Assessing perceptions of professionalism in medical learners by the level of training and sex.

Abstract

Canadian medical student and residents' severity ratings of professionalism vignettes were examined to identify the differences in ratings by the level of training and by sex. Eight hundred and thirty-five medical learners (400 medical students and 435 residents) were invited to participate in an online survey measuring medical professionalism. The survey was composed of questions about descriptive information and professionalism vignettes. The tool consists of 16 vignettes examining respondent's ability to recognize the professional and unprofessional behaviors. For each vignette, participants were asked to rate the severity of the infraction as "not a problem" to "severe." Wilcoxon rank sum tests and Fischer's Chi-square tests were used to examine the differences in perceptions of professionalism by the level of training and sex, and logistic regression models were created with the level of training and sex to examine their association with binary vignette responses (not a severe infraction and severe infraction); controlling for the effect of the other variable. Overall response rate for the completed survey was 30% (n = 253). Significant differences between males and females were found for lapse in excellence (P ≤ 0.039), inappropriate dress (P ≤ 0.003), lack of altruism (P ≤ 0.033), disrespect (P ≤ 0.013), shirking duty (P ≤ 0.028), and abuse of power (P ≤ 0.006). Females rated all six vignettes as more severe as compared to males. Shirking duty (P ≤ 0.002) was found to have the differences between learner responses. Regressions found sex to be associated with severity of professionalism infractions on seven vignettes. Future work is needed in the area of professionalism and sex to understand why female and male learners may perceive professionalism differently.