Residency and Pediatric
Nephrology Fellowship Programs
Associate Director, OSU Center for Faculty Advancement,
Mentoring and Engagement (FAME)
Nationwide Children's Hospital/The Ohio State University
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Objectives
1. Define 3 models for framing professionalism in the health
sciences
2. Describe 3 effective methods for assessing professionalism in
health science learners
3. Identify 1-2 methods that you can explore using in assessing
professionalism in your learners
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Professionalism
“There seems to be no agreement on what the term (i.e.,
professionalism) means.” DeAngelis
“Role modeling must be combined with reflection on the
action to truly teach professionalism.” Stern
“Because of the nature of professionalism, no single tool for
assessing it among medical learners and practicing physicians
exists.” Mueller
“Indeed, if the values and commitment that have made
modern medicine possible, creating both the powerfully
effective technologies and forging the therapeutic partnership
with patients, are lost, then medicine will very quickly run into
serious difficulties.” Tallis
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Professionalism
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Professionalism in the 21st Century
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Professionalism Models
Virtue
Professionalism
Identity Behavior
Moral character
Moral reasoning
Humanism
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Model 2 - Behaviors
Behaviors
Milestones
Competencies
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Model 3 – Professional Identity
Developmental
Socialization
Social compact
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Question 1
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Professionalism Models
Models Assumptions Strengths
(Actions result from……)
Virtue based Internalizing right values and Internal values first, moral
ethics until habits created reasoning later
Behavior based Clear expectations, feedback Expectations, direct
and reinforcement feedback and evaluation for
competence
Professional identity Developed identity by Developmental arc to
socialization and community ‘proper’ identity
of practice
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Professionalism Models:
Assessment Strategies
Virtues Behaviors Professional identity
Written exams Written exams Reflective (self-
assessment) exercises
Reflective (self- Reflective (self-assessment) Multisource assessments
assessment) exercises exercises
Observation/feedback Observation/feedback Moral reasoning exercises
Moral reasoning Multisource assessments
exercises
Critical incident/lapses
reports
Professionalism MEX
Adapted from: Irby, Hamstra. Acad Med 2016
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Professionalism Assessment:
Challenges
Lack of clarity about best educational methods &
assessments
Complexity of modern society
Recognition of moral imperative
Many choices
Thoughtful attempts, with sound bases, and
careful application, can add value to our learners,
our profession and society!
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Question 2
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Professionalism Assessment Methods
Methods Examples
Observed Clinical Encounter P-MEX, Standardized Direct Observation Tool
Multisource Feedback Multisource assessment tools
Simulation/Observed Structured Patient simulation with ethical dilemmas
Clinical Exam
Global Evaluation Rotation, course evaluations
Patient Feedback RCP Patient Questionnaire, Wake Forest Physician Trust
Scheme
Self-Assessment Groningen Reflection Ability Scale, Interpersonal
Reactivity Index
Reflection/Essays Reflective writing grading/discussion
Knowledge/Moral Reasoning Exams Case based scenarios: MCQ, essays
Professionalism Lapses/Critical Formal evaluation of observed lapse or self-reported
Incident Reports critical incident
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Mini-CEX framework –
Structured Clinical Observation
Observed Structured Clinical Exercise
Evaluates 21 specific behaviors
Trained raters
Valuable for formative assessment, feedback, reflection
And why?
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Recommendations
1. Define the Professionalism model underlying the assessment
tool to be employed.
2. Link assessment to educational task and effort – what is
being taught/learned.
3. Multiple assessment methods are superior to 1!
4. Utilize assessments that address multiple Professionalism
models (best if all 3).
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Professionalism Assessment:
A Team Sport
Questions?
Summary
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