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    Assessing professionalism in the context of an objective structured clinical examination: an in-depth study of the rating process

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    Authors
    Mazor, Kathleen M.
    Zanetti, Mary L.
    Alper, Eric J.
    Hatem, David S.
    Barrett, Susan V.
    Meterko, Vanessa
    Gammon, Wendy L.
    Pugnaire, Michele P.
    UMass Chan Affiliations
    Department of Medicine
    Meyers Primary Care Institute
    Department of Family Medicine and Community Health
    Office of Office of Educational Affairs
    Document Type
    Journal Article
    Publication Date
    2007-04-14
    Keywords
    Clinical Competence
    Communication
    *Education, Medical, Undergraduate
    Humans
    Massachusetts
    Physician-Patient Relations
    Students, Medical
    Life Sciences
    Medicine and Health Sciences
    Women's Studies
    
    Metadata
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    Link to Full Text
    http://dx.doi.org/10.1111/j.1365-2929.2006.02692.x
    Abstract
    INTRODUCTION: Professionalism is fundamental to the practice of medicine. Objective structured clinical examinations (OSCEs) have been proposed as appropriate for assessing some aspects of professionalism. This study investigated how raters assign professionalism ratings to medical students' performances in OSCE encounters. METHODS: Three standardised patients, 3 doctor preceptors, and 3 lay people viewed and rated 20 videotaped encounters between 3rd-year medical students and standardised patients. Raters recorded their thoughts while rating. Qualitative and quantitative analyses were conducted. Comments about observable behaviours were coded, and relative frequencies were computed. Correlations between counts of categorised comments and overall professionalism ratings were also computed. RESULTS: Raters varied in which behaviours they attended to, and how behaviours were evaluated. This was true within and between rater type. Raters also differed in the behaviours they consider when providing global evaluations of professionalism. CONCLUSIONS: This study highlights the complexity of the processes involved in assigning ratings to doctor-patient encounters. Greater emphasis on behavioural definitions of specific behaviours may not be a sufficient solution, as raters appear to vary in both attention to and evaluation of behaviours. Reliance on global ratings is also problematic, especially if relatively few raters are used, for similar reasons. We propose a model highlighting the multiple points where raters viewing the same encounter may diverge, resulting in different ratings of the same performance. Progress in assessment of professionalism will require further dialogue about what constitutes professional behaviour in the medical encounter, with input from multiple constituencies and multiple representatives within each constituency.
    Source
    Med Educ. 2007 Apr;41(4):331-40. Link to article on publisher's site
    DOI
    10.1111/j.1365-2929.2006.02692.x
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/50747
    PubMed ID
    17430277
    Related Resources
    Link to article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1111/j.1365-2929.2006.02692.x
    Scopus Count
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    UMass Chan Faculty and Researcher Publications

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