Abstract

BackgroundThe concept of professionalism is complex and subjective and relies on expert judgements. Currently, there are no existing objective measures of professionalism in anaesthesia. However, it is possible that at least some elements of professionalism may be indicated by objective measures. A number of studies have suggested that conscientiousness as a trait is a significant contributor to professionalism.MethodsA ‘Conscientiousness Index’ (CI) was developed by collation of routinely collected data from tasks expected to be carried out by anaesthetic trainees such as punctual submission of holiday and ‘not-on-call’ requests, attendance at audit meetings, timely submission of completed appraisal documentation and sickness/absence notifications. The CI consists of a sum of points deducted from a baseline of 50 for non-completion of these objective and measurable behaviours related to conscientiousness. This was correlated with consultants’ formal and informal subjective measures of professionalism in those trainees.Informal, subjective measures of professionalism consisted of a ‘Professionalism Index’ (PI). The PI consisted of a score developed from consultants’ expert, subjective views of professionalism for those trainees. Formal, subjective measures of professionalism consisted of a score derived from comments made by consultants in College Tutor feedback forms on their views on the professionalism of those trainees (College Tutor feedback; CT). The PI and CT scores were correlated against the CI using a Pearson or Spearman correlation coefficient.ResultsThere was a negative, but not statistically significant, relationship between the CI and formal, subjective measures of professionalism; CT scores (r = -0.341, p = 0.06), but no correlation between CI and consultants informal views of trainees’ professionalism; the PI scores (rs = -0.059, p = 0.759).ConclusionsThis may be due the ‘failure to fail’ phenomenon due to the high stakes nature of raising concerns of professionalism in postgraduate healthcare professionals or may be that the precision of the tool may be insufficient to distinguish between trainees who generally show highly professional behaviour. Future development of the tool may need to include more of the sub-facets of conscientiousness. Independently of a relationship with the construct of professionalism, a measure of conscientiousness might be of interest to future employers.

Highlights

  • The concept of professionalism is complex and subjective and relies on expert judgements

  • The Conscientiousness Index (CI) Figure 1 shows the frequency distribution for the CI scores for the 32 trainee anaesthetists in the study (21 males, 11 females)

  • We suggest a much larger sample size would be needed to detect any differences in conscientiousness or professionalism in such a highly conscientious group

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Summary

Introduction

The concept of professionalism is complex and subjective and relies on expert judgements. There are no existing objective measures of professionalism in anaesthesia. It is possible that at least some elements of professionalism may be indicated by objective measures. A number of studies have suggested that conscientiousness as a trait is a significant contributor to professionalism. Fitness to practice cases often involve what is described as ‘unprofessional behaviour’ or a ‘lack of professionalism’. Studies have shown a link between unprofessional behaviour in training and subsequent disciplinary action in later practice [2, 3]. There are no existing objective measures of professionalism in anaesthesia, and assessment of professionalism relies on subjective, expert judgements. Subjective measures have inherent problems with reliability, requiring repeated measures which are not always possible in order to ensure a consistent score

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