Transformation of medical students to become medical professionals is a core competency required for physicians in the 21st century. Role modeling was traditionally the key method of transmitting this skill. Medical schools are developing medical curricula which are explicit in ensuring students develop the professional competency and understand the values and attributes of this role. The purpose of this study was to determine student perception of professionalism at the University of Ottawa and gain insights for improvement in promotion of professionalism in undergraduate medical education.
Survey on student perception of professionalism in general, the curriculum and learning environment at the University of Ottawa, and the perception of student behaviors, was developed by faculty and students and sent electronically to all University of Ottawa medical students. The survey included both quantitative items including an adapted Pritzker list and qualitative responses to eight open ended questions on professionalism at the Faculty of Medicine, University of Ottawa. All analyses were performed using SAS version 9.1 (SAS Institute Inc. Cary, NC, USA). Chi-square and Fischer’s exact test (for cell count less than 5) were used to derive p-values for categorical variables by level of student learning.
The response rate was 45.6% (255 of 559 students) for all four years of the curriculum. 63% of the responses were from students in years 1 and 2 (preclerkship). Students identified role modeling as the single most important aspect of professionalism. The strongest curricular recommendations included faculty-led case scenario sessions, enhancing interprofessional interactions and the creation of special awards to staff and students to “celebrate” professionalism. Current evaluation systems were considered least effective. The importance of role modeling and information on how to report lapses and breaches was highlighted in the answers to the open ended questions.
Students identify the need for strong positive role models in their learning environment, and for effective evaluation of the professionalism of students and teachers. Medical school leaders must facilitate development of these components within the MD education and faculty development programs as well as in clinical milieus where student learning occurs.
Professionalism; Curriculum; Undergraduate medical education; Learning environment
Ethics training has become a core component of medical student and resident education. Curricula have been developed without the benefit of data regarding the views of physicians-in-training on the need for ethics instruction that focuses on practical issues and professional development topics.
A written survey was sent to all medical students and PGY1-3 residents at the University of New Mexico School of Medicine. The survey consisted of eight demographic questions and 124 content questions in 10 domains. Responses to a set of 24 items related to ethically important dilemmas, which may occur in the training period and subsequent professional practice, are reported. Items were each rated on a 9-point scale addressing the level of educational attention needed compared to the amount currently provided.
Survey respondents included 200 medical students (65% response) and 136 residents (58% response). Trainees, regardless of level of training or clinical discipline, perceived a need for more academic attention directed at practical ethical and professional dilemmas present during training and the practice of medicine. Women expressed a desire for more education directed at both training-based and practice-based ethical dilemmas when compared to men. A simple progression of interest in ethics topics related to level of medical training was not found. Residents in diverse clinical specialties differed in, perceived ethics educational needs. Psychiatry residents reported a need for enhanced education directed toward training stage ethics problems.
This study documents the importance placed on ethics education directed at practical real-world dilemmas and ethically important professional developmental issues by physicians-in-training. Academic medicine may be better able to fulfill its responsibilities in teaching ethics and professionalism and in serving its trainees by paying greater attention to these topics in undergraduate and graduate medical curricula.
In this paper we sought to explore undergraduate medical students’ views about their professional development during their studies that are considered to be related to medical professionalism.
A descriptive cross-sectional study using interpretative analysis of anonymous 10-item questionnaires was conducted at the University of Patras Medical School (UPMS), Greece. The study sample consisted of 134 undergraduate students in their fifth and sixth year of study at UPMS.
Undergraduate students emphasized the great significance of daily clinically-oriented practice in the wards in the group of behaviors consistent with medical professionalism. The integrated curriculum and informal discussions with members of the academic staff in the form of role models were also regarded as valuable approaches strongly enhancing professionalism. Students’ personal statements contained attributes regarding premium professional skills, including constancy and perfectionism throughout a lifelong learning process, so as to be able to provide high quality medical care to patients.
According to our undergraduate medical students themselves, the last 2 years of their studies are important to understand the essence of professionalism and develop their professional medical attitudes. Clinically-oriented teaching activities together with the informal curriculum of enhanced role modeling promote medical professional behaviors and increase standards of health care provided to patients.
undergraduate students; medicine; professionalism; medical education; Greece
A process evaluation was conducted to assess whether the newly developed Problem-Based Learning (PBL) curriculum designed to teach professionalism and ethics to biomedical graduate students was achieving its objectives. The curriculum was chosen to present realistic cases and issues in the practice of science, to promote skill development and to acculturate students to professional norms of science.
