Assessment of the medical professionalism climate in the inpatient units of a teaching hospital affiliated with Iran university of medical sciences (2023-2024)
Abstract
Professionalism impacts professional identity, staff efficiency, and patient care quality. The purpose of this study was to evaluate the professional behavior and climate in a teaching hospital in Iran. A cross-sectional study was performed among faculty members, nursing staff, and specialized residents. The study used the validated 30-item "Medical Professionalism Climate in Clinical Settings" questionnaire developed by Asghari et al., containing two domains: adherence to professional behavior, and perceptions of the professional climate. Data were analyzed using SPSS version 26. The study population consisted of 271 individuals working at a teaching hospital, 44.3% male and 55.7% female, averaging 34.79 years in age.The results showed there was a relationship between the total mean score, the professional behavior score, the professional climate score, and the participants' professional titles (P-value < 0.001), as well as the duration of their work experience in the department (P-value: 0.005, P-value: 0.039, P-value: 0.001, respectively). The faculty members achieved the best scores, followed by the residents, nurses, and nursing assistants. Analysis of the professional behavior scores revealed strengths and weaknesses among the medical staff. More training is recommended to enhance skills and promote positive behavior to boost hospital staff's job satisfaction and sense of belonging.
- Hoobehfekr S, Asghari F, Sayarifard A, Kadivar M, Kashefinejad S. Medical students' perception of professionalism climate in clinical settings. J Med Ethics Hist Med. 2021; 14: 10. doi: 10.18502/jmehm.v14i10.7238.
- Blank L, Kimball H, McDonald W, Merino J; ABIM Foundation; ACP Foundation; European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter 15 months later. Ann Intern Med. 2003; 138(10): 839-41. doi: 10.7326/0003-4819-138-10-200305200-00012.
- Asghari F, Shahvari Z, Ebadi A, et al. Developing and validating an instrument to measure: the medical professionalism climate in clinical settings. J Med Ethics Hist Med. 2021; 14: 11. doi: 10.18502/jmehm.v14i11.7666.
- Gillespie C, Paik S, Ark T, Zabar S, Kalet A. Residents' perceptions of their own professionalism and the professionalism of their learning environment. J Grad Med Educ. 2009; 1(2): 208-15. doi: 10.4300/JGME-D-09-00018.1.
- Yilmaz ND, Velipasaoglu S, Ozan S, et al. A multicenter study: how do medical students perceive clinical learning climate? Med Educ Online. 2016; 21: 30846. doi: 10.3402/meo.v21.30846.
- Emilia O, Suhoyo Y, Utomo PS. Teacher as role model in developing professional behavior of medical students: a qualitative study. Int J Med Educ. 2023; 14: 55-62. doi: 10.5116/ijme.6443.ae49.
- Quaintance JL, Arnold L, Thompson GS. Development of an instrument to measure the climate of professionalism in a clinical teaching environment. Acad Med. 2008; 83(10 Suppl): S5-8. doi: 10.1097/ACM.0b013e318183e3d4.
- Girotto LC, Machado KB, Moreira RFC, Martins MA, Tempski PZ. Impacts of the Accreditation Process for Undergraduate Medical Schools: A Scoping Review. Clin Teach. 2025; 22(2): e70031. doi: 10.1111/tct.70031.
- Aziz AB, Ali SK. Relationship between level of empathy during residency training and perception of professionalism climate. BMC Med Educ. 2020; 20(1): 320. doi: 10.1186/s12909-020-02231-0.
- Brazeau CM, Schroeder R, Rovi S, Boyd L. Relationships between medical student burnout, empathy, and professionalism climate. Acad Med. 2010; 85(10 Suppl): S33-6. doi: 10.1097/ACM.0b013e3181ed4c47.
- Guraya SY, Sulaiman N, Guraya SS, et al. Understanding the climate of medical professionalism among university students; A multi-center study. Innovations in Education and Teaching International. 2021; 58(3): 351-60. doi: 10.1080/14703297.2020.1751237.
- Eghbali F, Seyedpour SM, Pazouki A, Hosseini-Baharanchi FS. Professionalism in Residents of Iran University of Medical Sciences Hospitals and its Associated Factors. Iranian Journal of Surgery. 2017; 25(3): 45-53. [in Persian]
- Farhadi A, Elahi N, Jalali R. The effect of professionalism on the professional communication between nurses and physicians: A phenomenological study. J Nurs Midwifery Sci. 2016; 3(3): e141224. doi: 10.18869/acadpub.jnms.3.3.18.
