title: Factors inhibiting assessment of students' professional behaviour in the tutorial group during problem-based learning.
abstract: BACKGROUND
  We addressed the assessment of professional behaviour in tutorial groups by investigating students' perceptions of the frequency and impact of critical incidents that impede this assessment and 5 factors underlying these critical incidents.
  
  
  METHODS
  A questionnaire asking students to rate the frequency and impact of 40 critical incidents relating to effective assessment of professional behaviour on a 5-point Likert scale was developed and sent to all undergraduate medical students in Years 2-4 of a 6-year undergraduate curriculum.
  
  
  RESULTS
  The response rate was 70% (n = 393). Important factors underlying critical incidents are: lack of effective interaction; lack of thoroughness; tutors' failure to confront students with unprofessional behaviour; lack of effort to find solutions, and lack of student motivation. Confirmatory factor analysis showed a good model fit. Because the relationship between frequency of occurrence and degree of impediment varies, the best information about the true impact of critical incidents and the underlying factors is provided by the product of frequency and degree of impediment. Frequency of occurrence remains stable and degree of impediment increases in Years 2-4.
  
  
  CONCLUSIONS
  The results of this study can be used to design and improve faculty development programmes aimed at improving assessment of professional behaviour. Training programmes should motivate tutors by providing background information as to why and how sound assessment of professional behaviour is to be performed and encourage tutors to confront students with and discuss all aspects of professional behaviour, as well as provide appropriate feedback.
authors.affiliation: Department of Intensive Care and Internal Medicine, University Hospital Maastricht, Maastricht, The Netherlands. wvm@sint.azm.nl
authors.forename: Walther N K A
authors.initials: WN
authors.lastname: van Mook
authors.forename: Willem S
authors.initials: WS
authors.lastname: de Grave
authors.forename: Elise
authors.initials: E
authors.lastname: Huijssen-Huisman
authors.forename: Marianne
authors.initials: M
authors.lastname: de Witt-Luth
authors.forename: Diana H J M
authors.initials: DH
authors.lastname: Dolmans
authors.forename: Arno M M
authors.initials: AM
authors.lastname: Muijtjens
authors.forename: Lambert W
authors.initials: LW
authors.lastname: Schuwirth
authors.forename: Cees P M
authors.initials: CP
authors.lastname: van der Vleuten
mesh_terms: D001291:Attitude of Health Personnel; D003479:Curriculum; D004504:Education, Medical, Undergraduate; D006126:Group Processes; D006801:Humans; D009426:Netherlands; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D018794:Problem-Based Learning; D011361:Professional Competence / Q000592:standards*; D013337:Students, Medical