Assessment of attitude towards professionalism in healthcare providers : validity study of Penn State college of medicine professionalism questionnaire (PSCOM) survey tool

Professionalism is an essential core value for the healthcare providers. In recent years patient—doctor relationship has taken a new dimension. Patients now, are more aware of their rights. At the same time they also demand for accountability of healthcare providers. In United States patients are considered as clients and physicians as service providers. Same trend is also noticed in Pakistan. This trend undermines human touch in healthcare delivery. Towards this end it is important to understand the attitude of healthcare providers towards professionalism. Penn State College of Medicine (PSCOM) questionnaire was developed in United States to assess the attitude of medical students and doctors towards professionalism. This study is aimed at finding validity of this questionnaire in Pakistani context. METHOD: The study was conducted at National Institute of Child Health, Jinnah Sindh Medical University Karachi. Participants included final year MBBS students, nurses and doctors. Sample size (n=360) was based upon the recommended ratio of 10 participants per item. A pilot study (n=30) was conducted to assess the appropriateness of the questionnaire to be used. Reliability analysis was done using Cronbach\u27s alpha and validity evidence was sought through exploratory factor analysis (EFA). RESULTS: Study participants included 120 medical students, 120 nurses and 120 doctors (faculty, residents and interns). Age of the participant and professional experience did not show significant correlation with each subscale score and overall score of the questionnaire under study. The responses by the participants lacked consistency in subscales. However, overall reliability of 36 items was 0.862. EFA showed emergence of ten factors against which items of PSCOM questionnaire were loaded. Of this only factor 1 had reliability of 0.751. With regards to validity, the items of the original PSCOM scale were loaded on different factors/ subscales. This may be due to regional, contextual and/ or cultural differences. CONCLUSION: The PSCOM questionnaire was found reliable however its validity based upon the responses of study participants did not achieve the required scores. There is a need to develop a tool which is applicable in Pakistani context