Assessment of Professional Competency and Its Related Factors in Cardiology Interns Using a Self-Assessment Method

Assessment of Professional Competency and Its Related Factors in Cardiology Interns Using a Self-Assessment Method | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of Professional Competency and Its Related Factors in Cardiology Interns Using a Self-Assessment Method Mohammad Ali Qasemi Darzi, Maryam Ghaemi-Amiri, Hemmat Gholinia, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6321710/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and Objectives: The professional competence of medical interns in specialized fields such as cardiology plays a crucial role in the quality of healthcare services. This study aimed to assess the level of professional competence among cardiology interns and explore its related factors. Methods This descriptive cross-sectional study was conducted in 2023 on 153 medical interns at Babol University of Medical Sciences. Participants completed a researcher-developed questionnaire consisting of three sections: demographic characteristics, domains of professional competence, and related factors. Data were analyzed using independent t-tests, one-way ANOVA, and univariate and multivariate linear regression in SPSS version 26. Results The findings revealed that more than half of the interns rated their professional competence as moderate. The highest scores were observed in history-taking, physical examination, and differential diagnosis skills, while the lowest scores were reported in treatment management and practical skills. Regression analysis indicated that the educational program and interaction with faculty members had the most significant impact on professional competence, whereas demographic variables showed no significant effect. Conclusion Educational programs play a key role in enhancing interns' professional competence. Strengthening practical training and educational interactions can positively influence their clinical performance. It is recommended that educational programs incorporate simulation-based learning, problem-based learning, and increased clinical experience. Additionally, further research should be conducted in other internship departments and on the impact of training during professional practice. Professional Competence Self-Assessment Internship Residency Introduction Nowadays, universities worldwide are seeking innovative educational strategies to enhance students' professional competencies, clinical decision-making, and self-directed learning. In this regard, medical education has focused on defining professional competencies, designing competency-based curricula, and developing effective assessment tools ( 1 , 2 ). Professional competence encompasses knowledge, technical skills, and the ability to exercise clinical judgment and decision-making, enabling individuals to perform their duties effectively ( 3 , 4 ). Furthermore, this concept is defined as the functional capacity to integrate knowledge and skills across various specialized fields( 5 ). Internship and residency programs are considered some of the most important stages in medical education, as they place students in real clinical environments, providing opportunities for hands-on experience in patient management and treatment under the supervision of specialists. Therefore, the internship plays a key role in the development of students' professional competencies( 6 , 7 ). Professional competence in medical education, particularly in specialized fields such as cardiology, is of significant importance( 8 ). The cardiology department is one of the most challenging and dynamic educational fields in medical sciences, which can have a significant impact on enhancing the competence of interns( 9 ). The complexity of heart diseases, related medical emergencies, and the need for quick and accurate decision-making have made this department an ideal environment for enhancing clinical skills, critical thinking, and patient management( 10 ). Interns in this field not only encounter a wide range of heart diseases, including heart failure, heart attacks, and arrhythmias, but also have the opportunity to gain practical experience in interpreting ECGs, performing invasive procedures, and collaborating with multidisciplinary healthcare teams( 11 ). In addition, working in the high-pressure environment of the cardiology department enhances interns' skills in quick decision-making, stress management, and effective communication with patients and their families( 12 ). Therefore, training in this department not only helps enhance their knowledge and technical skills but also paves the way for the development of professionalism, responsibility, and self-efficacy in their professional journey. The professional competence of interns in the cardiology department is influenced by a combination of individual, educational, and environmental factors, each of which can impact their performance and learning. Individual factors include theoretical knowledge, practical