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Not showing up to mandatory teaching sessions has big implications! Kelly M et al. The Clinical Conscientiousness Index: A valid tool for exploring professionalism in the clinical undergraduate setting. Academic Medicine 2012;87(9):1218-­1224.

Reviewed by Karen Forbes

What was the study question?
Is a Clinical Conscientiousness Index (CCI) a valid proxy measure of professionalism in the undergraduate clinical setting?

How was the study done?
This study was conducted at University College Cork, Ireland, in follow-­‐up to a study that showed that a Conscientiousness Index (CI) could be used as a valid proxy measure of professionalism in pre-­‐clinical students. To determine students' CCI, data was collected on multiple factors: attendance at mandatory teaching sessions and summative exams (OSCEs), timeliness of assessment submissions, completion of rotation evaluations, receipt of an "alert" (for flagrantly poor behavior) at an OSCE, late online registration for the third year course, and other behaviors such a failure to adhere to dress code, failure to respond to repeated faculty emails or attending learning sessions in an unfit state. Students began with a baseline score of 50, and gained or lost points throughout the year; the final CCI was determined as a percentage of the overall maximum score obtained. Once the CCI was calculated, the authors evaluated the correlation of the index in relation to 1) faculty judgments on professionalism, 2) portfolio assessment and 3) OSCE scores.

What were the results?
Data were collected from 124 third year undergraduate medical students. There was a significant relationship (of medium effect size) between the CCI and faculty judgments on professionalism and between the CCI and OSCE performance, but not between the CCI and portfolio marks.

What are the implications of these findings?
Professionalism is a complex construct that is not captured by any single measure. A CCI may serve as an adjunctive tool assessing students. Since most of the data is easily and routinely collected, this tool is relatively easy to use.
Editor's note: This well-­‐done, well-­‐written, study adds an important element to the professionalism literature. That a simple, concrete measure of conscientiousness correlates so well with faculty perceptions of a student's professionalism is fascinating (SLB).

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