The perception to which the objectives for the curriculum and courses were being reached was assessed using 5-step Likert-scaled questions, open-ended questions and interviews of students and facilitators.
Process evaluation indicated that both facilitators and students perceived course objectives were being met. For example, active learning was preferred over lectures; both faculty and students percieved that the curriculum increased their understanding of norms, role obligations, and responsibilities of professional scientists; their ability to identify ethical situations was increased; skills in moral reasoning and effective group work were developed.
Information gathered was used to improve course implementation and instructional material. For example, a negative perception as an “ethics” course was addressed by redesigning case debriefing activities that reinforced learning objectives and important skills. Cases were refined to be more engaging and relevant for students, and facilitators were given more specific training and resources for each case. The PBL small group strategy can stimulate an environment more aware of ethical implications of science and increase socialization and open communication about professional behavior.
Measuring professionalism in undergraduate medical students is a difficult process, and no one method has currently emerged as the definitive means of assessment in this field. Student skills in reflection have been shown to be highly important in the development of professional behaviours. By studying student reflections on lapses in professional judgement, recorded as 'critical incidents', it is possible to explore themes which are significant for the development of professional behaviour in an undergraduate setting.
We examined critical incident reporting combined with optional written student reflection as a method for exploring professionalism in undergraduate medical students. 228 students split between Year 1 and 2 of one academic year of undergraduate medicine were studied retrospectively and a grounded theory approach to analysis was employed.
This year generated 16 critical incident reports and corresponding student reflections, all of which were considered. In addition to identifying the nature of the critical incidents, 3 principal themes emerged. These were the impact and consequences of the report having been made, student reactions to the events (both positive and negative), and student responses regarding future actions.
This study indicates that unprofessional behaviour can be identified and challenged by both the faculty and the students involved, and suggests that positive behavioural changes might be made with the aim of preventing future occurrences. We provide a low cost approach of measuring and recording professional behaviour.
Efforts to promote medical professionalism often focus on cognitive and technical competencies, rather than professional identity, commitment, and values. The Healer’s Art elective is designed to create a genuine community of inquiry into these foundational elements of professionalism.
Evaluations were obtained to characterize course impact and to understand students’ conceptions of professionalism.
Qualitative analysis of narrative course evaluation responses.
Healer’s Art students from U.S. and Canadian medical schools.
Analysis of common themes identified in response to questions about course learning, insights, and utility.
In 2003–2004, 25 schools offered the course. Evaluations were obtained from 467 of 582 students (80.2%) from 22 schools participating in the study. From a question about what students learned about the practice of medicine from the Healer’s Art, the most common themes were “definition of professionalism in medicine” and “legitimizing humanism in medicine.” The most common themes produced by a question about the most valuable insights gained in the course were “relationship between physicians and patients” and “creating authentic community.” The most common themes in response to a question about course utility were “creating authentic community” and “filling a curricular gap.”
In legitimizing humanistic elements of professionalism and creating a safe community, the Healer’s Art enabled students to uncover the underlying values and meaning of their work—an opportunity not typically present in required curricula. Attempts to teach professionalism should address issues of emotional safety and authentic community as prerequisites to learning and professional affiliation.
professionalism; community; doctor–patient relationship; humanism
In response to a growing need for students to appreciate ethical issues in medical research and publication, a brief team-based learning (TBL) course was presented to graduate students in the medical school of Hallym University in October and November 2007. To gather information as a basis for improving the course, questionnaires were distributed to 19 students and the feedback was evaluated. The questionnaire consisted of four categories: general course content (7 items), changes in attitudes toward research and publication ethics (6 items), the TBL format (6 items), and an open-ended question about the class (1 item). The most positive response had to do with the importance of the material. Students reported that their knowledge about ethical issues increased, and they expressed satisfaction regarding the communication with their tutors within the TBL format. Most students showed positive responses to the subject as well as to TBL. Since this was the first trial offering of this material in the graduate program at this medical school, it may have been novel to the students. The attitude change and the knowledge acquisition reported by students reflect a very positive outcome of this class. After adjustments to improve weaknesses, such as the short time allocation and students' lack of prior background, the outcomes of this TBL course on research and publication ethics provide a good basis for its continuation.
Research and Publication Ethics; Team-based Learning; Graduate Students; Survey; Course Evaluation
Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning of these competencies to practitioners of the future.
An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions.
Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p < 0.001), with the greatest increase noted among medical students. Highly significant changes in students' attitudes to shared learning were observed, indicating that safe medication practice is learnt more effectively with students from other healthcare disciplines. Qualitative data revealed that students' participation in the workshop improved communication and teamworking skills, and led to greater awareness of the role of other healthcare professionals.
This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.
Medical television programs offer students fictional representations of their chosen career. This study aimed to discover undergraduate medical students' viewing of medical television programs and students' perceptions of professionalism, ethics, realism and role models in the programs. The purpose was to consider implications for teaching strategies.
A medical television survey was administered to 386 undergraduate medical students across Years 1 to 4 at a university in New South Wales, Australia. The survey collected data on demographics, year of course, viewing of medical television programs, perception of programs' realism, depiction of ethics, professionalism and role models.
The shows watched by most students were House, Scrubs, and Grey's Anatomy, and students nominated watching 30 different medical programs in total. There was no statistical association between year of enrolment and perceptions of accuracy. The majority of students reported that friends or family members had asked them for their opinion on an ethical or medical issue presented on a program, and that they discussed ethical and medical matters with their friends. Students had high recall of ethical topics portrayed on the shows, and most believed that medical programs generally portrayed ideals of professionalism well.
Medical programs offer considerable currency and relevance with students and may be useful in teaching strategies that engage students in ethical lessons about practising medicine.
A survey was conducted to solicit data related to health professionals image of librarians. Physicians, residents, nurses, medical students, dentists, pharmacists, physical therapists, and occupational therapists were questioned about their experiences with and opinions of librarians, particularly the skills and characteristics needed by helpful, successful librarians. Health sciences librarians were also questioned about their own professional image and their perceptions of their patrons' impression of librarians. Librarians and health professionals alike ranked good communication as the most important skill for librarians. Computer or technological skills were ranked fourth by librarians but second by health professionals. Although librarians tended to describe themselves in slightly more positive terms than did their patrons, health professionals viewed librarians as approachable, responsive, supportive, and open to change. Health professionals also reported that they received accurate, reliable, and timely information from librarians and that this information was valuable.
Multi-dimensional, multi-symptom approaches to cancer symptom assessment and management have been emphasized across health disciplines. However, each dimension that is assessed significantly increases patient/subject burden. Efficient, reliable, and valid assessment of the critical dimensions of patients’ most salient symptoms is important in clinical and research settings. The Symptom Representation Questionnaire (SRQ), derived from information processing theory, assesses critical cognitive and emotional factors that are known to influence coping and outcomes. The SRQ was developed and evaluated in a three-phase process: 1) item selection, modification, and review by theoretical and clinical experts; 2) pilot evaluation of feasibility and psychometric properties; and 3) large sample psychometric evaluation. In phase three, members (n=713) of the National Ovarian Cancer Coalition participated via mailed surveys. Internal consistency was good for all subscales (α= 0.63 – 0.88). The internal structure of the SRQ was theoretically consistent except that emotional representation, identity, and consequence items all loaded onto a single factor. Between-group comparisons supported construct validity: representations differed between long-term survivors and women with active disease. Finally, there were significant correlations between SRQ subscales and Symptom Interference and Life Satisfaction. The SRQ appears to be a psychometrically sound instrument for assessing representations of cancer-related symptoms. This instrument could play an essential role in advancing knowledge of the relationships among representations of symptoms, symptom management processes, and symptom related outcomes. It could also be used in intervention research when changes in symptom representations are hypothesized to mediate changes in outcomes as a result of psycho-educational interventions.
Symptom assessment; illness representations; symptom management; ovarian cancer; cancer
We investigated the views of newly graduating physicians on their preparedness for postgraduate clinical training, and evaluated the relationship of preparedness with the educational environment and the pass rate on the National Medical Licensure Examination (NMLE).
Data were obtained from 2429 PGY-1 physicians-in-training (response rate, 36%) using a mailed cross-sectional survey. The Dundee Ready Education Environment Measure (DREEM) inventory was used to assess the learning environment at 80 Japanese medical schools. Preparedness was assessed based on 6 clinical areas related to the Association of American Medical Colleges Graduation Questionnaire.
Only 17% of the physicians-in-training felt prepared in the area of general clinical skills, 29% in basic knowledge of diagnosis and management of common conditions, 48% in communication skills, 19% in skills associated with evidence-based medicine, 54% in professionalism, and 37% in basic skills required for a physical examination. There were substantial differences among the medical schools in the perceived preparedness of their graduates. Significant positive correlations were found between preparedness for all clinical areas and a better educational environment (all p < 0.01), but there were no significant associations between the pass rate on the NMLE and perceived preparedness for any clinical area, as well as pass rate and educational environment (all p > 0.05).