skills, previous clinical experiences, and the interns' confidence levels when interacting with patients. Educational factors involve the quality of the curriculum, teaching methods, the extent of interaction with faculty, and receiving constructive feedback( 13 ). Additionally, environmental factors play a significant role in the professional competence of interns. High workload, stress from emergency situations, opportunities for practical learning, and the level of support and collaboration from the healthcare team are factors that can influence interns' performance and learning( 14 , 15 ). Despite identifying various dimensions of professional competence, comprehensive strategies that can assess multiple aspects of this competence simultaneously remain limited, especially those that reliably measure theoretical knowledge, technical skills, and interpersonal and human qualities( 16 , 17 ). In this context, self-assessment has emerged as one of the modern and effective approaches in educational planning. It is not only specific to the medical field but is also applicable in other academic areas. Studies have shown that students' self-assessment of practical skills can be more valuable than traditional academic evaluations. Many universities today incorporate this method alongside faculty evaluations to provide a more comprehensive and accurate assessment of students' professional competence( 6 ). Therefore, the professional competence of interns in the cardiology department plays a vital role in the quality of medical services and the improvement of patient health. This competence can be influenced by various factors, including individual characteristics, the quality of education, and the learning environment. Assessing the professional competence of interns and identifying the factors that affect it can contribute to the enhancement of medical education and help identify existing weaknesses. Thus, the aim of this study is to assess the professional competence of cardiology interns and identify the related factors through the self-assessment method at Babol University of Medical Sciences. Methods and Materials This study is a descriptive cross-sectional research conducted in 2023. The study population included general medicine interns from Babol University of Medical Sciences who had completed their cardiology internship by the time of the study. A convenience sampling method was used, and the sample size was determined using the Krejcie and Morgan ( 18 ) table, with a 20% attrition rate considered for the population of 260 students (general medicine interns from the cardiology department of Babol University of Medical Sciences in 2023). The final sample size was calculated to be 153. In this study, medical interns who were either currently enrolled or had previously completed their cardiology internship at the educational and medical centers of Babol University of Medical Sciences in 2023 were asked to respond to a researcher-developed questionnaire either physically or electronically. The questionnaire provided to the participants consisted of three sections: Demographic Questions : This section included questions on age, gender, basic science/pre-internship exam scores, marital status, place of residence, overall grade point average up to the end of the apprenticeship, and the number of other internship rotations completed prior to the cardiology rotation. Questions on Professional Competence Areas : These questions were based on the curriculum approved by the General Medicine Planning Office and the competencies of graduates from the Doctor of Medicine program. This section consisted of 68 questions, covering social skills, patient history taking and physical examination, differential diagnosis, treatment, and practical skills, with 2, 25, 6, 19, and 16 questions for each respective area. Responses to this section were recorded using a five-point Likert scale: (very good = 5, good = 4, average = 3, poor = 2, very poor = 1). Questions on the Impact of Related Factors on Professional Competence : This section assessed the interns' views on the factors influencing their professional competence in the cardiology internship program. It included 19 questions: 10 questions regarding the educational program and 3 questions each regarding student-related factors, educational resources, and faculty-related factors. The responses to this section were also recorded using a five-point Likert scale: (completely effective = 5, effective = 4, average effect = 3, low effect = 2, no effect = 1) (supplementary). Design of the Second and Third Sections of the Questionnaire In this study, the content of the educational program for the cardiology rotation in the general medicine internship, as approved by the Ministry of Health, Treatment, and Medical Education, and the competencies for graduates of the Doctor of Medicine program in the country, were used to design questions relevant to the research goal, based on the 5-point Likert scale. This was done with the guidance of the cardiology