Deontological competence as an integral component of a doctor's professionalism: development and validation of a diagnostic tool

In modern medicine, there remains a methodological gap between formal knowledge of these principles and the doctor's ability to apply them in difficult situations of clinical practice. The competence-based approach in education is insufficiently focused on the formation of this integrative ability. The present study aims to overcome this deficit by developing and validating an original questionnaire that measures the deontological competence of a doctor as an integral socio-psychological phenomenon. Based on the Code of Professional Ethics of a Doctor of the Russian Federation, 15 situational tasks were developed that simulate typical deontological dilemmas. Psychometric validation was performed on a representative sample (n=351). An expert assessment of the questions was carried out, the reliability of the test was determined. The formula for determining the general level of deontological competence of a doctor is presented. The pragmatic and substantive validity of the questionnaire was also established, which led to the conclusion that the deontological competence of a doctor is a complex characteristic that integrates cognitive, motivational, reflexive and communicative components of professional activity focused on ethical standards of medicine.  The results confirm that the technique has high differentiating properties and is sensitive to the stages of professional development. Thus, the questionnaire is the first psychometrically based domestic tool that comprehensively evaluates deontological competence. Its introduction into scientific and educational practice opens up opportunities for diagnosis, monitoring and targeted development of the ethical component of a doctor's professionalism, which creates the basis for improving the quality of ethical training. In modern medicine, there remains a methodological gap between formal knowledge of these principles and the doctor's ability to apply them in difficult situations of clinical practice. The competence-based approach in education is insufficiently focused on the formation of this integrative ability. The present study aims to overcome this deficit by developing and validating an original questionnaire that measures the deontological competence of a doctor as an integral socio-psychological phenomenon. Based on the Code of Professional Ethics of a Doctor of the Russian Federation, 15 situational tasks were developed that simulate typical deontological dilemmas. Psychometric validation was performed on a representative sample (n=351). An expert assessment of the questions was carried out, the reliability of the test was determined. The formula for determining the general level of deontological competence of a doctor is presented. The pragmatic and substantive validity of the questionnaire was also established, which led to the conclusion that the deontological competence of a doctor is a complex characteristic that integrates cognitive, motivational, reflexive and communicative components of professional activity focused on ethical standards of medicine.  The results confirm that the technique has high differentiating properties and is sensitive to the stages of professional development. Thus, the questionnaire is the first psychometrically based domestic tool that comprehensively evaluates deontological competence. Its introduction into scientific and educational practice opens up opportunities for diagnosis, monitoring and targeted development of the ethical component of a doctor's professionalism, which creates the basis for improving the quality of ethical training.

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