title: Feasibility, relevance and effectiveness of teaching and assessment of ethical status and communication skills as attributes of professionalism.
abstract: OBJECTIVE
  To examine the feasibility and effectiveness of teaching and assessing professionalism in a developing country.
  
  
  METHODS
  The pre-intervention and post-intervention study was conducted from January to August 2012 and comprised 7 workshops of three days each that were held at four teaching hospitals of Khyber Pakhtunkhwa province in Pakistan. Overall, there were 10 Objective Structured Clinical Examination stations and 10 written scenarios. After the pre-test, workshop was held on various aspects of professionalism which was considered 'intervention', and it was followed by a post-test similar to the pre-test at the end of day 3. Stata 12 was used for all statistical analyses.
  
  
  RESULTS
  There were 136 postgraduate residents in the study. The correlation between Objective Structured Clinical Examination stations and written exam for pre-test was 0.42 (p<0.001), while for post-test the correlation was 0.17(p=0.046). Correlation between pre-test written and post-test Objective Structured Clinical Examination stations was 0.23 (p=0.001), but the correlation between pre-test Objective Structured Clinical Examination stations and post-test written was not significant (p>0.05).The standardised effect size for the adjusted regression was 0.37 for both comparisons (p<0.001).Mean pre-test scores were 38.13+/-13.13% vs. 76.50+/-14.4%for the post-test score (p<0.001).
  
  
  CONCLUSIONS
  Although post-test scores increased significantly both for the Objective Structured Clinical Examination stations and the written scenarios, the former has shown a higher reliability compared to the written test. Furthermore, teaching and assessment of professionalism was found relevant, effective and feasible in resource-constrained countries. Teaching and assessment of professionalism has become globally relevant and is recommended to be included in the curricula of medical institutions.
authors.affiliation: Department of Medical Education, Postgraduate Medical Institute, Hayatabad, Peshawar, Pakistan.
authors.forename: Abid
authors.initials: A
authors.lastname: Jameel
authors.affiliation: Department of Medical Education, Postgraduate Medical Institute, Hayatabad, Peshawar, Pakistan.
authors.forename: Sahibzada Mahmood
authors.initials: SM
authors.lastname: Noor
authors.affiliation: Department of Medical Education, Postgraduate Medical Institute, Hayatabad, Peshawar, Pakistan.
authors.forename: Shahid
authors.initials: S
authors.lastname: Ayub
authors.affiliation: Department of Medical Education, Postgraduate Medical Institute, Hayatabad, Peshawar, Pakistan.
authors.forename: Sobia Sabir
authors.initials: SS
authors.lastname: Ali
authors.affiliation: Department of Medical Education, University of Illinois at Chicago, USA.
authors.forename: Yoon Soo
authors.initials: YS
authors.lastname: Park
authors.affiliation: Department of Medical Education, University of Illinois at Chicago, USA.
authors.forename: Ara
authors.initials: A
authors.lastname: Tekian
mesh_terms: D003142:Communication; D003906:Developing Countries; D004503:Education, Medical, Graduate / Q000379:methods*; D004992:Ethics, Medical / Q000193:education*; D005240:Feasibility Studies; D006801:Humans; D010154:Pakistan; D011361:Professional Competence; D000068616:Professionalism / Q000193:education*
keywords: Professionalism, Physician-patient relationship, Professional development, Postgraduate training, Curriculum development, OSCE, Pakistan, Developing countries.