department faculty at Babol University of Medical Sciences, and the items were reviewed by experts. Validity and Reliability of the Questionnaire Face Validity Qualitative Method : The questionnaire was distributed to 10 medical interns, who provided feedback on the difficulty level, relevance, and clarity of the items. Revisions were made based on their suggestions. Quantitative Method : The questionnaire was sent to the same 10 medical interns, who were asked to rate the importance of each item on a 5-point scale (5 = Very Important, 4 = Somewhat Important, 3 = Moderately Important, 2 = Slightly Important, 1 = Not Important). The impact score for each item was then calculated using a specific formula, and any item with a score above 1.5 was retained ( 19 ). Ultimately, all items were retained. Content Validity Qualitative Method : The questionnaire was sent to 10 experts, including 6 cardiologists and 4 medical education specialists with experience in designing and psychometric testing of tools. They were asked to review the scale for linguistic accuracy, the appropriateness of wording, and the placement of items. Quantitative Method : Then, to determine the quantitative validity of this questionnaire, the Content Validity Ratio (CVR) and Content Validity Index (CVI) indices were used. For CVR, the 10 previous experts rated the items based on their necessity using a 3-point Likert scale (1 = not necessary, 2 = useful but not essential, 3 = essential). The score was calculated using the following formula: CVR = (ne − N/2) / (N/2) Where: ne = the number of experts (faculty members) who selected "essential" N = total number of experts (faculty members) The responses were analyzed based on the Lawshe table, and the minimum acceptable value according to the Lawshe table was set to 0.62( 20 ). At this stage, all items were retained. After calculating the CVR, the CVI was assessed. For this purpose, the same 10 specialists who participated in determining the CVR were asked to rate the items using a Likert scale (completely relevant, relevant, somewhat relevant, not relevant). According to Polit et al. (2007), a minimum CVI of 0.78 is considered excellent for at least six specialists. In this study, the minimum acceptable CVI was set at 0.78, and all items met this threshold( 21 ). The S-CVI/Ave index was calculated with a minimum acceptable value of 0.90, resulting in a value of 0.898 ( 22 , 23 ). Reliability ICC (Intraclass Correlation Coefficient) : After validating the content, the reliability of the questionnaire was tested using the ICC, which was found to be 87%. Cronbach’s Alpha : The internal consistency of the questionnaire was evaluated using Cronbach's alpha. For the second section (competency evaluation items), the alpha was 97%, and for the third section (factors affecting professional competency), it was 90%. McDonald’s Omega : The McDonald’s omega coefficient was calculated, yielding values of 0.97 for the second section and 0.89 for the third section, both indicating high reliability. Ethical Considerations The research protocol for this study was approved by the Ethics Committee of Babol University of Medical Sciences under the code IR.MUBABOL.HRI.REC.1402.061. Participants' information remained confidential and was not shared with any third parties. No additional costs were incurred by the participants. In case of any withdrawal, participants were free to exit the study at any stage. The study’s objectives and procedures were explained to the participants, and they were assured that their data would only be used for research purposes and that their dignity and privacy would be upheld throughout the study. Data Analysis Method Mean, standard deviation (SD), count and percentage were used to describe the ability fields between participant’s features. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Independent sample’s t-test, One-way ANOVA followed by Tukey’s test, and Welch One-way ANOVA followed by Games-Howell’s test was used. Univariate linear regression was used to determine the relationship between participant’s features and ability fields. Multiple linear regression was used to adjust potential confounders. All analyses were performed by SPSS version 26 software (IBM Corp.). The significant level of the tests was considered less than 0.05. Results In this study, there were 153 participants, including 74 males (48.4%) and 79 females (51.6%). The mean age was 25.39±1.25 years. 