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Assessing Professionalism among First year Medical Students through

Professionalism Assessment Tool (PAT) _______________ *Corresponding
Author

Article in Journal of University College of Medicine and Dentistry · October 2024

DOI: 10.51846/jucmd.v3i1.2808

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JOURNAL OF UNIVERSIT Y COLLEGE OF MEDICINE & DENTISTRY

Original Article

Assessing Professionalism among First year Medical Students

through Professionalism Assessment Tool (PAT)
Nabiha Farasat1*, Muhammad Saeed1, Ruksana Majid2
________________________________________________________________

Abstract Professional doctors demonstrate competency

in performance, ethics, professional codes and
Objective: To assess the professional level among
1
Bolan Medical College, Quetta, 1st year MBBS students of Bolan Medical College, identity, commitment to excellence etc.3,4,6,7,8
Pakistan Quetta. Literature search demonstrate a lot of importance
Methodology: A descriptive cross-sectional study to professionalism in western world countries,
Quetta Institute of Medical Sciences, was carried at Bolan Medical College Quetta from
2

Quetta, Pakistan and countries like Saudi Arabia also essentially

September to November, 2022. All 200 medical
students of 1st year MBBS were invited to participateassess level of medical students’ profession-
in the study. A validated Professional Assessment alism.1,6,9,10, 11 On the other hand, in Pakistan,
Tool (PAT) was distributed by 3 senior demonstrators
during lectures. The PAT contained 33 items within though work has been carried out in this con-
five domains: (1) Reliability and Responsibility, text, yet none of these researchers assess level of
(2) Life-long Learning and Adaptability, (3) professionalism among undergraduate medical
_______________ Relationships with Others (4) Upholding Principles
of Integrity and Respect, and (5) Citizenship and students.7,8,12,13 Therefore, the aim of current study
*Corresponding Author Professional Engagement. Results were prepared by is to assess the level of professionalism from the
using SPSS version 29. Frequencies and percentages very start of their career. First year MBBS stu-
were calculated. A p-value<0.05 was considered as
Nabiha Farasat significant. dents were assessed through Professionalism As-
nabihasaeed@[Link] Results: Twenty four out of 200 students were sessment Tool (PAT). It provided us information
consistently absent at the time of data collection about missing data of professionalism among 1st
_______________ (99% response rate). Fifty one percent were females
year medical students of Bolan Medical College,
(n=102/200). Seventy out of 200 students (35%)
Received: 12th July 2023 were 20 years of age. Thirty four percent (68/200) Quetta and assisted in making strategies to take
Revised: 16th September 2023 demonstrated only the basic level of critical think- steps to enhance professionalism among under-
Accepted: 16th October 2023 ing and only 10 students (5%) demonstrated the
graduate medical students.
higher cognitive level. Overall, statistically signifi-
cant results were observed at items number 3 and 1
(p-<.01)of domain 3 and 4 respectively (empathizing
to the situations of others and actively and produc- Methodology
DOI 10.51846/jucmd.v3i1.2808 tively participating in the profession respectively)
Conclusion: Students of 1st year MBBS demonstrate It was a descriptive, quantitative cross-section-
positive attitude towards professionalism. al study carried out in 1st year MBBS students
of Bolan Medical College, Quetta, Baluchistan,
Keywords: Medical Students, Assessment, 1st Year,
Professionalism level Pakistan. After taking permission of the faculty
member of the concerned subject, and by using
Introduction simple convenient sampling strategy data was
In medicine, professionalism forms a bridge collected between the months of September
between doctor and the patient. World Feder- November, 2022. All (n=200) MBBS students
ation for Medical Education (WFME) declared of 1st year were included in the study. Ethical
“Professionalism” as an emerging element that approval was taken from Bolan University of
is a mixture of implicit moral commitment and Medical & Health Sciences (IRB No. 0028/BUM-
explicit behaviors.1 It squeezes qualities of per- HS/IRB/23; Dated 29.10.23.)
fection, humanism, liability, and generosity that To check the validity of questionnaire among
depend on clinical aptitude, communication Pakistani population, a pilot study was carried
abilities, ethical and legal knowledge.2,3 Profes- out on 28 MBBS students of 1st year, the Reli-
sionalism stretches a continuum between per- ability coefficient (Cronbach’s alpha) was 847. A
son’s attributes, capacities and behaviors to the pre-formulated and validated students self-rat-
macro-societal level, which encompasses polit- ing instrument Professionalism Assessment Tool
ical objectives, moral principles and economic (PAT) developed by Kelly in 2011 was utilized.10
imperatives.4 Keeping in perspective the appar- Confidentiality was confirmed through obtain-
ent change in healthcare system, conflict of in- ing informed consent from participants, utilizing
terest regarding commercialism and its effect on appropriate data collection methods, securely
doctor’s practice, worries arise from an ever-in- storing data, ethically using data, and disposing
creasing medico-legal disputes. These disputes of data safely. All medical students from 1st year
are the main factor that makes physicians and were included whereas students from 2nd, 3rd and
clinicians anxious in their clinical practices.5 4th and final year were excluded from this research

34
JOURNAL OF UNIVERSIT Y COLLEGE OF MEDICINE & DENTISTRY

project. Demographic data including age, gender, professional 6 Serve society by using society using expertise to .002
year, medical experience, other degrees (O level, A level, solve problems
BSc, MSc etc.) of medical students was collected. The PAT
contained 33 items within five domains; (1) Reliability and
Responsibility, (2) Life-long Learning and Adaptability, (3)
Relationships with Others (4) Upholding Principles of Integrity
and Respect, and (5) Citizenship and Professional Engagement.
Each domain assesses a specific number of related variables
using the Miller's Performance Level Label (knows, knows
how, shows, shows how, and teaches how). This Likert scale
was weighted from 1 to 5 (1=knows, 2=know how, 3=shows,
4= shows how, 5=teaches how) each performance level label of
the rating system was aligned with a modification of Miller’s
Framework for Clinical Assessment. SPSS version 29 was
utilized to analyze the data. A p-value 0.05 considered significant.

