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2017 ; 12
(5
): e0177321
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Assessing medical professionalism: A systematic review of instruments and their
measurement properties
#MMPMID28498838
Li H
; Ding N
; Zhang Y
; Liu Y
; Wen D
PLoS One
2017[]; 12
(5
): e0177321
PMID28498838
show ga
BACKGROUND: Over the last three decades, various instruments were developed and
employed to assess medical professionalism, but their measurement properties have
yet to be fully evaluated. This study aimed to systematically evaluate these
instruments' measurement properties and the methodological quality of their
related studies within a universally acceptable standardized framework and then
provide corresponding recommendations. METHODS: A systematic search of the
electronic databases PubMed, Web of Science, and PsycINFO was conducted to
collect studies published from 1990-2015. After screening titles, abstracts, and
full texts for eligibility, the articles included in this study were classified
according to their respective instrument's usage. A two-phase assessment was
conducted: 1) methodological quality was assessed by following the
COnsensus-based Standards for the selection of health status Measurement
INstruments (COSMIN) checklist; and 2) the quality of measurement properties was
assessed according to Terwee's criteria. Results were integrated using
best-evidence synthesis to look for recommendable instruments. RESULTS: After
screening 2,959 records, 74 instruments from 80 existing studies were included.
The overall methodological quality of these studies was unsatisfactory, with
reasons including but not limited to unknown missing data, inadequate sample
sizes, and vague hypotheses. Content validity, cross-cultural validity, and
criterion validity were either unreported or negative ratings in most studies.
Based on best-evidence synthesis, three instruments were recommended: Hisar's
instrument for nursing students, Nurse Practitioners' Roles and Competencies
Scale, and Perceived Faculty Competency Inventory. CONCLUSION: Although
instruments measuring medical professionalism are diverse, only a limited number
of studies were methodologically sound. Future studies should give priority to
systematically improving the performance of existing instruments and to
longitudinal studies.