129 participant fill in the electronic version and 24 participant fill in the paper version of questionnaire. The baseline features of study participants and comparison ability fields between them are reported in Table 1. The number of Top students in relation to the “Total grade point average until the end of the internship”, “Comprehensive test score of the preliminary education course”, and “comprehensive test score before entering the internship course” were 38 (24.8%), 35 (22.9%), and 21 (13.7%), respectively. The mean values of Treatment area differed significantly between rotation number ( P -value=0.043), so that Tukey’s test reveal that mean of Treatment area in “>5 rotation number” group is larger than “2-5 rotation number”. Additionally, there were significant differences in the Treatment area ( P -value=0.040), Practical skills area ( P -value=0.037), and Total ability field ( P -value=0.032) across the “comprehensive test score before entering the internship course”. Descriptive statistics of standardized Influencing Factors and Ability Fields based on study participants are presented in Table 2 . The results revealed that, overall, 51% of the interns rated their competence as average. Additionally, the interns achieved the highest scores in the following order: Social field, Differential diagnosis scope, History and physical examination area, Practical skills area, and Treatment area. Associations between baseline features of study participants and ability fields are shown in Table 3 . More than five rotation number group compare to two to five rotation number group, higher mean of Treatment Area (beta (β)=5.486, P -value=0.014, 95% confidence interval (CI):1.110, 9.861) and Total Ability Field (β=13.142, P -value=0.041, 95% CI:0.522, 25.762) was observed. In comprehensive test score before entering the internship course, Poor group compared to Intermediate group, lower mean of Treatment Area (β=-6.783, P -value=0.044, 95% CI: -13.240, -0.326) was observed. In comprehensive test score before entering the internship course, Top group compared to Intermediate group, lower mean of History and Physical Examination Area (β=-6.304, P -value=0.040, 95% CI: -12.436, -0.171), Practical skills area (β=-5.301, P -value=0.019, 95% CI: -9.727, -0.874), Total Ability Field (β=-17.914, P -value=0.041, 95% CI:-35.119, -0.708) was observed. Associations between influencing factors and ability fields are presented in Table 4 . In the crude model, Social Field was associated with each unit increase of Curriculum Area (β=0.061, P -value<0.001, 95% CI:0.031, 0.090), The Field Related to The Student (β=0.121, P -value=0.039, 95% CI:0.006,0.236), Educational Facilities Area (β=0.136, P -value=0.001, 95% CI:0.058, 0.214), and The Field Related to The Teacher (β=0.167, P -value<0.001, 95% CI:0.087, 0.247). After adjusting for potential confounders, The Field Related to The Teacher (β=0.123, P -value=0.026, 95% CI:0.015, 0.231) remained significantly associated with Social Field. In the crude model, History and Physical Examination Area was associated with Curriculum Area (β=0.601, P -value<0.001, 95% CI:0.303, 0.899), The Field Related to The Student (β=1.721, P -value=0.003, 95% CI:0.593, 2.848), Educational Facilities Area (β=1.010, P -value=0.013, 95% CI:0.217, 1.803), and The Field Related to The Teacher (β=1.052, P -value=0.013, 95% CI:0.230, 1.874). However, after adjusting for potential confounders, no significant associations were found between influencing factors and the History and Physical Examination Area. In the crude model, The Scope of Differential Diagnosis was associated with each unit increase of The Field Related to The Student (β=0.421, P -value=0.013, 95% CI:0.089, 0.752). However, after adjusting for potential confounders, no significant associations were found between the influencing factors and The Scope of Differential Diagnosis. In the crude model, Treatment Area was associated with each unit increase of Curriculum Area (β=0.437, P -value=0.001, 95% CI:0.192, 0.754) and The Field Related to The Student (β=1.611, P -value=0.003, 95% CI:0.563, 2.658). After adjusting for potential confounders, significant association remained between the Curriculum Area (β=0.432, P -value=0.030, 95% CI:0.043, 0.821) and The Field Related to The Student (β=1.330, P -value=0.038, 95% CI:0.078, 2.583) with the Treatment Area. In the crude model, Practical Skills Area was associated with each unit increase of Curriculum Area (β=0.501, P -value<0.001, 95% CI:0.302, 0.700), The Field Related to The Student (β=1.229, P -value=0.002, 95% CI:0.458, 2.000), Educational Facilities Area (β=0.689, P -value=0.013, 95% CI:0.145, 1.232), and The Field Related to The Teacher (β=0.848, P -value=0.003, 95% CI:0.289, 1.407). After adjusting for potential confounders, Practical Skills Area remained significantly associated with the Curriculum Area (β=0.440, P -value=0.003, 95% CI:0.156, 0.724). In the crude model, the Total Ability was associated with each unit increase of Curriculum Area (β=1.718, P -value<0.001, 95% CI:0.929, 2.506), The Field Related to The Student (β=5.102, P -value=0.001, 95% CI:2.117, 8.087), Educational Facilities Area (β=2.586, P -value=0.017, 95% CI:0.468, 4.704), and The Field Related to The Teacher (β=2.636, P -value=0.019, 95% CI:0.438, 4.834). After adjusting for potential confounders, Total Ability Field remained significantly associated with the Curriculum Area (β=1.407, P -value=0.015, 95% CI:0.275, 2.538). Discussion The present study was conducted to assess professional competence and its related factors among interns in the cardiology