Integrating wellbeing and social accountability into medical professionalism self-assessment: A mixed methods approach

Abstract

Background

Medical professionalism is an essential characteristic of excellent physicians and in most need of training. It should involve areas not included in traditional frameworks, such as physicians’ self-care and social accountability. This study aims to develop a comprehensive self-assessment instrument to improve medical professionalism training in medical students.

Methods

Mixed-methods design that integrated a scoping review, a qualitative framework method, and a cross-sectional design. The qualitative phase included focus groups with 19 medical students and 9 in-depth interviews with clinician educators. The quantitative phase included descriptive and exploratory factor analysis of 112 interviews to fifth-year medical students at the Catholic University in Chile.

Results

In the scoping review, 290 articles were screened. The Professionalism Mini-Evaluation Exercise (P-MEX) instrument was selected as the reference instrument. The qualitative phase generated 188 open codes and 468 quotes, which were analyzed using the Atlas-ti 8.0 software®. Three levels of professional assessment emerged. The micro level included self-reflection and self-care skills; the meso level included doctor–patient relationship, team interaction, and management skills; and the macro level included social accountability skills. The new adapted instrument (P-MEX-LA) contained 30 items and achieved high reliability and internal consistency (Omega 0.86; Cronbach’s alpha 0.82). Self-care and social accountability skills were the areas with the lowest level of achievement by students.

Discussion

A Latin American self-assessment version of the P-MEX instrument (P-MEX-LA) that included self-care and social accountability skills achieved high content validity, internal consistency, and reliability. It could contribute to improving medical professionalism training among medical students.