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To the Editor: In their study of behaviors of highly professional resident physicians, Dr Reed and colleagues¹ attempted to measure professionalism using instrument items they describe as reflecting the best practices in professionalism measurement. However, we believe that a consideration of measurement requirements and useful measure construction is warranted.

Measures are useful when they are unidimensional and linear and use a standard unit of measurement repeated throughout the measurement continuum.² A tape measure is an example of such measures; length or width is measured separately on a linear equal-interval scale using a standard unit (inches or centimeters). These measurement requirements, which are needed in both physical and social sciences, appear violated in the professionalism measurement developed in the study by Reed et al.

Unidimensional measures capture one dimension at a time. Unidimensionality reflects an instrument's intent for use with a single construct. Measuring one dimension at a time allows for . . . [Full Text of this Article]

Michael J. Peeters, PharmD
michael.peeters@utoledo.edu
College of Pharmacy

Svetlana Beltyukova, PhD
College of Education
University of Toledo
Toledo, Ohio

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Behaviors of Highly Professional Resident Physicians
Darcy A. Reed, Colin P. West, Paul S. Mueller, Robert D. Ficalora, Gregory J. Engstler, and Thomas J. Beckman
JAMA. 2008;300(11):1326-1333.
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Measuring Professionalism in Resident Physicians—Reply
Darcy A. Reed, Colin P. West, and Thomas J. Beckman
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