educational department at Babol University of Medical Sciences. In this study, five domains were examined and evaluated, including social skills, history-taking and physical examination skills, differential diagnosis skills, clinical management and treatment skills, and practical skills. In current study, we evaluated the relationship between influencing factors and ability fields in medical students. We found positive associations between them. After adjusting for potential confounders, The Field Related to The Teacher (β = 0.123, P -value = 0.026, 95% CI:0.015, 0.231) was significantly associated with Social Field. There was significant association between the Curriculum Area (β = 0.432, P -value = 0.030, 95% CI:0.043, 0.821) and The Field Related to The Student (β = 1.330, P -value = 0.038, 95% CI:0.078, 2.583) with the Treatment Area. Practical Skills Area remained significantly associated with the Curriculum Area (β = 0.440, P -value = 0.003, 95% CI:0.156, 0.724). Total Ability Field remained significantly associated with the Curriculum Area (β = 1.407, P -value = 0.015, 95% CI:0.275, 2.538). We found that curriculum area is significantly associated with medical student professional abilities in the treatment area, practical skills and total professional ability field. According to our results the curriculum area plays a pivotal role in shaping medical students' professional abilities. Several factors outlined in medical education publications account for the association between the curriculum and the professional capabilities of medical students in both social and treatment settings. According to Xu et al., a well-structured curriculum enhances students' self-guided learning abilities, which are pivotal for lifelong learning and professional growth. This aligns with the findings of the present study, where the quality and structure of the educational program were identified as influential factors in the professional competency of cardiology interns( 24 ). Additionally, Schmoyer et al. emphasizes that interprofessional education fosters teamwork and collaboration skills, essential for effective patient care by integrating these components into the curriculum, medical schools can better prepare students to excel in both social interactions and clinical treatment, ultimately lead to better outcomes for patients ( 25 ). Our results suggest that the curriculum area has a significant impact on professional ability in the fields of treatment skills and practical skills, but not in social field, history taking, physical examination, and differential diagnosis. Our findings were in line with the results of Khanna et al.'s study. They highlighted the importance of a well-structured curriculum in equipping students for practice, particularly in domains such as social skills, treatment skills, and practical skills. This further supports the notion that a comprehensive and well-organized educational framework plays a crucial role in enhancing professional competency among medical trainees( 26 ). Moreover, another study underscored the value of curriculum integration in enhancing professional abilities, particularly in practical and social fields. This suggests that incorporating interdisciplinary and structured educational approaches can significantly contribute to the development of essential competencies among medical trainees( 27 ). The study by Moatari et al. also stated that strengthening the medical competencies required by society necessitates greater attention throughout the academic curriculum and continuous education programs( 28 ). Given that the educational curriculum in Iran has remained largely unchanged for years, various studies, including Yazdani et al., have recommended revising teaching methods in alignment with the clinical curriculum( 29 ). Matlabe-Nejad et al. reported that graduates' perceptions of their professional competencies largely reflected dissatisfaction with their acquired practical skills, indicating weaknesses in clinical teaching methods( 30 ). Similarly, Soodagar et al. found that although students self-reported an acceptable level of practical skills, the educational program had not fully achieved its intended learning objectives. Consequently, their study emphasized the need for modifications in training to enhance competencies that had received lower ratings( 31 ). Another aspect of our finding was that in addition to curriculum area the field related to students was also significantly associated with treatment area. There are some possible reasons. In treatment area, students might have more hands-on experience and direct patient interaction, which could improve their professional ability more significantly than theoretical knowledge alone. Treatment area often include immediate feedback from patients and supervisors, allowing students to reflect and improve their skills more rapidly ( 32 , 33 ). The treatment area might involve more complex and high-stakes situations, making the student's role and their related parameters more critical to