Abstract
IntroductionThis study developed a new Professional Decision-Making in Medicine Measure that assesses the use of effective decision-making strategies: seek help, manage emotions, recognize consequences and rules, and test assumptions and motives. The aim was to develop a content valid measure and obtain initial evidence for construct validity so that the measure could be used in future research or educational assessment.MethodsClinical scenario-based items were developed based on a review of the literature and interviews with physicians. For each item, respondents are tasked with selecting two responses (out of six plausible options) that they would choose in that situation. Three of the six options reflect a decision-making strategy; these responses are scored as correct. Data were collected from a sample of 318 fourth-year medical students in the United States. They completed a 16-item version of the measure (Form A) and measures of social desirability, moral disengagement, and professionalism attitudes. Professionalism ratings from clerkships were also obtained. A sub-group (n = 63) completed a second 16-item measure (Form B) to pilot test the instrument, as two test forms are useful for pre-posttest designs.ResultsScores on the new measure indicated that, on average, participants answered 75% of items correctly. Evidence for construct validity included the lack of correlation between scores on the measure and socially desirable responding, negative correlation with moral disengagement, and modest to low correlations with professionalism attitudes. A positive correlation was observed with a clerkship rating focused on professionalism in peer interactions.ConclusionsThese findings demonstrate modest proficiency in the use of decision-making strategies among fourth-year medical students. Additional research using the Professional Decision-Making Measure should explore scores among physicians in various career stages, and the causes and correlates of scores. Educators could utilize the measure to assess courses that teach decision-making strategies.
Highlights
This study developed a new Professional Decision-Making in Medicine Measure that assesses the use of effective decision-making strategies: seek help, manage emotions, recognize consequences and rules, and test assumptions and motives
Professional decision-making in medicine measure analysis, decision to publish, or preparation of the manuscript
Inculcating professionalism among medical students and trainees involves formal and informal learning in the classroom and in clinical settings [7, 8]. No matter their career stage, professionalism requires an intentional approach to navigating the duties of a physician responsibly [9, 10]
Summary
Our aim was to provide initial construct validity evidence by examining the correlations of PDM scores with these additional measures. (The respect factor is comprised of two items, contributing to its low reliability.) Our aim was to provide evidence that the PDM measures a construct distinct from attitudes; we anticipated low to modest correlations of PSPQ scales with PDM scores. (It is of note that we considered, but did not obtain, disciplinary actions data because the sample size for such cases was too small to be useful for analysis.) professionalism ratings by faculty educators are not without limitations [17, 52], our aim was to examine a potential source of criterion-related validity. Our aim was to develop a content valid professional decision-making in medicine measure (Form A) and provide preliminary evidence for its construct validity
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