Results
There were 200 students in 1st year medicine, out of which 51% were
Figure 1: Mean of all 5 domains PAT
females (n=102/200). Demographic details are presented in Table 1.
Discussion
Table 1: presenting demographic view

Sr. Gender wise distribution of Total students present % In the current study, comparing gender and age with items
No. present students demonstrated statistically significant results (p<.001), obtained
1 Girls 102 51 from Domain 3; item no. 3.1, Domain 4; item no. 4.5 and 4.7
2 Boys 98 49
respectively (establish rapport, use professional language and
being mindful of the environment and dress up in a profes-
Gender wise distribution of absent students
sional manner respectively). There were significant results
1 Girls 16 8 (p-.05) observed at Items No. 3.4 and 5.1 from Domain 3 and 5
2 Boys 8 4 “empathizing to the situations of others," Actively and produc-
Age wise distribution of students tively participating in the profession respectively"
1 20 years 70 35
Doctors are supposed to demonstrate harmonious relationship
2 >20 years 54 27 with patients.14 A professional doctor satisfies patients not
3 19 years 26 13 only by providing effective treatment but also through his/her
Level of thinking attitude. Patient’s first visit in hospital/clinic is very critical,
and relation between doctor-patient depends upon attitude
1 Critical thinkers 68 34
and behavior of doctor/clinician. Doctor’s good attitude with
2 Higher cognitive level 10 5 patient helps in providing high quality health care experiences,
moreover, doctor’s satisfactory behavior reduces the anxiety of
Table 2: Age and gender wise correlation between items
patient.15 Study participants of current study were cognizance
of effective rapport.3 We observed very highly significant re-
Sr. Gender wise comparison with Domain i.e., Reliability, sults at items discussed below including good rapport, using
No. Responsibility and Accountability
professional language and wearing professional dress. Compe-
Items p-value
tent professional doctor by developing good rapport (p<0.001)
Correlation between age and Domain 3 i.e., Relationships with provides effective treatment and satisfies patients with his/her
Others
attitude. Students of Bolan Medical College, Quetta were cogni-
1 Establish rapport <.001 zant about the impact of effective rapport. High statistically sig-
2 Empathizing to the situations of others >.001 nificant results of current study of this item demonstrated that
Age and Domain 4 i.e., Validate Principles of Integrity and Respect medical students are familiar about the importance of friendly
3 Use of professional language and being mindful of <.001
relationship with patients. Study conducted by Dang BN recog-
the environment nizes patient’s anxiety reduces if doctors build trust in 1st vis-
4 Dress up in a professional manner <.001 it15. Doctor’s behavior, communication skills and providing re-
assurance not only mitigate anxiety but also ameliorate quality
Crosstab results of age and Domain 5. Citizenship and Professional
Engagement of life by improving their overall health care experience.15 There
may be severe unpleasant issues (i.e., physical harm, obstetric
5 Actively and productively participating in the pro- .001
fession trauma, medication errors, communication barriers, minimal
health education, and limited medical comprehension) recog-
nized if patient and doctor presents language-discordant care.

JUCMD, 2024, Vol. 3(1) 35

JOURNAL OF UNIVERSIT Y COLLEGE OF MEDICINE & DENTISTRY

On the other hand, if language-clash care has been associated collection and/or answering the questions.
between doctor and patient it will ameliorate patient satisfaction,
approach to health care facilities. Additionally, language-clash Conclusion
career in forces the curative bond between the doctor and
patient. In US 66% medical colleges provides different language First year medical students are demonstrating professional
courses for smooth flow of patient-doctor communication.16 The behavior. As they are juniors and don't have direct contact with
results of current study participants of 1st year MBBS express patients so are unaware about the importance of many of items
cognizance about communication power (p<.001) Undergraduate of the questionnaire. However, they gave positive response to
students of Bolan Medical College, Quetta college interact and those items that were linked with their 1st year professional
experiences with cultural diversity during training. life. They were aware of wearing professional dress and using
professional language that heightened impact on patient
Doctor wearing professional dress are supposed to demonstrate satisfaction. They were motivated and felt empathy to work with
positive attitude, should be proficient in language to satisfy their full energy for the betterment of the sick community.
patients and relatives. Clothing gives one’s personal identity and
wearing white coat symbolize status and group identity. Patients Authors' Contributation: NF conceived idea, manuscript
psychologically trust doctors due to their white coat. Current writing. MS performed methodology and data analyis. RM did
study explained professional behavior of 1st Year MBBS towards critical review of literature.
patients. Students of Bolan Medical College Quetta were aware
of this norm (p<.001) and appreciate professional dress code Acknowledgement: Authors acknowledge students voluntarily
that gives them respect,17 makes them distinguishable from participation in the study.
non-professionals (patients, relatives, staff). Study conducted by
Jabbal and Porter confirms patient preference white coat, induce Supplementary Material: [Link]
highest trust and confidence on doctor.18 Being professional they ment/d/1SpigTaZpmW9V47bbVw4P4EatfZ7sRHDl/edit
incorporate norms and values of medical community. In a study
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