Different educational environments among universities may be partly responsible for the differences in perceived preparedness of medical students for postgraduate clinical training. This study also highlights the poor correlation between self-assessed preparedness for practice and the NMLE.
The Edinburgh Postnatal Depression Scale (EPDS) is the instrument most used worldwide for screening of Post-Partum Depression (PPD). The SRQ20 questionnaire has been largely used for screening of minor psychiatric disorders. This study aimed to compare the accuracy of the two instruments in screening for PPD. At the third-month follow-up home visit to infants of the 2004 Pelotas Birth Cohort, Southern Brazil, a sub-sample of 378 mothers was selected. Among other questions, EPDS and SRQ20 were applied by trained fieldworkers. Up to 15 days later, a mental health professional re-interviewed the mother (the gold standard interview). Sensitivity and specificity of each cutoff point were calculated for EPDS and SRQ20 and the results were plotted at a ROC curve. The areas under both curves were compared. Highest sensitivity and specificity cutoff were observed for EPDS ≥ 10 (sensitivity 82.7%, 95%CI 74.0 – 89.4; specificity 65.3%, 95%CI 59.4 – 71.0) and for SRQ20 ≥ 6 (sensitivity 70.5%, 95%CI 60.8 – 79.0%; specificity 75.5%, 95%CI 70.0 – 80.5%). Shape of ROC curves and areas under both curves were virtually identical (respectively, 0.8401 ± 0.02 for EPDS and 0.8402 ± 0.02 for SRQ20; p = 0.9). In conclusion SRQ20 showed to be as valid as EPDS as a screening tool for PPD at third month after delivery.
Teaching ethics to nurses leads to their involvement in providing high quality care, enable them to duly encounter ethical issues. One of the key elements of educational systems is nursing instructors. Even though lots of studies show the role of instructors in students’ learning, their role in promotion of professional ethics has been attended to less.
The objective of this study is surveying the experience of nursing students with respect to the role of instructors in promotion of professional ethics.
This qualitative study enrolled 15 undergraduate nursing students from three nursing schools in Teheran whom depth interview was performed. The interview was semi-structured with open ended questions. The analysis was accomplished by use of qualitative content-analysis method.
Data analysis demonstrated 2 main themes and 7 subcategories in regard to the role of instructors in promotion of professional ethics in nursing students including: 1) the effective professional role model 2) facilitating creative learning. The effective professional role model encompasses individual characteristics and beliefs, clinical skills and professional commitment of role model. Creative learning facilitates by encouraging critical thinking and decision-making, Providing supportive learning conditions, providing proper space for sharing knowledge followed by evaluation and creative feedback.
The findings of this study provides a background for strengthening the role of instructors in promotion of professional ethics with more emphasis on research which increase capability of instructors at nursing education centers.
Nursing; Nursing student; Ethics
This study has used Item Response Theory (IRT) to examine the psychometric properties of Health-Related Quality-of-Life.
This investigation is a descriptive- analytic study. Subjects were 370 undergraduate students of nursing and midwifery who were selected from Tabriz University of Medical Sciences. All participants were asked to complete the Farsi version of WHOQOL-BREF. Samejima's graded response model was used for the analyses.
The results revealed that the discrimination parameters for all items in the four scales were low to moderate. The threshold parameters showed adequate representation of the relevant traits from low to the mean trait level. With the exception of 15, 18, 24 and 26 items, all other items showed low item information function values, and thus relatively high reliability from low trait levels to moderate levels.
The results of this study indicate that although there was general support for the psychometric properties of the WHOQOL-BREF from an IRT perspective, this measure can be further improved. IRT analyses provided useful measurement information and demonstrated to be a better methodological approach for enhancing our knowledge of the functionality of WHOQOL-BREF.
Item response theory; Psychometrics; Quality of life
The values such as participation/empathy, communication/sharing, self-awareness, moral integrity, sensitivity/trustfulness, commitment to ongoing professional development, and sense of duty linked to the practice of the medical professionalism were defined by various professional oaths.
The aim of this study was to evaluate how these values are considered by the students of the degree course of medicine.
Materials and Methods:
Four hundred twenty three students (254 females, 169 males) taking part of the first, fourth, and fifth years of the degree course in medicine were asked to answer seven questions. Pearson's Chi-square, Wilcoxon rank sum test, and Kruskal–Wallis test were used for the statistical analysis.
