Educational Review
Assessing professionalism in health profession degree programs: A scoping review

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Abstract

Background

To identify and classify methods for assessing professionalism across health profession degree programs and identify gaps in the literature regarding types of assessments.

Methods

The authors conducted a scoping review of articles published from database inception through 24 January 2020. Included articles described an assessment approach for professionalism in health profession degree programs available in full-text in the English language. Articles were classified based on profession, timing of assessment, feedback type, assessment type, professionalism dimension, and Barr's modified Kirkpatrick hierarchy.

Results

Authors classified 277 articles meeting inclusion criteria. Most articles were from medical education (62.5%) conducted during didactic (62.1%) or experiential/clinical curriculum (49.8%). Few articles (15.5%) described longitudinal assessment. Feedback type was formative (32.2%) or summative (35%), with only 8.3% using both. Assessment types frequently reported included self-administered rating scales (30%), reflections (18.8%), observed clinical encounters (17.3%), and knowledge-based tests (13.4%). Ethical practice principles (65%) and effective interactions with patients (48.4%) were the most frequently assessed dimensions of professionalism. Authors observed balanced distribution among Barr's modified Kirkpatrick model at levels of reaction (38.3%), modification of perceptions and attitudes (33.6%), acquisition of knowledge and skills (39%), and behavioral change (36.1%).

Implications

The classification scheme identified in current literature on professionalism assessment does not align with International Ottawa Conference Working Group on the Assessment of Professionalism recommendations. Gaps identified were limited description of professionalism assessment during admissions, infrequent longitudinal assessment, limited use of methods for both formative and summative assessment, and limited reports of assessments applicable to interprofessional education settings.

Section snippets

Background

Professionalism is a key component of development of students in health profession degree programs.1, 2, 3, 4, 5, 6, 7 However, the concept of professionalism is difficult to define and assess.8,9 Definitions of professionalism across multiple health professions range from “active demonstration of the traits of a professional” to a lengthy description that encompasses traits or attributes that have been adopted as norms for the specific health profession.10, 11, 12, 13 Assessment approaches for

Methods

We conducted a scoping review following methodology included in the PRIMSA-ScR (preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews) reporting guidelines to summarize existing practices used to assess professionalism.14 A professional medical librarian searched multiple bibliographic databases covering medical, education (general and medical), psychology, and social and behavioral science literature. Databases searched include MEDLINE (Medical

Results

A total of 1920 articles were retrieved with 277 articles meeting the inclusion criteria for classification. Refer to Appendix 2 for the PRISMA flow diagram of search results. Results are summarized in Table 2. A full list of included studies can be found in Table 3. Of the articles included, 179 (64.6%) were published between 2010 and 2019.

Discussion

The goal of this scoping review was to provide an update of literature to identify: (1) patterns and characteristics of methods to assess professionalism across health profession degree programs and (2) current gaps in the literature. Professionalism is a transcending attribute essential to all health professions and of particular importance with the expansion of interprofessional team-based care. Our review was intended to expand upon earlier systematic reviews and consensus group

Disclosure(s)

None.

Declaration of competing interest

None.

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  • Cited by (5)

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    Present Address: Department of Pharmacy: Clinical and Administrative Sciences, University of Oklahoma College of Pharmacy, 1110 N. Stonewall Ave, CPB 229, Oklahoma City, OK 73173.

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