Assessment of medical professionalism: preliminary results of a qualitative study

Abstract

Background: The importance of medical professionalism has been well documented in the literature. Cultural background affects the constituents of professionalism. However, few studies have explored the domains of medical professionalism in an Asian context. We aim to describe the views and experiences of both patients and faculty on medical professionalism in an urban Asian city state. Methods: Data for this qualitative study were collected through focus group discussions (FGDs) with patients and in-depth interviews (IDIs) with faculty members. The IDIs and FGDs were audio-recorded and transcribed verbatim. Thematic analysis was conducted by two independent coders using a priori framework derived from Professionalism Mini Evaluation Exercise (P-MEX). Sociodemographic data of faculty members and patients were obtained through brief questionnaires. Results: A total of 31 patients (58.1% male, all had visited healthcare facilities within the past year) and 26 faculty members (42.3% male, 38.5% from medical disciplines, median years as faculty is 11) participated in this study. The results supported the four domains of medical professionalism -Doctor-patient relationship skills, Reflective skills, Time management and Inter-professional relationship skills. Two new sub-domains which emerged from data were (1) communicated effectively with patient and (2) demonstrated collegiality. Conclusions:The domains of professionalism in Singapore were similar to previous studies. This study allows a better understanding of medical professionalism to enhance the assessment and ultimately, the teaching of medical professionalism in an urban multi-ethnic Asian city.

Assessment of medical professionalism: A Delphi study

“…In our study, 4 items "solicited feedback", "advocated on behalf of a patient", "extended his/herself to meet patient needs" and "used health resources appropriately" did not achieve the level of agreement to be included for both rounds, suggesting that these items may be less relevant in the local context as compared to other items in the list. This is largely in congruent with the findings of our previous qualitative study which showed that these items were less relevant to patients and/or faculty [28]. Similarly, in a study to define professionalism in anaesthesiology, "resourcefulness" which is similar to "used health resources appropriately", was deemed to be less important [37].…”

“…Similarly, in a study to define professionalism in anaesthesiology, "resourcefulness" which is similar to "used health resources appropriately", was deemed to be less important [37]. This may be because of the difficulty to agree as to what is "appropriate use of health resources", as raised by participants in this Delphi survey and in our previous qualitative study [28]. Modifications to these items may be needed in the future after the pilot testing of the P-MEX.…”

“…The first questionnaire contained 23 observer-based items assessing medical professionalism based on the results of the previous survey and qualitative study ( Figure 1) [28]. The experts were asked to rate the level of agreement with each item as assessment of medical professionalism on a 5-point scale scored as follows: 1= Definitely include, 2= Possibly include, 3= Neutral, 4= Possibly exclude, 5= Definitely exclude.…”

“…Our previous qualitative study with patients (healthcare recipients) and faculty (medical educators) had identified 23 items to assess medical professionalism, covering four domains of medical professionalism (Doctor-patient relationship skills, Reflective skills, Time management and Interprofessional relationship skills) [28]. The aim of this study was to gain consensus among the stakeholders in residency programs on the items to be used to assess medical professionalism in a multi-ethnic and multi-cultural Asian context.…”

Barriers to obtaining reliable results from evaluations of teaching quality in undergraduate medical education

“…Axial coding explores and establishes various relationships between concepts and categories through the coding paradigms of conditions, strategies, and results. Selective coding further deletes and integrates the previous research results, formulates story lines, and constructs a theoretical framework [27][28][29]. For example, when "emphasis on teaching quality" was mentioned extensively by the participants, it was selected as one open code, thus positioning it as a central category of the indicators.…”