The survey showed a high level of knowledge and self-awareness about the values and skills of medical profession. In particular, the respect, accountability, and the professional skills of competence were considered fundamental in clinical practice. However, the students considered that these values not sufficiently present in their educational experience.
Teaching methods should be harmonized with the contents and with the educational needs to ensure a more complex patient-based approach and the classical lectures of teachers should be more integrated with learning through experience methods.
Empathy; Ethical values; Influencing factors; Medical education; Teaching methods
Nowadays, with development of medical sciences, several ethical challenges have raised which make research more complicated. Observance of student’s right in selecting interested research topic and the supervisor, in addition to its positive effect on the research process, will cause satisfaction and quality promotion in the educational system. To observe that issue, during a confidential survey of a number of postgraduate students in 2009, students were asked to confidentially describe any displeasure they might get during their study and research. The most important items included: imposing thesis by a supervisor without informing the student, compulsory assignment of students to a specific supervisor, little time allocated for students by the supervising team who may be selected without students interests, prolongation of the research time, and non-cooperation in publishing the results.
Establishment of a proper way to transfer student’s displeasure or criticism to supervisors and establishing a continuous program for informing research teams including supervisors and students about ethical codes can positively affect the issue.
Ethics; Thesis; Supervisor; Doctorate students; Research
Background and Objectives
The diverse US population requires medical cultural competency education for health providers throughout their pre-professional and professional years. We present a curriculum to train pre-health professional undergraduates by combining classroom education in the humanities and cross-cultural communication skills with volunteer clinical experiences at the University of California, Los Angeles (UCLA) hospital.
The course was open to a maximum of 15 UCLA junior and senior undergraduate students with a pre-health or humanities major and was held in the spring quarters of 2002–2004. The change in students' knowledge of cultural competency was evaluated using the Provider's Guide to Quality and Culture Quiz (QCQ) and through students' written assignments and evaluations.
Trainees displayed a statistically significant improvement in scores on the QCQ. Participants' written assignments and subjective evaluations confirmed an improvement in awareness and a high motivation to continue learning at the graduate level.
This is the first evaluated undergraduate curriculum that integrates interdisciplinary cultural competency training with patient volunteering in the medical field. The didactic, volunteering, and writing components of the course comprise a broadly applicable tool for training future health care providers at other institutions.
To evaluate the impact guest speakers have on student development in a professional development seminar series.
Over a 5-semester period, presentations were given by 18 guest speakers as part of a professional development seminar series.
A 28-item survey instrument was constructed and administered to 68 students to assess the impact of the guest speakers on the students' professional development. Forty-six (68%) students completed the survey instrument, and the results demonstrated the value of the guest speakers, most notably in the areas of career development and professional responsibility.
Exposing pharmacy students to guest speakers from varied pharmacy career paths positively impacted students' knowledge of career options and professional development.
guest speakers; professional development; career counseling; advising; mentoring
To create, implement, and evaluate a microteaching exercise to enhance student development of communication skills, critical-thinking skills, and problem-solving abilities.
A microteaching exercise was developed and implemented in 2 semesters of a professional development series. Advisees from 3 classes developed 7-minute presentations for classmates, followed by a brief question-and-answer session.
Evaluation and Assessment
Presenters received peer evaluations and a DVD of their presentation and then wrote a reflective essay on their performance. A 33-item survey instrument was administered to assess student impressions of the microteaching exercise. Survey results demonstrated students valued the microteaching exercise in terms of overall impression of the exercise, the class experience, personal outcomes, and the evaluation process.
A microteaching exercise is a valuable tool to help students develop communication, critical-thinking, and problem-solving skills. Further, it helps increase student learning, helps students to “think on their feet” and be reflective, provides an opportunity to have students analyze their own and fellow classmates' presentation methods and develops their skill in the provision of constructive feedback through peer assessment.
faculty advisor; microteaching; self-reflection; peer evaluation
Ethical reasoning and decision-making may be thought of as 'professional skills', and in this sense are as relevant to efficient clinical practice as the biomedical and clinical sciences are to the diagnosis of a patient's problem. Despite this, however, undergraduate medical programmes in ethics tend to focus on the teaching of bioethical theories, concepts and/or prominent ethical issues such as IVF and euthanasia, rather than the use of such ethics knowledge (theories, principles, concepts, rules) to clinical practice. Not surprisingly, many students and clinicians experience considerable difficulty in using what they know about ethics to help them make competent ethical decisions in their day-to-day clinical practice. This paper describes the development of a seminar programme for teaching senior medical students a more systematic approach to ethical reasoning and analysis and clinical decision-making.
