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A Blueprint to Assess Professionalism: Results of a Systematic Review

Wilkinson, Tim J. MB, ChB, M Clin Ed, PhD, FRACP; Wade, Winnie B. MA (Curriculum Studies), MA (Education); Knock, L Doug MSc

doi: 10.1097/ACM.0b013e31819fbaa2

Purpose: Assessing professionalism is hampered by varying definitions and these definitions' lack of a clear breakdown of the elements of professionalism into aspects that can be measured. Professionalism is multidimensional, so a combination of assessment tools is required. In this study, conducted during 2007–2008, the authors aimed to match assessment tools to definable elements of professionalism and to identify gaps where professionalism elements are not well addressed by existing assessment tools.

Method: The authors conducted literature reviews of definitions of professionalism and of relevant assessment tools, clustered the definitions of professionalism into assessable components, and clustered assessment tools of a similar nature. They then created a “blueprint” whereby the elements of professionalism are matched to relevant assessment tools.

Results: Five clusters of professionalism were formed: adherence to ethical practice principles, effective interactions with patients and with people who are important to those patients, effective interactions with people working within the health system, reliability, and commitment to autonomous maintenance / improvement of competence in oneself, others, and systems. Nine clusters of assessment tools were identified: observed clinical encounters, collated views of coworkers, records of incidents of unprofessionalism, critical incident reports, simulations, paper-based tests, patients' opinions, global views of supervisor, and self-administered rating scales.

Conclusions: Professionalism can be assessed using a combination of observed clinical encounters, multisource feedback, patients' opinions, paper-based tests or simulations, measures of research and/or teaching activities, and scrutiny of self-assessments compared with assessments by others. Attributes that require more development in their measurement are reflectiveness, advocacy, lifelong learning, dealing with uncertainty, balancing availability to others with care for oneself, and seeking and responding to results of an audit.

Professor Wilkinson is associate dean (medical education), University of Otago, Christchurch, New Zealand.

Ms. Wade is director of education, Royal College of Physicians, London, United Kingdom.

Mr. Knock is deputy librarian, Queen Elizabeth Hospital, London, United Kingdom. When this report was written, he was medical education information specialist, Royal College of Physicians, London, United Kingdom.

Correspondence should be addressed to Professor Wilkinson, University of Otago, Christchurch, C/- The Princess Margaret Hospital, PO Box 800, Christchurch, New Zealand; telephone: 64-3-3377899; fax: 64-3-3377975; e-mail: (

© 2009 Association of American Medical Colleges