Table 1 Items used for the four SASs, and mean item scores for each respondent group
Items used for scales | Item score | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
4th-year medical students | 6th-year medical students | 2nd-year residents | Instructors | |||||||||||
Item | Stage 2 | Stage 3 Inclusion | Stage 4 Independence | Higher | Mean | (SD) | Mean | (SD) | Mean | (SD) | Mean | (SD) | ||
1 | I cannot tolerate that colleagues who sympathize with my actions have a different mindset from me. | F | R | 5.56 | (1.244) | 5.51 | (1.270) | 5.51 | (1.502) | 5.65 | (1.086) | |||
2 | I find it difficult to suppress my desires and act rationally. | F | R | 5.05 | (1.437) | 5.08 | (1.406) | 5.45 | (1.442) | 5.41 | (1.322) | |||
3 | It is difficult for me to adjust and act according to the different values of each medical professional and the demands for physicians. | F | R | R | 4.19 | (1.377) | 4.20 | (1.268) | 4.34 | (1.550) | 5.00 | (1.202) | ||
4 | I have never thought about the reasons or principles behind the required code of conduct. | F | R | 4.56 | (1.251) | 4.33 | (1.238) | 4.51 | (1.249) | 4.86 | (1.316) | |||
5 | I am sometimes unable to do something I was not interested in despite understanding its necessity. | F | R | 3.84 | (1.313) | 4.23 | (1.454) | 4.43 | (1.678) | 4.27 | (1.347) | |||
7 | I behave correctly as a physician on a daily basis. | F | F | 4.25 | (0.999) | 4.24 | (1.108) | 5.00 | (1.319) | 5.41 | (1.235) | |||
8 | I am aware of my position as a physician. | F | F | 4.97 | (1.330) | 4.68 | (1.361) | 6.26 | (1.113) | 6.65 | (0.633) | |||
9 | I have accepted the words of gratitude and the frustration and anger of patients as a personal evaluation of myself. | F | F | 4.86 | (1.080) | 5.18 | (1.092) | 5.13 | (0.992) | 5.57 | (0.835) | |||
10 | I consider long-term significance and concerns when I think about what I should do. | F | F | 5.29 | (1.087) | 5.18 | (1.112) | 5.28 | (1.136) | 5.54 | (0.767) | |||
11 | I have used my own beliefs and ideals as a standard to evaluate my own actions as a physician. | F | F | 4.58 | (1.024) | 4.62 | (1.030) | 4.43 | (1.156) | 4.89 | (0.994) | |||
12 | If I were able to play a role in improving society and organizations, I would be satisfied even if I did not receive individual recognition. | F | F | 4.23 | (1.386) | 4.04 | (1.411) | 4.28 | (1.347) | 4.57 | (1.425) | |||
13 | I induce action in the people around me based on the principles I believe in to fulfill my role as a physician. | F | F | 4.48 | (1.027) | 4.38 | (1.117) | 4.43 | (1.078) | 5.11 | (0.843) | |||
14 | I take on various roles in accordance with the demands of society. | F | F | 4.57 | (1.199) | 4.28 | (1.159) | 5.13 | (0.947) | 5.49 | (0.901) | |||
16 | Adhering to the rules and code of conduct of one’s institution is the basis of correct behavior as a physician. | F | R | 3.08 | (1.255) | 3.29 | (1.205) | 3.26 | (1.224) | 3.27 | (1.465) | |||
17 | I recall and confirm the systems and rules for acting appropriately as a physician. | F | R | 2.85 | (0.993) | 3.05 | (1.052) | 3.09 | (1.299) | 3.08 | (1.278) | |||
18 | The colleagues I can be close friends with are those who have the same concerns and interests as me. | F | R | 3.42 | (1.555) | 3.26 | (1.411) | 3.62 | (1.468) | 3.49 | (1.557) | |||
19 | The way senior physicians act towards me is more important than how they feel about me. | F | R | 3.93 | (1.153) | 3.93 | (1.047) | 3.85 | (1.302) | 3.73 | (1.521) | |||
20 | Good test results and qualifications are important evaluation of self. | F | R | 4.28 | (1.377) | 3.85 | (1.400) | 4.70 | (1.600) | 4.54 | (1.445) | |||
21 | It is important to me that specific actions required of me in each medical setting are clearly specified. | F | R | 3.21 | (0.968) | 3.47 | (1.141) | 3.46 | (1.312) | 3.86 | (1.206) | |||
22 | I act with respect for the opinions of my colleagues when I have a conflict of opinion with those around me. | F | R | 3.37 | (0.985) | 3.39 | (0.938) | 3.49 | (1.249) | 3.51 | (0.731) | |||
23 | I take great care not to offend senior physicians or colleagues. | F | R | 3.16 | (1.147) | 2.98 | (0.970) | 2.89 | (1.127) | 3.46 | (1.238) | |||
24 | I first consider how to share responsibilities with colleagues in order to fulfill duties required of me. | F | R | 3.21 | (1.146) | 3.43 | (1.051) | 3.17 | (1.028) | 3.08 | (1.211) | |||
25 | I have set aside my own interests to meet the ideals and expectations of society. | F | F | 3.87 | (1.121) | 3.85 | (1.042) | 3.98 | (1.482) | 4.41 | (1.117) | |||
26 | When I am acknowledged by senior physicians or colleagues, I feel that I am being recognized. | F | R | 2.77 | (1.086) | 2.73 | (1.115) | 3.17 | (1.324) | 3.11 | (1.329) | |||
27 | I am working to improve my behavior as a physician by constantly analyzing and reflecting on my own actions. | F | F | 4.78 | (0.984) | 4.83 | (1.064) | 4.89 | (1.068) | 5.03 | (0.986) | |||
Number of respondents | 317 | 319 | 321 | 319 | 118 (117) | 120 (119) | 47 (46) | 37 | ||||||
Number of items | 11 | 6 | 3 | 6 | ||||||||||
Cronbach’s α | 0.66 | 0.53 | 0.61 | 0.63 | ||||||||||