At the University of Newcastle, health law and ethics is taught and assessed in each year of the five-year curriculum. However, the critical question for assessment remains: 'Does teaching ethics have a measurable effect on the clinical activity of medical students who have had such courses?' Those responsible for teaching confront this question each year they sit down to construct their assessment tools. Should they assess what the student knows? Should they assess the student's moral reasoning, that is, what decisions the student makes, and, how these decisions are justified, or should they assess what the student actually does when dealing with patients in the clinical setting, and how he or she does it? From 1982 to 1991, assessment at Newcastle was primarily aimed at determining the quality of the students' ethics knowledge base. This paper describes the strengths and limitations of a purely knowledge-based method of evaluation and why in 1992, we are now attempting to redefine and assess, what we call 'clinical ethical competence' in terms of how students actually apply this knowledge base in a controlled clinical context.
Doctors are asked to play the roles of both a healer and a professional. In dealing with this inherent demand, we should first ask ourselves if we are selecting students who show traits that would enable them to become a good doctor. The primary concern of this study was to identify the core elements of medical professionalism that will develop into professional competence that we should be sought in medical school applicants.
Materials and Methods
One hundred-six responses from the Delphi survey done by medical school professors and 230 completed questionnaires from medical students were used for analysis. We also set out to analyze the level of medical professionalism in newly entering medical students using a 5-point Likert scale.
Of the 27 elements of medical professionalism examined, the most important core element was thought to be 'life-long learning skills'. The level of professionalism in Korean medical students was mostly assessed to be less than the 3.0 mean score given by the professors. Medical students tended to rate themselves higher than did the professors for their level of medical professionalism.
Medical professionalism can be categorized into three domains; professional knowledge, professional skills, and professional attitude. For the prominent differences in the recognition of the levels of professionalism elements in medical students by students and professors, further studies investigating the reasons for discrepancy are needed.
Professional competence; medical students; elements
Nursing educators need rigorously developed instruments to assess competency in evidence based practice (EBP) at undergraduate level. This concept is defined as the capability to choose and use an integrated combination of knowledge, skills and attitudes with the intention to develop a task in a certain context. Also, we understand that EBP is gaining knowledge and skills, as well as increasing positive attitudes toward EBP that will promote a change in behaviour to implement EBP in practice. This study aims to develop a psychometric test of the Evidence Based Practice Evaluation Competence Questionnaire (EBP-COQ) among undergraduate nursing students.
The questionnaire was developed by item generation through a review of scientific literature and focus groups. The instrument was validated in terms of content validity through an expert review. The EBP-COQ was administered to a cohort of nursing students (n =100) to evaluate test reliability and select the best items. Psychometric properties of the final instrument were assessed in a sample of 261 nursing students.
The EBP-COQ consisted of 25 items. A factorial analysis grouped the items into the three categories that define competence relating to EBP: attitude, knowledge and skills. Cronbach’s alpha was 0.888 for the entire questionnaire. The factor solution explained 55.55% of the variance.
EBP-COQ appears to measure with adequate reliability the attributes of undergraduate nursing students’ competence in EBP. The instrument is quick to disseminate and easy to score, making it a suitable instrument for nursing educators to evaluate students’ self-perceived competence in EBP.
Competence; Evidence-based practice; Undergraduate nursing; Questionnaire; Validation
Although professionalism has emerged as a key competency for today’s physicians, there exists little insight into how best to teach medical students the relevant skills or instill in them the commitment required to practice according to the highest professional standards. Ten UCSF medical students were interviewed at three time points (second, third, and fourth years of school). Interviews focused on students’ learning and development regarding end-of-life care (EOLC). Students described varying steps in their professional development from their second to fourth years of school, including feeling confused about the definition of professionalism and integrating their personal and professional identities. In addition to professional development, four other themes contributed to the development of medical student understanding of how to provide EOLC as a professional: (1) curricular discordance, (2) role models, (3) the tightrope between trained versus human reactions, and (4) ethical dilemmas. These five themes represent dilemmas that students often learned how to respond to over the course of school. Professional development in EOLC required the acquisition of skills necessary to balance the tension between and navigate conflicting messages present in medical student training.
Professionalism; Medical practice; End-of-life care; Professional development