Charlotte E. Rees

Assessment of professionalism: Recommendations from the Ottawa 2010 Conference

Over the past 25 years, professionalism has emerged as a substantive and sustained theme, the operationalization and measurement of which has become a major concern for those involved in medical education. However, how to go about establishing the elements that constitute appropriate professionalism in order to assess them is difficult. Using a discourse analysis approach, the International Ottawa Conference Working Group on Professionalism studied some of the dominant notions of professionalism, and in particular the implications for its assessment. The results presented here reveal different ways of thinking about professionalism that can lead towards a multi-dimensional, multi-paradigmatic approach to assessing professionalism at different levels: individual, inter-personal, societal–institutional. Recommendations for research about professionalism assessment are also presented.

Evaluating the reliability and validity of three tools to assess the quality of health information on the Internet

The quality of Internet information needs to be evaluated and several tools exist for this purpose. However, none have demonstrated reliability and validity. This study tested the internal consistency and validity of the information quality tool (IQT), quality scale (QS) and DISCERN using 89 web sites discussing smoking cessation. The inter-rater reliability of the tools was established by exploring the agreement between two independent raters for 22 (25%) of the sites. The IQT and DISCERN possessed satisfactory internal consistency (as measured by Cronbachs alpha). The IQT, QS and DISCERN showed satisfactory inter-rater reliability (as measured by kappa and intraclass correlations). The IQT, QS and DISCERN correlated positively with each other, supporting the convergent validity of the tools. This study provides some evidence for the reliability and validity of the IQT, QS and DISCERN, although this needs testing in further research with different types of Internet information and larger sample sizes.

Differences in medical students' explicit discourses of professionalism: acting, representing, becoming

Medical Education 2011; 45: 585–602

Is it me or is it them? Factors that influence the passing of underperforming students.

Context  Research has found that clinical assessments do not always accurately reflect medical student performance. Barriers to failing underperformance in students have been identified in other vocational settings. Is ‘failure to fail’ an issue for medical educators in the UK, and, if so, what are its determinants?

Evaluating the reliability of DISCERN: a tool for assessing the quality of written patient information on treatment choices

Patients require good quality, evidence based information so that they can participate actively in the decision making process. The DISCERN instrument has been developed to help patients rate the quality of written information materials about treatment choices. This study evaluated the reliability of DISCERN using 31 information leaflets discussing treatment options for prostate cancer. The index of agreement between two independent raters was substantial for the overall quality rating (kappa=0.65, 95% confidence interval 0.49, 0.82), indicating that the instrument could be used to discriminate reliably between low and high quality prostate cancer publications. Healthcare professionals should inform patients of the availability of the instrument and encourage its use by patients who regularly attend to written sources of information on treatment choices. Early indications show that DISCERN could enable both patients and healthcare professionals to discriminate between the plethora of variable quality information currently available.

The problem with outcomes‐based curricula in medical education: insights from educational theory

Background  Educators across the world are charged with the responsibility of producing core learning outcomes for medical curricula. However, much educational theory exists which deliberates the value of learning outcomes in education.

Narrative, emotion and action: analysing ‘most memorable’ professionalism dilemmas

OBJECTIVES  Although previous studies have explored medical learners’‘most memorable’ experiences, these have typically focused on patient deaths or mistakes. Drawing on multiple theoretical perspectives to understand the interplay between narrative, emotion and action, this paper aims to explore the whats and hows of written narratives of most memorable professionalism dilemmas: what types of dilemma are most memorable? When and where do they take place? How do students act? What characteristics relate to these dilemmas? How are dilemmas narrated?

The reliability of assessment criteria for undergraduate medical students' communication skills portfolios: the Nottingham experience.

Introduction  Some educators have argued that portfolios should not be assessed summatively because there is little evidence supporting the reliability of their assessment. This study aims to determine the reliability of assessment criteria used for a portfolio at the University of Nottingham.

Shedding the cobra effect: problematising thematic emergence, triangulation, saturation and member checking

Qualitative research is widely accepted as a legitimate approach to inquiry in health professions education (HPE). To secure this status, qualitative researchers have developed a variety of strategies (e.g. reliance on post‐positivist qualitative methodologies, use of different rhetorical techniques, etc.) to facilitate the acceptance of their research methodologies and methods by the HPE community. Although these strategies have supported the acceptance of qualitative research in HPE, they have also brought about some unintended consequences. One of these consequences is that some HPE scholars have begun to use terms in qualitative publications without critically reflecting on: (i) their ontological and epistemological roots; (ii) their definitions, or (iii) their implications.

Theory in medical education research: how do we get there?

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