Psychometric analysis of the Swedish version of the General Medical Council's multi source feedback questionnaires

Developing an Instrument to Evaluate Undergraduate Healthcare Students' Professionalism

Professionalism is a multidimensional quality acquired over time. Undergraduate years lay a foundation for the development of professionalism. Tools monitoring the students' professional development are needed. Our tool development followed three phases: 1) identifying meaningful criteria for professionalism adapted to the education level, 2) developing an evaluation instrument in a process maximising construct validity, 3) testing the evaluation instrument in an interprofessional study. The evaluation instrument proved to be applicable in the field and it meets validity standards. Some differences between professions were found and discussed. Professionality starts to develop during the education, and early monitoring is important to support students' optimal development. The evaluation instrument supports both self- and expert evaluation of healthcare students' professional development.

Patient involvement in assessment of postgraduate medical learners: A scoping review

CONTEXT

Competency-based assessment of learners may benefit from a more holistic, inclusive, approach for determining readiness for unsupervised practice. However, despite movements towards greater patient partnership in health care generally, inclusion of patients in postgraduate medical learners' assessment is largely absent.

METHODS

We conducted a scoping review to map the nature, extent and range of literature examining the inclusion (or exclusion) of patients within the assessment of postgraduate medical learners. Guided by Arskey and O'Malley's framework and informed by Levac et al. and Thomas et al., we searched two databases (MEDLINE® and Embase®) from inception until February 2021 using subheadings related to assessment, patients and postgraduate learners. Data analysis examined characteristics regarding the nature and factor influencing patient involvement in assessment.

RESULTS

We identified 41 papers spanning four decades. Some literature suggests patients are willing to be engaged in assessment, however choose not to engage when, for example, language barriers may exist. When stratified by specialty or clinical setting, the influence of factors such as gender, race, ethnicity or medical condition seems to remain consistent. Patients may participate in assessment as a stand-alone group or part of a multi-source feedback process. Patients generally provided high ratings but commented on the observed professional behaviours and communication skills in comparison with physicians who focused on medical expertise.

CONCLUSION

Factors that influence patient involvement in assessment are multifactorial including patients' willingness themselves, language and reading-comprehension challenges and available resources for training programmes to facilitate the integration of patient assessments. These barriers however are not insurmountable. While understudied, research examining patient involvement in assessment is increasing; however, our review suggests that the extent which the unique insights will be taken up in postgraduate medical education may be dependent on assessment systems readiness and, in particular, physician readiness to partner with patients in this way.

The role of social networks in diabetes self‐care: A cross‐sectional study

Background

Patient involvement with diabetes self‐care is critical to reducing complications, morbidity, and mortality. Social media, as one of the most important forms of digital health, has always been available for diabetes self‐care, although the role of these media in supporting patient self‐care is unclear.

Aims

The aim of this study was to investigate the role of social networks in diabetes self‐care. In this study, the most important social networks used to receive self‐care services, diabetes self‐care behaviors, diabetes self‐care educations and benefits of using various services provided through social networks were identified.

Methods

The present study is a cross‐sectional study that was conducted through an electronic researcher‐made questionnaire in 2021. Two hundred and eighteen patients were selected to participate in the study from centers of diabetes of Fasa city, south of Iran. Sampling was performed by convenience sampling and in accordance with inclusion and exclusion criteria. Data were analyzed by descriptive statistics and analytical tests.

Results

In the data analysis section on Diabetes self‐care behaviors, there was no significant relationship between gender (p = 0.292), age (p = 0.49), type of diabetes (p = 0.909) and duration of diabetes (p = 0.076) with the use of self‐care services provided through social networks. There was a significant relationship between education level and the use of self‐care services provided through social networks (p = 0.01). “Recognizing diabetes and its complications,” “observing personal hygiene,” and “the impact of physical activity on diabetes control” were the most important educations. “Increasing patient knowledge and understanding about diabetes and its complications,” “reducing the consumption of high‐calorie foods and sugars,” and “observing personal and public health” were the most important social network's benefits, respectively.

Conclusions

Various self‐care educations and services provided through social networks can increase the in‐depth knowledge of diabetic patients about self‐care techniques and their effective role in controlling and managing diabetes and performing more self‐care processes.

