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The relationship between Conscientiousness, Professionalism and Performance


Marina Sawdon

Dr Marina Sawdon

Director of Assessment & Associate Professor of Medical Education



Why this research is needed

Robust measures of professionalism continue to be elusive. This may be attributed to the complex nature of professionalism, which goes beyond the application of knowledge and skills to encompass humanism, accountability, altruism and the pursuit of excellence. There is evidence that concerns about undergraduate programme performance are a risk factor for subsequent disciplinary action.

This project is a collaborative effort involving several colleagues. Key collaborators include Prof John McLachlan and Prof Gabrielle Finn. We have developed an objective, scalar measure of the trait of conscientiousness; the Conscientiousness Index (CI), which we have shown to be valid, reliable and stable, as well as being simple and cost effective to implement. We have previously shown the CI to correlate with both staff and students’ views of professionalism, performance in knowledge and skills examinations, as well self-reported conscientiousness as measured by written tests of psychological characteristics.

More recently, we have shown the Conscientiousness Index, measured early in undergraduate medical education, significantly predicts future performance, including in the clinical workplace. Our current work is therefore exploring whether conscientiousness can be used during the undergraduate medical school selection process.

This unique body of work has had national and international impact and is significantly changing perspectives and procedures. The programme of research is influencing policy in bodies such as the General Medical Council and the Health and Care Professions Council.


M. Sawdon & JC. McLachlan. (2020) ‘10% of your medical students will cause 90% of your problems’: a prospective correlational study. BMJ Open 2020; 10:e038472. DOI: 10.1136/bmjopen-2020-038472

M. Sawdon, K. Whitehouse, GM. Finn, JC. McLachlan, & D. Murray. (2017) Relating professionalism and conscientiousness to develop an objective, scalar, proxy measure of professionalism in anaesthetic trainees. BMC Medical Education. 2017; 17:49. DOI: 10.1186/s12909-017-0891-6

M. Kelly, S. O'Flynn, JC. McLachlan, M. Sawdon. The Clinical Conscientiousness Index: a valid tool to explore professionalism in the clinical undergraduate setting. Academic Medicine. 2012;87:1218-1224

Finn, G., Sawdon, M., Clipsham, L. & McLachlan JC. Peer estimates of low professionalism correlate with low Conscientiousness Index scores. Medical Education 2009; 43(9): 960-967.

M. Sawdon & JC. McLachlan. Conscientiousness predicts later medical school and post-graduation performance, can be used for selection, and is a major component of professionalism. Ottawa, Lyon Hybrid Conference, August 2022

M. Sawdon, I. Smith & JC. McLachlan. The relationship between conscientiousness as measured by a short, 10-item Big Five personality inventory and the Conscientiousness Index. ASME, Aberdeen, July 2022

M. Sawdon & JC. McLachlan. Measuring professionalism through conscientiousness. International Conference on Medical Education (ICME). Virtual Conference. April 2021

M. Sawdon & JC. McLachlan. The predictive validity of the Conscientiousness Index in preclinical medical education for later clinical performance: a pilot study. Ottawa Conference on the Assessment of Competence in Medicine and the Healthcare Professions, March 2020, Kuala Lumpur, Malaysia (delivered remotely due to COVID-19)

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