- Singh PK, Singh S, Ahmad S, Singh VK, Kumar R. Navigating power dynamics and hierarchies in medical education: Enhancing faculty experiences and institutional culture. J Postgrad Med. 2025;71(2):82-90. doi: 10.4103/jpgm.jpgm_728_24.
- Salehi PP, Jacobs D, Suhail-Sindhu T, Judson BL, Azizzadeh B, Lee YH. Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology. Otolaryngol Head Neck Surg. 2020; 163(5):906-914. doi: 10.1177/0194599820926105.
- Beus JM, Bergman ME, Payne CS. The influence of organizational tenure on safety climate strength: A first look. Accident Analysis & Prevention. 2010; 42(5): 1431-1437. doi: 10.1016/j.aap.2009.06.002.
- Zhenjing G, Chupradit S, Ku KY, Nassani AA, Haffar M. Impact of Employees' Workplace Environment on Employees' Performance: A Multi-Mediation Model. Front Public Health. 2022; 10:890400. doi: 10.3389/fpubh.2022.890400.
- Cang X. Vining in the Blind: The Perils of Survivorship Bias. Advances in Economics, Management and Political Sciences. 2024; 72. doi: 10.54254/2754-1169/72/20240675.
- Parsa M. Medicine and patients' privacy. IJMEHM 2009; 2(4): 1-14. [in Persian]
- Petrilli CM, Saint S, Jennings JJ, Caruso A, Kuhn L, Snyder A, Chopra V. Understanding patient preference for physician attire: a cross-sectional observational study of 10 academic medical centres in the USA. BMJ Open. 2018; 8(5): e021239. doi: 10.1136/bmjopen-2017-021239.
- Kim J, Ba Y, Kim JY, Youn BY. Patient perception of physician attire: a systematic review update. BMJ Open. 2025; 15(8): e100824. doi: 10.1136/bmjopen-2025-100824.
- Paterick TJ, Carson GV, Allen MC, Paterick TE. Medical informed consent: general considerations for physicians. Mayo Clin Proc. 2008; 83(3): 313-9. doi: 10.4065/83.3.313.
- Addis BA, Gelaw YM, Eyowas FA, Bogale TW, Aynalem ZB, Guadie HA. "Time wasted by health professionals is time not invested in patients": time management practice and associated factors among health professionals at public hospitals in Bahir Dar, Ethiopia: a multicenter mixed method study. Front Public Health. 2023; 11:1159275. doi: 10.3389/fpubh.2023.1159275.
- James KA, Ross SE, Vance B, Nath R, Harrison MI, West DR. INEFFICIENCY IN PRIMARY CARE: Common Causes and Potential Solutions. Available fromhttps://www.aafp.org/pubs/fpm/issues/2015/0300/p18.pdf (Accessed on 2025).
- Keane D, Harman-Jones B, Khalid O, Hakeem S, Sarfraz MA. The way doctors dress: stakeholder preferences and the impact on their perceptions. British Journal of Medical Practitioners. 2019; 12(3): a018.
- Hansson SO, Fröding B. Ethical conflicts in patient-centred care. Clinical Ethics. 2021; 16(2): 55-66. doi:10.1177/1477750920962356.
- Porter ME, Lee TH. The Strategy That Will Fix Health Care. Harvard Business Review. 2013; 91(10): 50-70.
- Bhati D, Deogade MS, Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus. 2023; 15(10): e47731. doi: 10.7759/cureus.47731.
- Kluge EH. Resource allocation in healthcare: implications of models of medicine as a profession. MedGenMed. 2007; 9(1): 57.
- Hossny EK, Sabra HE. Effect of nurses' perception to workplace civility climate on nurse-physician collaboration. Nurs Open. 2021; 8(2): 620-627. doi: 10.1002/nop2.666.
- an Dael J, Reader TW, Gillespie A, Neves AL, Darzi A, Mayer EK. Learning from complaints in healthcare: a realist review of academic literature, policy evidence and front-line insights. BMJ Qual Saf. 2020; 29(8): 684-695. doi: 10.1136/bmjqs-2019-009704.
- Mistri IU, Badge A, Shahu S. Enhancing Patient Safety Culture in Hospitals. Cureus. 2023; 15(12): e51159. doi: 10.7759/cureus.51159.
- Yang T, Jiang X. When colleague got recognized: Third-party's reaction to witnessing employee recognition. Front Psychol. 2023; 14: 968782. doi: 10.3389/fpsyg.2023.968782.
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Issue | Vol 18 (2025) | |
Section | Original Article(s) | |
Keywords | ||
Professionalism; Professional behavior; Professional climate; Iran; Medical ethics. |
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