Basing the evaluation of professionalism on observable behaviors: a cautionary tale

Academic Medicine : Journal of the Association of American Medical Colleges
Shiphra GinsburgL Lingard

Abstract

The evaluation of professionalism often relies on the observation and interpretation of students' behaviors; however, little research is available regarding faculty's interpretations of these behaviors. Interviews were conducted with 30 faculty, who were asked to respond to five videotaped scenarios in which students are placed in professionally challenging situations. Behaviors were catalogued by person and by scenario. There was little agreement between faculty about what students should and should not do in each scenario. Abstracted principles (e.g., honesty, altruism) were defined and applied inconsistently, both between and within individual faculty. There was no apparent "shared standard" that faculty held for professional behavior in students, and similar behaviors (e.g., lying) could be interpreted as either professional or unprofessional. Future efforts at evaluation need to look beyond the behaviors, and should incorporate the reasoning and motivations behind students' actions in challenging professional situations.

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