Defining competency-based evaluation objectives in family medicine: professionalism.

Objective: To develop and describe observable evaluation objectives for assessing competence in professionalism, which are grounded in the experience of practising physicians.

Design: Modified nominal group technique.

Setting: The College of Family Physicians of Canada in Mississauga, Ont.

Participants: An expert group of 7 family physicians and 1 educational consultant, all of whom had experience in assessing competence in family medicine. Group members represented the Canadian context with respect to region, sex, language, community type, and experience.

Methods: Using an iterative process, the expert group defined a list of observable behaviours that are indicative of professionalism, or not, in the family medicine setting. Themes relate to professional behaviour in family medicine; specific observable behaviours are those that family physicians believe are indicative of professionalism for each theme.

Main Findings: The expert group identified 12 themes and 140 specific observable behaviours to assist in the observation and discussion of professional behaviour in family medicine workplace settings.

Conclusion: Competency-based education literature emphasizes the importance of formative evaluation and feedback. Such feedback is particularly challenging in the domain of professionalism because of its personal nature and the potential for emotional reactions. Effective dialogue between learners and teachers begins with clear expectations and reference to descriptions of relevant, specific behaviour. This research has generated a competency-based resource to assist the assessment of professional behaviour in family medicine educational programs.