East Meets West: Evidence for Validity for the China Medical Professionalism Inventory

Abstract

Abstract The characteristics of medical professionalism (MP) vary across cultural contexts. Theories of professionalism and MP tools currently rely on Western cultural perspectives. The authors developed the China Medical Professionalism Inventory (CMPI) using standard processes through four steps: Phase I) systematic review and synthesis of the literature to develop an item pool; Phase II) survey of Chinese clinical and educational experts to develop evidence based on test content; Phase III) two rounds of pilot studies of practicing physicians to measure internal structure and internal consistency; and Phase IV) refinement of the instrument using an expert survey and pilot study. Systematic review of the English- and Chinese-language literature identified 1537 professionalism-specific items from 63 sources as foundation of the item pool. The authors conducted two rounds of expert review, including surveying nationally prominent Chinese healthcare leaders (n = 34, response rate 85%, and n = 76, response rate 63%). The authors conducted three pilot studies of practicing Chinese physicians (n = 360, response rate 92%; n = 3653, response rate 89%; and n = 955, response rate 95%). The results generated a 40-item CMPI and a shortened 20-item CMPI, with four domains “Respect, Compassion, and Communication; Integrity; Excellence; and Responsibility.” Applying the standards of Messick, the American Psychological Association, and Kane, the authors present the CMPI's validity evidence related to content, response process, internal structure, relationship to other variables, and consequences. This study aims to extend the conceptualization and reach of MP measurement.