{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:48:53Z","timestamp":1792788533443,"version":"4.5.0"},"reference-count":46,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"School of Liberal Arts and Natural Sciences, University of Birmingham","id":[{"id":"https:\/\/ror.org\/03angcq70","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["mededpublish.org"],"crossmark-restriction":false},"short-container-title":["MedEdPublish"],"abstract":"<ns5:p>Background In 2019, an International Working Group on the Assessment of Professionalism (IWGAP) identified a lack of patient voice in the literature relating to assessment of professionalism. This study sought to gather public perspectives on professionalism and associated methods for assessment. Methods A mixed-method study was conducted to understand public perceptions of healthcare student professionalism and how these perceptions might inform future assessment practices. One hundred street surveys with members of the public were analysed and results were used as stimuli during two focus groups with simulated patients (SPs). Focus-group data were analysed in an iterative process to identify themes. Results While 97% of survey respondents were in favour of assessing professionalism for undergraduate healthcare students, preferences for formal or informal assessments varied. \u2018Benevolence\u2019 and \u2018competence\u2019 were considered key components of professionalism, with \u2018Showing respect for patients and colleagues\u2019 ranked as the most important aspect. Seven focus-group themes were identified: presentation, attitudes and values, patient relationship and centredness, trustworthiness, timekeeping, knowledge, and formality and mode of assessment. Conclusions While the public recognises the need to assess professionalism, healthcare programmes should re-assess the focus of examinations, which might prioritise aspects of professionalism deemed less important by patients.<\/ns5:p>","DOI":"10.12688\/mep.21119.1","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T16:20:08Z","timestamp":1760372408000},"page":"206","update-policy":"https:\/\/doi.org\/10.12688\/mep.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Public and Simulated Patient voice in the assessment of professionalism on healthcare degree programmes"],"prefix":"10.12688","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4466-8443","authenticated-orcid":false,"given":"Jonathan D. T.","family":"Ward","sequence":"first","affiliation":[{"name":"Interactive Studies Unit Birmingham B15 2TT University of Birmingham College of Medicine and Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose W. 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Cruess","year":"2009"},{"key":"ref-14","doi-asserted-by":"publisher","first-page":"34-37","DOI":"10.51846\/jucmd.v3i1.2808","article-title":"Assessing professionalism among first year medical students through Professionalism Assessment Tool (PAT).","volume":"3","author":"N Farasat","year":"2023","journal-title":"JUCMD."},{"key":"ref-15","doi-asserted-by":"publisher","first-page":"e952-e956","DOI":"10.3109\/0142159X.2012.714888","article-title":"Assessment of professionalism: a consolidation of current thinking.","volume":"35","author":"J Goldie","year":"2013","journal-title":"Med Teach."},{"key":"ref-16","doi-asserted-by":"publisher","first-page":"226-235","DOI":"10.1001\/jama.287.2.226","article-title":"Defining and assessing professional competence.","volume":"287","author":"R Epstein","year":"2002","journal-title":"JAMA."},{"key":"ref-17","article-title":"Professionalism in healthcare 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Med."},{"key":"ref-38","doi-asserted-by":"publisher","first-page":"960-967","DOI":"10.1111\/j.1365-2923.2009.03453.x","article-title":"Peer estimation of lack of professionalism correlates with low conscientiousness index scores.","volume":"43","author":"G Finn","year":"2009","journal-title":"Med Educ."},{"key":"ref-39","doi-asserted-by":"publisher","first-page":"1218-1224","DOI":"10.1097\/ACM.0b013e3182628499","article-title":"The clinical conscientiousness index: a valid tool for exploring professionalism in the clinical undergraduate setting.","volume":"87","author":"M Kelly","year":"2012","journal-title":"Acad Med."},{"key":"ref-40","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1001\/jamainternmed.2019.0152","article-title":"Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis.","volume":"179","author":"M Panagioti","year":"2019","journal-title":"JAMA Intern Med."},{"key":"ref-41","doi-asserted-by":"publisher","first-page":"317-328","DOI":"10.11111\/jkana.2019.25.4.317","article-title":"Relationship among nursing professionalism, nursing work environment, and patient safety nursing activities in general hospital nurses.","volume":"25","author":"M Lee","year":"2019","journal-title":"J Korean Acad Nurs Adm."},{"key":"ref-42","doi-asserted-by":"publisher","first-page":"249-255","DOI":"10.1080\/0142159X.2018.1543862","article-title":"Assessment of professionalism: From where have we come \u2013 to where are we going? An update from the ottawa consensus group on the assessment of professionalism.","volume":"41","author":"B Hodges","year":"2019","journal-title":"Med Teach."},{"key":"ref-43","doi-asserted-by":"publisher","first-page":"354-363","DOI":"10.3109\/0142159X.2011.577300","article-title":"Assessment of professionalism: recommendations from the Ottawa 2010 conference.","volume":"33","author":"B Hodges","year":"2011","journal-title":"Med Teach."},{"key":"ref-47","article-title":"Successful qualitative research.","author":"V Clarke","year":"2013"},{"key":"ref-49","doi-asserted-by":"publisher","first-page":"1573-1588","DOI":"10.1016\/s0277-9536(98)00222-6","article-title":"A systematic review of the literature on patient priorities for general practice care. 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Dali Chitaishvili M.D., PhD., Tbilisi State Medical University, Tbilisi, 08 Nov 2025, version 1, indexed","URL":"https:\/\/mededpublish.org\/articles\/15-206\/v1#referee-response-43927","order":0,"name":"referee-response-43927","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/mep.22623.r44454, Mohd Faizan Siddiqui, Osh State University, Osh, Osh Region, 24 Dec 2025, version 1, indexed","URL":"https:\/\/mededpublish.org\/articles\/15-206\/v1#referee-response-44454","order":1,"name":"referee-response-44454","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/mep.22623.r45509, Magnus Hultin, Ume\u00e5 universitet, Ume\u00e5, 13 Oct 2026, version 1, indexed","URL":"https:\/\/mededpublish.org\/articles\/15-206\/v1#referee-response-45509","order":2,"name":"referee-response-45509","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Research costs were funded by the School of Liberal Arts and Natural Sciences, University of Birmingham, Birmingham, UK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}