Volume 11, Issue 4 (2023)                   Health Educ Health Promot 2023, 11(4): 561-568 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Abdi N, Ghanei Gheshlagh R, Kolahdozan M, Rahmani K, Rezaei M, Vahedi S, et al . Development and Validation of the Ethical Behavior Intention Scale for Medical Students Based on the Theory of Planned Behavior. Health Educ Health Promot 2023; 11 (4) :561-568
URL: http://hehp.modares.ac.ir/article-5-69976-en.html
1- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
2- Department of Nursing, Faculty of Nursing, Kurdistan University of Medical Sciences, Sanandaj, Iran
3- Vice Chancellor for Student and Cultural Affairs, Kurdistan University of Medical Sciences, Sanandaj, Iran
4- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
5- Department of Anatomical Sciences, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
6- Department of Cardiology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
7- Department of Biology and Vector Control, School of Health, Ilam University of Medical sciences, Ilam, Iran
Abstract:   (372 Views)
Aims: Professionalism encompasses clinical competence, communication skills, and ethical and legal awareness. The assessment of professional ethics varies among different groups based on their characteristics. This study aimed to develop and validate an ethical behavior intention instrument for medical students, based on the theory of planned behavior.
Instrument & Methods: In this cross-sectional study, an item pool was generated based on an extensive literature review. Then, psychometric features, such as face validity (qualitative and quantitative), content validity (qualitative and quantitative), item analysis, and construct validity (exploratory factor analysis) were evaluated. Finally, the reliability was assessed using internal consistency (Cronbach's alpha).
Findings: A total of 200 medical students filled out the questionnaires, with a mean age of 21.84±4.47 years. In face validity, content validity ratio, and item analysis, six, nine, and three items were removed, respectively. In the exploratory factor analysis, six factors of gaining informed consent, accepting role limitations and collaborating with the treatment team, respect for colleagues and professors, abstract norms, perceived behavior control, and respect for patient values, needs, and culture together explained 51.128% of the total variance. Moreover, seven items were not included in any factor. The internal consistency of the entire questionnaire and its dimensions was acceptable.
Conclusion: The ethical behavior intention scale, which is designed based on the theory of planned behavior, is a valid and reliable scale that covers and measures the standards of professional ethics in medical students.
Full-Text [PDF 738 kb]   (254 Downloads) |   |   Full-Text (HTML)  (13 Views)  
Article Type: Descriptive & Survey | Subject: Spiritual Health
Received: 2023/07/21 | Accepted: 2023/11/4 | Published: 2023/11/18
* Corresponding Author Address: Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Pasdaran Boulevard, Sanandaj, Iran. Postal Code: 66177-13446 (yadzar2014@gmail.com)

1. Farastkhah M. The role of academic ethics in promotion of higher education. J Ethics Behav. 2007;27(1):24-7. [Persian] [Link]
2. Fasihi Harandy T, Soltani Arabshahi K. A survey of input and process of clinical education in Iran University of Medical Sciences. Payesh. 2003;2(2):127-32. [Persian] [Link]
3. Andersson H, Svensson A, Frank C, Rantala A, Holmberg M, Bremer A. Ethics education to support ethical competence learning in healthcare: An integrative systematic review. BMC Med Ethics. 2022;23(1):29. [Link] [DOI:10.1186/s12910-022-00766-z]
4. Pellegrino ED, Thomasma DC. The virtues in medical practice. Oxford: Oxford University Press; 1993. [Link] [DOI:10.1093/oso/9780195082890.001.0001]
5. Bagheri A. Priorities of medical ethics: Results of a national study. J Med Ethics Hist Med. 2010;4(5):39-48. [Persian] [Link]
