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. 2014 May 21;9(5):e97069.
doi: 10.1371/journal.pone.0097069. eCollection 2014.

Measuring professionalism in medicine and nursing: results of a European survey

Kiki M J M H Lombarts  1 , Thomas Plochg  2 , Caroline A Thompson  3 , Onyebuchi A Arah  4 ; DUQuE Project Consortium
Collaborators, Affiliations

Measuring professionalism in medicine and nursing: results of a European survey

Kiki M J M H Lombarts et al. PLoS One. .

Abstract

Background: Leveraging professionalism has been put forward as a strategy to drive improvement of patient care. We investigate professionalism as a factor influencing the uptake of quality improvement activities by physicians and nurses working in European hospitals.

Objective: To (i) investigate the reliability and validity of data yielded by using the self-developed professionalism measurement tool for physicians and nurses, (ii) describe their levels of professionalism displayed, and (iii) quantify the extent to which professional attitudes would predict professional behaviors.

Methods and materials: We designed and deployed survey instruments amongst 5920 physicians and nurses working in European hospitals. This was conducted under the cross-sectional multilevel study "Deepening Our Understanding of Quality Improvement in Europe" (DUQuE). We used psychometric and generalized linear mixed modelling techniques to address the aforementioned objectives.

Results: In all, 2067 (response rate 69.8%) physicians and 2805 nurses (94.8%) representing 74 hospitals in 7 European countries participated. The professionalism instrument revealed five subscales of professional attitude and one scale for professional behaviour with moderate to high internal consistency and reliability. Physicians and nurses display equally high professional attitude sum scores (11.8 and 11.9 respectively out of 16) but seem to have different perceptions towards separate professionalism aspects. Lastly, professionals displaying higher levels of professional attitudes were more involved in quality improvement actions (physicians: b = 0.019, P<0.0001; nurses: b = 0.016, P<0.0001) and more inclined to report colleagues' underperformance (physicians--odds ratio (OR) 1.12, 95% CI 1.01-1.24; nurses - OR 1.11, 95% CI 1.01-1.23) or medical errors (physicians--OR 1.14, 95% CI 1.01-1.23; nurses - OR 1.43, 95% CI 1.22-1.67). Involvement in QI actions was found to increase the odds of reporting incompetence or medical errors.

Conclusion: A tool that reliably and validly measures European physicians' and nurses' commitment to professionalism is now available. Collectively leveraging professionalism as a quality improvement strategy may be beneficial to patient care quality.

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Conflict of interest statement

Competing Interests: The employment of Drs. Klaus and Jones by Dr Foster Intelligence did not and do not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. Dr. M. Car was at the time of the study, and still is, a PhD student at the Imperial College of London. He was funded by Dr Foster Intelligence for his research activities only.

Figures

Figure 1
Figure 1. Summary of professional values as defined by the Physician’s Charter (1) and the Code of Ethics for Nurses (2).
See this image and copyright information in PMC

References

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    1. American Nurse Association (2001) Code of Ethics for Nurses. Available: www.nursingworld.org.
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    1. Conway PH, Cassel CK (2012) Engaging Physicians and Leveraging Professionalism. JAMA 308: 979–80. - PubMed

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