Division of Nephrology, Department of Internal Medicine, St Luke's International Hospital, Tokyo, Japan.
Med Educ. 2009 Oct;43(10):968-78. doi: 10.1111/j.1365-2923.2009.03437.x.
Assessing medical professionalism among medical residents is of great importance. The Professionalism Mini-Evaluation Exercise (P-MEX) is a tool for assessing professionalism that was developed, tested for reliability and validated in Canada. Prior to the present study, no Japanese version of the P-MEX had been tested.
We modified the P-MEX for use in Japan and tested it on medical residents in a Japanese teaching hospital. For each resident, eight evaluators completed the P-MEX forms. A total of 184 P-MEX forms were completed on 23 senior residents. The construct validity of the P-MEX was analysed by confirmatory factor analysis through structural equation modelling. The reliability of the P-MEX was tested using generalisability theory and a decision study. After performing the assessment and providing feedback to the residents, we conducted a survey on the residents' perceptions of the assessment.
Results indicate content and construct validity. A confirmatory factor analysis revealed that factor loadings ranged from 0.58 to 0.96, indicating good construct validity except for one item (P12: Maintained appropriate boundaries with patients and colleagues). Structural equation modelling showed that adding new items developed in Japan to the P-MEX provided adequate factor validity. A decision study showed confidence intervals sufficiently narrow with as few as 10 evaluations, slightly more than the eight forms verified in Canada. Most residents stated that the items were reasonable and appropriate, the results of the assessment were consistent with their own self-evaluation and the assessment enhanced their motivation.
Our study demonstrated good evidence of adequate reliability and validity of the P-MEX for the assessment of professionalism among Japanese residents. Moreover, the addition of new items developed in Japan provided adequate factor validity.
评估住院医师的医学专业精神非常重要。专业精神微型评估测验(P-MEX)是一种评估专业精神的工具,它在加拿大开发、测试可靠性并得到验证。在此之前,没有经过测试的 P-MEX 日文版。
我们对 P-MEX 进行了修改,使其适用于日本,并在日本一家教学医院对住院医师进行了测试。对于每位住院医师,有 8 位评估者完成了 P-MEX 表格。共有 184 份 P-MEX 表格由 23 名高级住院医师填写。通过结构方程模型的验证性因子分析,分析了 P-MEX 的结构有效性。使用可概括性理论和决策研究测试了 P-MEX 的可靠性。在对住院医师进行评估并向其提供反馈后,我们对住院医师对评估的看法进行了调查。
结果表明内容和结构有效性。验证性因子分析显示,因子负荷从 0.58 到 0.96,除了一项(P12:与患者和同事保持适当的界限)外,表明具有良好的结构有效性。结构方程模型表明,向 P-MEX 添加日本开发的新项目提供了足够的因子有效性。决策研究表明,置信区间足够狭窄,只需 10 次评估,略多于在加拿大验证的 8 次评估。大多数住院医师表示,这些项目是合理和适当的,评估结果与他们自己的自我评价一致,评估增强了他们的动力。
我们的研究表明,P-MEX 用于评估日本住院医师的专业精神具有足够的可靠性和有效性的证据。此外,添加日本开发的新项目提供了足够的因子有效性。