their professional development. On the other hand, the significant relationship between the instructor-related domain and the social skills domain indicates that the instructor’s approach can enhance students’ social skills. This finding highlights the crucial role of instructors in teaching social skills to students. One of the questions in the social skills domain assessed confidence in various clinical situations. Similarly, the study by N.S. Bashkirova et al. demonstrated that differences exist between students' self-esteem and their ideal versus actual self-perceptions( 34 ). Given these findings, there is a need to enhance students’ confidence through practical, experience-based training and active instructor engagement. Since age, gender, marital status, place of residence, cumulative Grade Point Average by the end of the internship, and basic sciences exam score showed no significant relationship with interns’ professional competency, it can be concluded that demographic characteristics and theoretical education and assessments do not significantly influence students’ perceived competency. In contrast, readiness for clinical evaluations, such as the number of rotations and the pre-internship exam, plays a more critical role in students’ empowerment. In terms of theoretical education, the study by Moti et al. indicated that while students possess adequate theoretical knowledge, their inability to bridge theory with practice results in a lack of competence in fundamental nursing skills. They found discrepancies between what newly registered nurses learned in the classroom and what they observed in clinical practice, which aligns with the present study’s findings( 35 ). Another key finding of this study was that students with moderate pre-internship exam scores reported higher satisfaction with their professional competency, particularly in the treatment domain, compared to those with weak or strong scores. This suggests that students who are either exceptionally strong or weak in theoretical subjects may be less satisfied with their perceived competency. This aligns with previous studies that found a weak correlation between theoretical and practical performance( 36 ). Additionally, the results indicate that students exhibit higher confidence and perceive themselves as more competent in areas they frequently encounter and study theoretically, such as history-taking and formulating differential diagnoses. Conversely, in domains where they have limited exposure or are newly introduced during their internship, such as disease management and practical skills, lower self-assessment scores are expected. Mirzadeh et al. also identified a lack of competence in patient management and rational drug prescription as challenges reported by students( 37 ). Furthermore, the perception of students, especially in professional and public settings, is highly significant, as reflected in the present findings. The instructor-related domain had the highest mean score among all domains, emphasizing the importance of communication with other healthcare team members in fostering competency. Similarly, the study by Khorramand et al., which explored the interaction between interns and nurses, highlighted that weak communication could negatively impact patient management and teamwork. Their study recommended integrating training on effective communication with the nursing team into internship objectives, content, and teaching methods( 38 ). Conclusion This study revealed that medical interns in the cardiology department assess their professional competencies at a moderate level, with certain skills, such as history-taking and physical examination, receiving higher scores compared to clinical management and practical skills. These findings highlight the importance of designing structured educational programs that can enhance clinical decision-making and patient management skills. Moreover, the significant relationship between the curriculum and professional competency suggests that modifying educational approaches can have a substantial impact on the clinical performance of interns. Study Limitations Population Limitation : This study was conducted solely on interns from a single university, which may restrict the generalizability of the results. Reliance on Self-Assessment : The data in this study were collected based on students’ self-assessment, which may introduce bias in evaluating their actual competencies. Lack of Consideration for Other Influential Factors : Key variables such as prior clinical experiences, individual learning strategies, and interactions with faculty members were not thoroughly examined. Focus on a Single Specialty : This study focused only on the cardiology department and did not consider other medical fields. Recommendations for Future Studies To enhance the generalizability of the findings, similar studies should be conducted in other internship departments and medical universities. Additionally, incorporating objective assessment methods, such as clinical simulations