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 .
Acad Med. 2021 Nov 1;96(11S):S151-S157. doi: 10.1097/ACM.0000000000004286.
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.
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 admission years). Reliability and construct validity for the P-MEX were evaluated using Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA).
Cronbach's alpha for the P-MEX was 0.91. The EFA yielded 4 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 of .058 and a comparative fit index of .92, confirming the reproducibility of the 4-factor structure of professionalism.
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.
随着医学教育中专业性的重要性日益增加，开发能够展示出可靠效度证据的专业性评估方法势在必行。专业精神微型评估练习（P-MEX）是一种在真实临床环境中已证明具有效度证据的评估方法。确定专业性评估的因子结构可以确定可用于提供诊断和可操作反馈的专业性构建。本研究在模拟患者环境中检查了 P-MEX 的效度证据，P-MEX 是一种专注且标准化的专业性评估。
在 3 个标准化患者站的考试中，275 名儿科住院医师申请人接受了 P-MEX 评估，这是在 8 年期间（2012 年至 2019 年住院医师招生年）汇总的数据。使用 Cronbach's alpha、探索性因素分析（EFA）和验证性因素分析（CFA）评估 P-MEX 的可靠性和构念效度。
P-MEX 的 Cronbach's alpha 为 0.91。EFA 产生了 4 个因素：医患关系技能、跨专业技能、专业举止和反思技能。CFA 显示出良好的模型拟合度，均方根误差逼近值为 0.058，比较拟合指数为 0.92，确认了专业性的 4 因素结构的可重复性。
P-MEX 作为一种专业性评估方法具有构念效度，在医患关系技能、跨专业技能、专业举止和反思技能方面有 4 个潜在的子领域。这些结果为在 P-MEX 评估中提供诊断和可操作的子分数提供了新的信心。教育工作者可能希望将 P-MEX 评估纳入其专业性课程。
