Nadia M Bajwa1, Mathieu Nendaz, Klara M Posfay-Barbe, Rachel Yudkowsky, Yoon Soo Park. 1. N.M. Bajwa is residency program director, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, and faculty member, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-1445-4594. M.R. Nendaz is professor and director, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, and attending physician, Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0003-3795-3254. K.M. Posfay-Barbe is professor and chairperson, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland; ORCID: https://orcid.org/0000-0001-9464-5704. R. Yudkowsky is professor, Department of Medical Education, College of Medicine at the University of Illinois at Chicago, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-2145-7582. Y.S. Park is associate professor, Harvard Medical School, and director of health professions education research, Massachusetts General Hospital, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-8583-4335.
Abstract
PURPOSE: With the growing importance of professionalism in medical education, it is imperative to develop professionalism assessments that demonstrate robust validity evidence. The Professionalism Mini-Evaluation Exercise (P-MEX) is an assessment that has demonstrated validity evidence in the authentic clinical setting. Identifying the factorial structure of professionalism assessments determines professionalism constructs that can be used to provide diagnostic and actionable feedback. This study examines validity evidence for the P-MEX, a focused and standardized assessment of professionalism, in a simulated patient setting. METHOD: The P-MEX was administered to 275 pediatric residency applicants as part of a 3-station standardized patient encounter, pooling data over an 8-year period (2012 to 2019 residency selection years). Reliability and construct validity for the P-MEX were evaluated using Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS: Cronbach's alpha for the P-MEX was 0.91. The EFA yielded four factors: doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. The CFA demonstrated good model fit with a root mean square error of approximation (RMSEA) of .058 and a comparative fit index (CFI) of .92, confirming the reproducibility of the 4-factor structure of professionalism. CONCLUSIONS: The P-MEX demonstrates construct validity as an assessment of professionalism, with 4 underlying subdomains in doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. These results yield new confidence in providing diagnostic and actionable subscores within the P-MEX assessment. Educators may wish to integrate the P-MEX assessment into their professionalism curricula.
PURPOSE: With the growing importance of professionalism in medical education, it is imperative to develop professionalism assessments that demonstrate robust validity evidence. The Professionalism Mini-Evaluation Exercise (P-MEX) is an assessment that has demonstrated validity evidence in the authentic clinical setting. Identifying the factorial structure of professionalism assessments determines professionalism constructs that can be used to provide diagnostic and actionable feedback. This study examines validity evidence for the P-MEX, a focused and standardized assessment of professionalism, in a simulated patient setting. METHOD: The P-MEX was administered to 275 pediatric residency applicants as part of a 3-station standardized patient encounter, pooling data over an 8-year period (2012 to 2019 residency selection years). Reliability and construct validity for the P-MEX were evaluated using Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). RESULTS: Cronbach's alpha for the P-MEX was 0.91. The EFA yielded four factors: doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. The CFA demonstrated good model fit with a root mean square error of approximation (RMSEA) of .058 and a comparative fit index (CFI) of .92, confirming the reproducibility of the 4-factor structure of professionalism. CONCLUSIONS: The P-MEX demonstrates construct validity as an assessment of professionalism, with 4 underlying subdomains in doctor-patient relationship skills, interprofessional skills, professional demeanor, and reflective skills. These results yield new confidence in providing diagnostic and actionable subscores within the P-MEX assessment. Educators may wish to integrate the P-MEX assessment into their professionalism curricula.