and practical examinations, alongside self-assessment could improve the accuracy of professional competency evaluations. Examining the impact of different teaching methods, including problem-based learning and simulation-based education, could contribute to optimizing educational programs. Furthermore, analyzing the role of individual and environmental factors, such as previous clinical experiences, the level of interaction with faculty members, and the structure of clinical learning environments, is crucial for enhancing interns' professional competencies. Finally, conducting longitudinal studies to assess the impact of educational interventions on graduates' performance in real-world clinical settings could help develop sustainable and effective educational strategies. Declarations Acknowledgment This article was derived from a Doctor of Medicine thesis. The authors would like to thank the research deputy at Babol University of Medical Sciences for their support. Authors’ contributions Mehrdad Saravi and Maryam Ghaemi-Amiri collaborated on designing the study with input from all authors. Mohammad Ali Ghasemi-Darzi collected the data, while Hemmat Gholinia conducted the statistical analysis. Maryam Ghaemi-Amiri drafted the initial manuscript. All authors contributed to finalizing the manuscript, interpreting results, and critically revising it for important intellectual content. The final manuscript was reviewed and approved by all authors. Availability of data and materials The data that support the findings of this study were used under license for the current study, and so are not publicly available. Funding Not applicable Consent for publication Not applicable Clinical trial number Not applicable Competing interests The authors declare no competing interests. References Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting paradigms: from Flexner to competencies. Acad Med. 2002;77(5):361–7. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA. 2002;287(2):226–35. Axley L. Competency: A Concept Analysis. Nurs Forum. 2008;43(4):214–22. Dictionary M-W. The Merriam-webster dictionary. Incorporated: Merriam-Webster; 2006. Meretoja R, Koponen L. A systematic model to compare nurses' optimal and actual competencies in the clinical setting. J Adv Nurs. 2012;68(2):414–22. Safari M, Yazdanpanah B, Ghafarian HR, Yazdanpanah S. 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Senior Medical Students' Self Evaluation Of Their Capability In General Competencies In Shiraz University Of Medical Sciences. Iran J Med Educ. 2008;7(2):371–7. Yazdani R, Simin Zahra M, Mortazavi M, Madankan D. Evaluation of Clinical Competency and the Influential Factors in Dentistry Students Using the Self-assessment Method. J Mashhad Dent School. 2018;42(4):348–55. Motallebnejad M, Madani Z, Ahmadi E, Hosseini Sr. The Viewpoints of Dentists Graduated from Babol Dental School about Their Professional Capability. Iran J Med Educ. 2005;5(2):139–45. Sodagar A, Jafari A, Sedighpour L, Ghahremani Gol H. Assessment of the clinical skills of dental students in the dept. of pediatric dentistry. Iran J Pediatr Dentistry. 2015;10(2):81–8. Williamson S, Hostetter C, Byers K, Huggins P. I found myself at this practicum: Student reflections on field education. Adv Social Work. 2010;11(2):235–47. Azoulay B, Orkibi H. Helpful and hindering factors in psychodrama field training: A longitudinal mixed methods study of student development. Front Psychol. 2018;9:196. Bashkirova N, Kramarchuk V, Rosytska O. SELF-EVALUATION OF PROFESSIONAL COMPETENCIES AMONG MEDICAL INTERNS. Věda a perspektivy. 2023. Moeti MR. Perceptions of the clinical competence of newly registered nurses in the North West province. University of Pretoria; 2005. Haupt F, Kanzow P. The Relation Between Students' Theoretical Knowledge and Practical Skills in Endodontics: Retrospective Analysis. Interact J Med Res. 2023;12:e46305. Mirzadeh M-s, Soleymani-Salehabadi H, Akhondi-Meybodi M. Self-Assessment of Medical Interns on Their Ability to Management of Inpatients in the Internal Department at Shahid Sadoughi University of Medical Sciences. J Med Educ Dev. 2021;16(1):55–65. Shams B, Kheradmand A, Mahmoodi M, Hosseini SF, Rafaie E, Vaghef Davari F. Interns’ Viewpoints About Nurses’ Capability And Behavior Towards Patients And Interns. Iran J Med Educ. 2004;4(2):63–8. Tables Tables 1 to 4 are available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files table.docx Q.