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In Reply: In response to Drs Peeters and Beltyukova, we recognize that an individual's position along constructs like depression and professionalism is often inferred by measuring (with psychological tests) the person's behaviors; nevertheless, these measurements are often sufficient to test psychological theories.¹ Moreover, measurements become less arbitrary when scores are linked to meaningful events in the lives of respondents,¹ as in our study that demonstrated associations between residents' professionalism scores and fundamental markers of residents' performance, including medical knowledge, clinical skills, and conscientious behaviors.

Peeters and Beltyukova argue that all measurements, including those of professionalism, should be unidimensional. There is a distinction between the multidimensional nature of professionalism and our study methods. The prevailing model for measuring professionalism requires the triangulation of professionalism assessments by multiple observers in realistic contexts over time.² Consequently, our outcome measure comprised professionalism scores assigned by peers, senior residents, faculty, medical students, and nonphysician professionals . . . [Full Text of this Article]

Darcy A. Reed, MD, MPH
reed.darcy@mayo.edu

Colin P. West, MD, PhD; Thomas J. Beckman, MD
Department of Internal Medicine
Mayo Clinic College of Medicine
Rochester, Minnesota

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