Assessment of professionalism in undergraduate and graduate medical education: a scoping review

Professionalism is a cornerstone of medical education and forms a foundation for ethical healthcare. Its importance is often overlooked because of implicit teaching and inconsistent evaluations arising from a lack of standardized definitions and assessment tools. This scoping review aimed to map the literature on assessing professionalism in undergraduate and graduate medical education over the past decade, identify existing approaches, and highlight knowledge gaps.

This scoping review involved a systematic search of PubMed, Lilacs, Scopus, and Web of Science databases for peer-reviewed articles on professionalism in medical education from 2015 to 2025. After the screening process, two independent reviewers evaluated the data, and a third reviewer resolved any disagreements. The data were organized into tables and reported thematically.

A total of 584 articles were identified, 72 of which met the inclusion criteria. The definitions of professionalism vary, reflecting cultural and institutional differences. Teaching professionalism encompasses role modeling, structured programs, simulation, and evaluation. However, faculty commitment and resource limitations hinder consistency. Assessment tools like Professionalism Mini-Evaluation Exercise (P-MEX) offer valuable insights but face implementation challenges. Teacher feedback is one of the most commonly used and effective strategies to develop professionalism. Teaching and assessment face challenges such as the lack of standardized definitions, time constraints, cultural resistance, and inconsistencies in evaluators' judgments. Institutional support and validated tools are essential to address these barriers.

Professionalism is essential to medical education, but it faces challenges in defining, teaching, and assessing. Therefore, a standardized yet adaptable definition that considers cultural factors is required. Current assessment methods are subjective, and implementation can be problematic. Evaluating professionalism requires balancing standardization, context, and meaningful feedback. Longitudinal, multi-source, and modern strategies enhance reliability. Future research should validate new methods, explore innovative feedback, and prioritize professionalism in competency-based medical education.