6. Pauli HG. White KL, McWhinney IR. Medical education, research, and scientific thinking in the 21st century (part one of three). Educ Health. 2000;13(1):15-25. [Link] [DOI:10.1080/135762800110538]
7. Martins VSM, Nogueira Costa Santos CM, Bataglia PUR, Figueiredo Duarte IMR. The teaching of ethics and the moral competence of medical and nursing students. Health Care Anal. 2021;29:113-26. [Link] [DOI:10.1007/s10728-020-00401-1]
8. Boudoulas KD, Geleris P, Boudoulas H. Medical education: eternal values. Hellenic J Cardiol, 2012;53(3):173-8. [Link]
9. Golparvar M. The relationship between ethics and justice education with the avoidance of deception. Ethics Sci Technol. 2010;5(2-1):57-66. [Persian] [Link]
10. Miori VM, Doyle KA, Campbell K. Gender differences in academic ethics with recommendations for curricular change. J Coll Teach Learn (TLC). 2011;8(3). [Link] [DOI:10.19030/tlc.v8i3.4120]
11. Alipourdarvish Z, Dolatabadi R. Offering a model on factors affecting physicians' knowledge-sharing intention based on the theory of planned behavior in teaching hospitals affiliated to Tehran University of Medical Sciences. Hosp J. 2013;11(4):35-44. [Persian] [Link]
12. Ajzen I, Fishbein M. Understanding attitudes and predictiing social behavior. London: Pearson; 1980. [Link]
13. Shakour M., Badrian M. Assessment of professionalism between medical students in clinical situations. Int J Med Invest. 2015;4(2):199-207. [Link]
14. Kwan Y, Png K, Phang JK, Leung YY, Goh H, Seah Y, et al. A systematic review of the quality and utility of observer-based instruments for assessing medical professionalism. J Grad Med Educ. 2018;10(6):628-38. [Link] [DOI:10.4300/JGME-D-18-00086.1]
15. Lacasse Y, Godbout C, Series F. Health-related quality of life in obstructive sleep apnoea. Eur Respir J. 2002;19(3):499-503. [Link] [DOI:10.1183/09031936.02.00216902]
16. Bolarinwa OA. Principles and methods of validity and reliability testing of questionnaires used in social and health science researches. Niger Postgrad Med J. 2015;22(4):195-201. [Link] [DOI:10.4103/1117-1936.173959]
17. Lawshe CH. A quantitative approach to content validity. Personnel Psychol. 1975;28(4):563-75. [Link] [DOI:10.1111/j.1744-6570.1975.tb01393.x]
18. Lenz ER. Measurement in nursing and health research. New York: Springer Publishing; 2010. [Link]
19. Polit DF, Beck CT. The content validity index: Are you sure you know what's being reported? Critique and recommendations. Res Nurs Health. 2006;29(5):489-97. [Link] [DOI:10.1002/nur.20147]
20. Boateng GO, Neilands TB, Frongillo EA, Melgar-Quiñonez HR, Young SL. Best practices for developing and validating scales for health, social, and behavioral research: A primer. Frontiers Public Health. 2018;6:149. [Link] [DOI:10.3389/fpubh.2018.00149]
21. DeVellis RF. Scale development: theory and applications. New York: SAGE Publications; 2003. [Link]
22. Mundfrom DJ, Shaw DG, Ke TL. Minimum sample size recommendations for conducting factor analysis. Int J Test. 2005;5(2):159-68. [Link] [DOI:10.1207/s15327574ijt0502_4]
23. Munro BH. Statistical methods for health care research. Philadelphia: Lippincott Williams & Wilkins; 2005. [Link]
24. Shrestha N. Factor analysis as a tool for survey analysis. Am J Appl Mathematics Statistics. 2021;9(1):4-11. [Link] [DOI:10.12691/ajams-9-1-2]
25. Nunnally JC. Psychometric theory-25 years ago and now. Educ Res. 1975;4(10):7-21. [Link] [DOI:10.3102/0013189X004010007]
26. Nia HS, Ebadi A, Lehto RH, Mousavi B, Peyrovi H, Chan YH. Reliability and validity of the persian version of templer death anxiety scale-extended in veterans of Iran-Iraq warfare. Iran J Psychiatry Behav Sci. 2014;8(4):29-37. [Link]
27. Osborne JW. Best practices in quantitative methods. New York: SAGE Publications; 2008. [Link] [DOI:10.4135/9781412995627]
28. Vakili MM, Hidarnia AR, Niknami S. Development and psychometrics of an interpersonal communication skills scale (ASMA) among Zanjan health volunteers. Hayat. 2012;18(1):5-19. [Persian] [Link]