Assessing Professionalism in Medicine - A Scoping Review of Assessment Tools from 1990 to 2018

BACKGROUND

Medical professionalism enhances doctor-patient relationships and advances patient-centric care. However, despite its pivotal role, the concept of medical professionalism remains diversely understood, taught and thus poorly assessed with Singapore lacking a linguistically sensitive, context specific and culturally appropriate assessment tool. A scoping review of assessments of professionalism in medicine was thus carried out to better guide its understanding.

METHODS

Arksey and O'Malley's (2005) approach to scoping reviews was used to identify appropriate publications featured in four databases published between 1 January 1990 and 31 December 2018. Seven members of the research team employed thematic analysis to evaluate the selected articles.

RESULTS

3799 abstracts were identified, 138 full-text articles reviewed and 74 studies included. The two themes identified were the context-specific nature of assessments and competency-based stages in medical professionalism.

CONCLUSIONS

Prevailing assessments of professionalism in medicine must contend with differences in setting, context and levels of professional development as these explicate variances found in existing assessment criteria and approaches. However, acknowledging the significance of context-specific competency-based stages in medical professionalism will allow the forwarding of guiding principles to aid the design of a culturally-sensitive and practical approach to assessing professionalism.

[Questionnaires of person centered care in primary care. A systematic review]

Objetivo

Pese a la importancia de la «atención centrada en la persona» (ACP), hay evidentes limitaciones para valorarla y medirla, debidas probablemente a la dificultad para definirla. El objetivo del estudio fue identificar herramientas validadas que midiesen la ACP o algunos de sus aspectos en el ámbito de la atención primaria.

Diseño

Revisión sistemática.

Fuentes de datos

MEDLINE, Embase, Cochrane, PSYCinfo, IME-Biomedicina, LILACS y TESEO hasta del 31 de mayo de 2018.

Selección de estudios

Los criterios de inclusión fueron: a) estudios de validación de cuestionarios, revisiones sistemáticas sobre estudios de validación u otros estudios descriptivos, b) realizados todos ellos en el ámbito de la atención primaria y c) que midieran aspectos de la ACP en profesionales y/o pacientes. Dos investigadores revisaron de forma independiente los artículos y sus discrepancias fueron resueltas por un tercer investigador.

Extracción de datos

Se recogieron datos sobre los aspectos de la ACP medidos, población a la que se dirige, tipo de cuestionario, y datos sobre validez y fiabilidad.

Resultados

Se localizaron 1.415 artículos a los que se añadieron 54 referencias adicionales identificadas a través de referencias de los artículos de la revisión sistemática. Tras una depuración finalmente fueron 75 los artículos que cumplieron todos los criterios y 39 las herramientas identificadas y clasificadas según las dimensiones analizadas.

Conclusiones

Debido a la dificultad de medir la ACP en su conjunto, la mayor parte de los artículos hacen referencia solo a alguno de sus aspectos o dimensiones, predominando la perspectiva del paciente frente a la del profesional. Estas herramientas son, no obstante, un importante punto de partida para futuros cuestionarios que intenten valorar de forma integral la ACP.

Swedish adaptation of the General Medical Council's multisource feedback questionnaires: a qualitative study

OBJECTIVES

to explore potential users' opinions of a translated and culturally adapted Swedish version of the General Medical Council's MultiSource Feedback Questionnaires.

METHODS

In this qualitative study, we used content analysis on semi-structured interviews from 44 resident doctors, 29 medical colleagues and 28 patients to analyse their opinions of the Swedish adapted version, created through translation and expert review. Transcribed interview data concerning the informants' general thoughts about the tool were coded manually by three independent coders into categories, compiled as themes, and exemplified by citations. Data regarding specific question wording and relevance were used as a basis for final questionnaire revision.

RESULTS

The informants valued the tool's potential to provide essential feedback to support the development of residents' medical competences and communication skills. Resident doctors welcomed support in their self-reflection. Colleagues saw it as a valuable tool for assessment that needs to be used sensitively. Patients appreciated opportunities to communicate feedback.  Ambiguous or irrelevant questions and response options were identified. Some colleague-related questions about specific skills and knowledge appeared ambiguous to residents. The final questionnaire revision - based on the expert review and the interview analysis - resulted in a number of changes: four questions were deleted, twelve were reformulated, and six were added.

CONCLUSIONS

Potential users perceived the Swedish adapted version as a beneficial tool for residents in their professional development. Further research is needed to explore how this tool can influence doctors' development when used in real-life settings.