Abstract
BackgroundOver the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments’ measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations.MethodsA systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990–2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument’s usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee’s criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments.ResultsAfter screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar’s instrument for nursing students, Nurse Practitioners’ Roles and Competencies Scale, and Perceived Faculty Competency Inventory.ConclusionAlthough instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing instruments and to longitudinal studies.
Highlights
Facing medical professionals’ commitment to the society is being challenged by external forces of change within health care delivery systems, medical professionalism has received widespread attention as one of the core factors in providing high-quality patient care [1,2,3,4]
A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee’s criteria
As demonstrated by many studies, professionalism is central to the practice of medicine because of its close associations with improvements in physician-patient relationships, patient satisfaction, health care professionals’ career satisfaction, and even healthcare outcomes [4,5,6,7]
Summary
Facing medical professionals’ commitment to the society is being challenged by external forces of change within health care delivery systems, medical professionalism has received widespread attention as one of the core factors in providing high-quality patient care [1,2,3,4]. For health researchers, educators and administrators, using and developing appropriate instruments to assess medical professionalism according to their purposes and target populations poses to be a challenge. Over the last three decades, various instruments to assess medical professionalism were developed and employed in many empirical researches [13,14,15]. Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments’ measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and provide corresponding recommendations
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