29. Smith RC, Dorsey AM, Lyles JS, Frankel RM. Teaching self-awareness enhances learning about patient-centered interviewing. Acad Med: J Assoc Am Med Coll. 1999;74(11):1242-8. [Link] [DOI:10.1097/00001888-199911000-00020]
30. Rees CE, Knight LV. The trouble with assessing students' professionalism: Theoretical insights from sociocognitive psychology. Acad Med. 2007;82(1):46-50. [Link] [DOI:10.1097/01.ACM.0000249931.85609.05]
31. Taghaddosinejad F, Akhlaghi M, Yaghmaei A, Hojjati A. A survey of obtaining informed consent and acquit from admitted patients in Emam Khomeini hospital. Iran J Forensic Med. 2008;14(1):12-7. [Persian] [Link]
32. Silva MC. Competency, comprehension, and the ethics of informed consent. Nursingconnections. 1993;6(3):47-51. [Link]
33. Parsapour A, Parsapour MB, Larijani B. Informed consent, contents, conditions and practical methods. Iran J Diabetes Metabolism. 2005;5:1-14. [Perisan] [Link]
34. Pier M. Medical ethics: Patients' rights. In: Khazanedari S translator. Tehran: Education Development Center of Shaheed Beheshti University of Medical Sciences; 2003. p. 81-93. [Persian] [Link]
35. Simon CM, et al. Comparison of the informed consent process for randomized clinical trials in pediatric and adult oncology. J Clin Oncol. 2004;22(13):2708-17. [Link] [DOI:10.1200/JCO.2004.10.034]
36. Amini M, Moosavi SM, Mohammadnejad SM. The informatory of the inpatients' informed consent: A survey in selected hospitals. Iran J Med Ethics History Med. 2009;2(3):61-70. [Persian] [Link]
37. Association AM. AMA code of ethics 2004. Editorially revised 2006. Revised 2016. Canberra: Australian Medical Association; 2004. p. 20. [Link]
38. Klemenc-Ketis Z, Vrecko H. Development and validation of a professionalism assessment scale for medical students. Int J Med Educ. 2014;5:205-11. [Link] [DOI:10.5116/ijme.544b.7972]
39. Aramesh K, Mohebbi M, Jessri M, Sanagou M. Measuring professionalism in residency training programs in Iran. Med Teach. 2009;31(8):e356-61. [Link] [DOI:10.1080/01421590802638022]
40. Arnold EL, Blank LL, Race KE, Cipparrone N. Can professionalism be measured? The development of a scale for use in the medical environment. Acad Med. 1998;73(10):1119-21. [Link] [DOI:10.1097/00001888-199810000-00025]
41. Blackall GF, Melnick SA, Shoop GH, George J, Lerner SM, Wilson PK, et al. Professionalism in medical education: the development and validation of a survey instrument to assess attitudes toward professionalism. Med Teach. 2007;29(2-3):e58-62. [Link] [DOI:10.1080/01421590601044984]
42. Pakpour Haji Agha A, Ghafranipour F, Heydarnia A, Safari M, Shojaeizadeh D. Theories Models and methods of health education and promotion. Tehran: Aasar-E Sobhan Publishing; 2009. p. 22-4. [Persian] [Link]
43. Pololi M, Frankel RM, Clay M, Jobe AC. One year's experience with a program to facilitate personal and professional development in medical students using reflection groups. Educ Health. 2001;14(1):36-49. [Link] [DOI:10.1080/13576280010015074]
44. Ajzen I. The theory of planned behavior. Organizational Behav Human Decision Processes. 1991;50(2):179-211. [Link] [DOI:10.1016/0749-5978(91)90020-T]
45. Millstein SG. Utility of the theories of reasoned action and planned behavior for predicting physician behavior: A prospective analysis. Health Psychol. 1996;15(5):398-402. [Link] [DOI:10.1037/0278-6133.15.5.398]
46. Ferencz-Kaddari M, Shifman A, Koslowsky M. Modeling psychologists' ethical intention: Application of an expanded theory of planned behavior. Psychol Rep. 2016;118(3):691-709. [Link] [DOI:10.1177/0033294116647691]
47. Emadzadeh A, Farzad F, Gholami H, Bahari A, Zarezadeh Y. Development of a framework for assessing professionalism in medical students. Future Med Educ J. 2014;4(1):8-12. [Link]

Add your comments about this article : Your username or Email:

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.