Kwon Hyo-Jin, Lee Young-Mee, Lee Young-Hee, Chang Hyung-Joo
Division of Medical Education, Department of Medical Humanities, Korea University College of Medicine, Seoul, Korea.
Korean J Med Educ. 2017 Jun;29(2):81-91. doi: 10.3946/kjme.2017.55. Epub 2017 May 29.
Medical professionalism is a fundamental competency for all physicians and continuous development of professionalism during residency training is crucial. The purpose of this study was to develop an instrument assessing residents' attitudes toward unprofessional behaviors.
A questionnaire survey was conducted in cooperation with the Korea Resident Association from May to July 2013. A total of 317 residents from seven university-affiliated hospitals in South Korea participated in the survey.
In the exploratory factor analysis, seven factors were extracted from the data; factor loadings of the 44 items ranged between 0.40 and 0.89. Through iterative discussion, three items below 0.45 were deleted and one additional item was removed due to its irrelevance. Twelve items included in Factor 1 were divided into two different categories. A final version of the questionnaire containing 40 items in eight categories was assessed using confirmatory factor analysis. It was deemed to have a good fit; the root mean square error of approximation and comparative fit index were 0.07 and 0.9, respectively. The reliability (Cronbach's ) of the inventory was 0.97.
The items of this instrument encompass a broad range of residents' behaviors in clinical practice, research, and publication. In addition, it includes some types of misconduct that can be considered unique features of the authors' cultural backgrounds. We recommend this instrument as an assessment tool to diagnose residents' perceptions and attitudes towards professionalism lapses and to provide insight regarding potential improvement in professionalism education.
医学职业素养是所有医生的一项基本能力，住院医师培训期间职业素养的持续发展至关重要。本研究的目的是开发一种评估住院医师对不专业行为态度的工具。
2013年5月至7月与韩国住院医师协会合作进行了问卷调查。韩国七家大学附属医院的317名住院医师参与了调查。
在探索性因素分析中，从数据中提取了七个因素；44个条目的因素负荷在0.40至0.89之间。通过反复讨论，删除了三个低于0.45的条目，并因一个条目不相关而将其删除。因素1中包含的12个条目被分为两个不同类别。使用验证性因素分析对包含八个类别的40个条目的问卷最终版本进行了评估。结果显示拟合良好；近似均方根误差和比较拟合指数分别为0.07和0.9。该量表的信度（克朗巴哈系数）为0.97。
该工具的条目涵盖了住院医师在临床实践、研究和发表方面的广泛行为。此外，它还包括一些可被视为作者文化背景独特特征的不当行为类型。我们推荐该工具作为一种评估工具，以诊断住院医师对职业素养缺失的认知和态度，并为职业素养教育的潜在改进提供见解。
