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Psychiatry educators and training programs are charged with facilitating trainees' growth as professionals who not only possess the requisite knowledge and skills to treat patients appropriately but also uphold ethical standards and embody the values central to professionalism. Professionalism, as operationalized by the Medical Professionalism Project (1), requires attending to patient welfare, patient autonomy, and social justice. Furthermore, it entails commitments to professional competence, honesty, confidentiality, maintaining professional boundaries, improving quality of care and access to care, scientific knowledge, managing conflicts of interest to maintain trust, and professional responsibilities.
All medical specialties must assess trainees' professionalism as one of six core competencies mandated by both the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties (2-4). Not surprisingly, diverse views exist regarding how best to evaluate trainees' professionalism, evaluate changes over time, provide useful feedback, and evaluate the efficacy of educational programs (5).
Methods to assess professionalism include structured clinical oral exams; simulated patients; evaluations from patients, nursing staff, resident peers, and faculty (often referred to as 360-degree evaluations); clinical supervision; and written tests varying from essays to multiple-choice. Most research has focused on medical students and trainees in specialties other than psychiatry, although literature is emerging concerning the assessment of specific competencies, including professionalism, in psychiatry training (6-12).
Minimal evidence exists on the views and preferences of psychiatry residents toward various methods of assessing professionalism. Trainees may view certain methods as more valuable for their evaluation, which may reflect their perspectives on the validity of the methods or underlying beliefs and attitudes about the training process and educational assessment that educators should understand. Therefore, we examined the perspectives of psychiatry trainees regarding methods of evaluating professionalism, utilizing a subset of data from a larger survey of psychiatry residents' perspectives on ethics and professionalism in training (13). On the basis of our previous research (14), we predicted that diverse learning approaches and clinically-oriented assessment methods would be preferred.
Method
Participants
All psychiatry residents in postgraduate years (PGY) 1-6 at seven training programs were asked to respond to this survey. The seven programs, a convenience sample selected to represent a range of training settings, were 1) Mayo Clinic College of Medicine; 2) Medical College of Wisconsin; 3) University of Arkansas for...