본문 바로가기
KERD
논문

Development an instrument assessing residents’ attitude towards professionalism lapsesin training

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

주제분류기타의약학

초록

Purpose: Medical professionalism is a fundamental competency for all physicians and continuous development of professionalism during residency training is crucial. The purpose of this study was to develop an instrument assessing residents’ attitudes toward unprofessional behaviors. Methods: A questionnaire survey was conducted in cooperation with the Korea Resident Association from May to July 2013. A total of 317 residents from seven university-affiliated hospitals in South Korea participated in the survey. Results: In the exploratory factor analysis, seven factors were extracted from the data; factor loadings of the 44 items ranged between 0.40 and 0.89. Through iterative discussion, three items below 0.45 were deleted and one additional item was removed due to its irrelevance. Twelve items included in Factor 1 were divided into two different categories. A final version of the questionnaire containing 40 items in eight categories was assessed using confirmatory factor analysis. It was deemed to have a good fit; the root mean square error of approximation and comparative fit index were 0.07 and 0.9, respectively. The reliability (Cronbach’s α) of the inventory was 0.97. Conclusion: The items of this instrument encompass a broad range of residents’ behaviors in clinical practice, research, and publication. In addition, it includes some types of misconduct that can be considered unique features of the authors’ cultural backgrounds. We recommend this instrument as an assessment tool to diagnose residents’ perceptions and attitudes towards professionalism lapses and to provide insight regarding potential improvement in professionalism education.

Abstract

Purpose: Medical professionalism is a fundamental competency for all physicians and continuous development of professionalism during residency training is crucial. The purpose of this study was to develop an instrument assessing residents’ attitudes toward unprofessional behaviors. Methods: A questionnaire survey was conducted in cooperation with the Korea Resident Association from May to July 2013. A total of 317 residents from seven university-affiliated hospitals in South Korea participated in the survey. Results: In the exploratory factor analysis, seven factors were extracted from the data; factor loadings of the 44 items ranged between 0.40 and 0.89. Through iterative discussion, three items below 0.45 were deleted and one additional item was removed due to its irrelevance. Twelve items included in Factor 1 were divided into two different categories. A final version of the questionnaire containing 40 items in eight categories was assessed using confirmatory factor analysis. It was deemed to have a good fit; the root mean square error of approximation and comparative fit index were 0.07 and 0.9, respectively. The reliability (Cronbach’s α) of the inventory was 0.97. Conclusion: The items of this instrument encompass a broad range of residents’ behaviors in clinical practice, research, and publication. In addition, it includes some types of misconduct that can be considered unique features of the authors’ cultural backgrounds. We recommend this instrument as an assessment tool to diagnose residents’ perceptions and attitudes towards professionalism lapses and to provide insight regarding potential improvement in professionalism education.

참고문헌 (21)

  1. Papadakis MA, "Perspective: the education community must develop best practices informed by evidence-based research to remediate lapses of professionalism", Acad Med, 87, pp.1694~1698 (2012)
  2. Wynia MK, "More than a list of values and desired behaviors: a foundational understanding of medical professionalism", Acad Med, 89, pp.712~714 (2014)
  3. Hodges BD, "Assessment of professionalism:recommendations from the Ottawa 2010Conference", Med Teach, 33, pp.354~363 (2011)
  4. Wilkinson TJ, "A blueprint to assess professionalism: results of a systematic review", Acad Med, 84, pp.551~558 (2009)
  5. Cohen JJ, "Professionalism in medical education, an American perspective: from evidence to accountability", Med Educ, 40, pp.607~617 (2006)
  6. Papadakis MA, "Early detection and evaluation of professionalism deficiencies in medical students: one school’s approach", Acad Med, 76, pp.1100~1106 (2001)
  7. Teherani A, "Categorization of unprofessional behaviours identified during administration of and remediation after a comprehensive clinical performance examination using a validated professionalism framework", Med Teach, 31, pp.1007~1012 (2009)
  8. Stern DT, "Measuring medical professionalism" (2006), Oxford University Press
  9. Papadakis MA, "Performance during internal medicine residency training and subsequent disciplinary action by state licensing boards", Ann Intern Med, 148, pp.869~876 (2008)
  10. Fargen KM, "Unprofessional behaviors among tomorrow’s physicians: review of the literature with a focus on risk factors, temporal trends, and future directions", Acad Med, 91, pp.858~864 (2016)
  11. Reed DA, "Behaviors of highly professional resident physicians", JAMA, 300, pp.1326~1333 (2008)
  12. Ho MJ, "A cross-cultural study of students’ approaches to professional dilemmas: sticks or ripples", Med Educ, 46, pp.245~256 (2012)
  13. Cruess SR, "Teaching professionalism across cultural and national borders: lessons learned from an AMEE workshop", Med Teach, 32, pp.371~374 (2010)
  14. Swick HM, "Toward a normative definition of medical professionalism", Acad Med, 75, pp.612~616 (2000)
  15. Cruess SR, "“Profession”: a working definition for medical educators", Teach Learn Med, 16, pp.74~76 (2004)
  16. Wynia MK, "The role of professionalism and selfregulation in detecting impaired or incompetent physicians", JAMA, 304, pp.210~212 (2010)
  17. Chang HJ, "Investigation of unethical and unprofessional behavior in Korean residency training", Teach Learn Med, 27, pp.370~378 (2015)
  18. Nagler A, "The professionalism disconnect: do entering residents identify yet participate in unprofessional behaviors?", BMC Med Educ, 14, pp.60~ (2014)
  19. Kaley JR, "Prevalence and types of misrepresentation of publication record by pathology residency applicants", Arch Pathol Lab Med, 137, pp.979~982 (2013)
  20. Aach RD, "Alcohol and other substance abuse and impairment among physicians in residency training", Ann Intern Med, 116, pp.245~254 (1992)
  21. Chung CK, "“Phantom”publications among plastic surgery residency applicants", Ann Plast Surg, 68, pp.391~395 (2012)

관련 논문AI추천

이 간행물의 다른 논문 (6건)