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6321710","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":452543538,"identity":"ac0b4bd2-77e4-44b1-bfee-d7affa254e63","order_by":0,"name":"Mohammad Ali Qasemi Darzi","email":"","orcid":"","institution":"School of Medicine, Babol University of Medical Sciences, Babol","correspondingAuthor":false,"prefix":"","firstName":"Mohammad","middleName":"Ali Qasemi","lastName":"Darzi","suffix":""},{"id":452543542,"identity":"fec482be-cd4f-4d33-b431-37ba6d07117d","order_by":1,"name":"Maryam Ghaemi-Amiri","email":"","orcid":"","institution":"Department of Medical Sciences Education Development, Education Development Center, Babol University of Medical Sciences, Babol","correspondingAuthor":false,"prefix":"","firstName":"Maryam","middleName":"","lastName":"Ghaemi-Amiri","suffix":""},{"id":452543544,"identity":"11302a41-1986-4fe0-b5ee-f4f8a7906496","order_by":2,"name":"Hemmat Gholinia","email":"","orcid":"","institution":"Health Research Institute, Babol University of Medical Sciences, Babol","correspondingAuthor":false,"prefix":"","firstName":"Hemmat","middleName":"","lastName":"Gholinia","suffix":""},{"id":452543546,"identity":"5397ecd2-46c2-40df-ba5e-0da1f068179d","order_by":3,"name":"Mehrdad Saravi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYFACHhBihrATKoAEM3MDKVrOgLQwkqKFsQ1M4tei29577MObGmt7/tmHn0k8nFcbzd8O1PKjYhtOLWZnziXPnHMsPXHGuTQzicRtx3NnHGZsYOw5cxu3lhs5xsw8bIcTGM4wGBskbjuW2wDUwszYhkfL/TdALf8O28ufYf9skDjnWO58glpu8Bgz87YdZtxwhsfwQWJDTe4GglrO5Bgzzu1LT9x4hqfwQcKxA7kbgVoO4vXL8TPGDG++WdvLnWHfcPBHTV3uvPOHDz74UYFbCzo4DCYPEK0eCOpIUTwKRsEoGAUjBAAAsAhdRhkdoscAAAAASUVORK5CYII=","orcid":"","institution":"Department of Cardiology, School of Medicine, Babol University of Medical Sciences, Babol","correspondingAuthor":true,"prefix":"","firstName":"Mehrdad","middleName":"","lastName":"Saravi","suffix":""}],"badges":[],"createdAt":"2025-03-27 15:08:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6321710/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6321710/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91628805,"identity":"e528e634-67f2-4d69-a583-4768ef03c647","added_by":"auto","created_at":"2025-09-18 12:38:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":769269,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6321710/v1/6ec92b1c-7fc0-48ca-89c4-d5894f462f78.pdf"},{"id":82293111,"identity":"0301e48a-b485-458e-aa6d-218a01a4ec95","added_by":"auto","created_at":"2025-05-08 18:26:05","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":39320,"visible":true,"origin":"","legend":"","description":"","filename":"table.docx","url":"https://assets-eu.researchsquare.com/files/rs-6321710/v1/091944a40fac1054af41144d.docx"},{"id":82292409,"identity":"f7d34b3f-b2ad-4623-a527-9a11b872c0e6","added_by":"auto","created_at":"2025-05-08 18:18:05","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":22307,"visible":true,"origin":"","legend":"","description":"","filename":"Q.docx","url":"https://assets-eu.researchsquare.com/files/rs-6321710/v1/c96804855782e451f2fcfd63.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessment of Professional Competency and Its Related Factors in Cardiology Interns Using a Self-Assessment Method","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNowadays, universities worldwide are seeking innovative educational strategies to enhance students' professional competencies, clinical decision-making, and self-directed learning. In this regard, medical education has focused on defining professional competencies, designing competency-based curricula, and developing effective assessment tools (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Professional competence encompasses knowledge, technical skills, and the ability to exercise clinical judgment and decision-making, enabling individuals to perform their duties effectively (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Furthermore, this concept is defined as the functional capacity to integrate knowledge and skills across various specialized fields(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Internship and residency programs are considered some of the most important stages in medical education, as they place students in real clinical environments, providing opportunities for hands-on experience in patient management and treatment under the supervision of specialists. Therefore, the internship plays a key role in the development of students' professional competencies(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eProfessional competence in medical education, particularly in specialized fields such as cardiology, is of significant importance(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). The cardiology department is one of the most challenging and dynamic educational fields in medical sciences, which can have a significant impact on enhancing the competence of interns(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The complexity of heart diseases, related medical emergencies, and the need for quick and accurate decision-making have made this department an ideal environment for enhancing clinical skills, critical thinking, and patient management(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Interns in this field not only encounter a wide range of heart diseases, including heart failure, heart attacks, and arrhythmias, but also have the opportunity to gain practical experience in interpreting ECGs, performing invasive procedures, and collaborating with multidisciplinary healthcare teams(\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). In addition, working in the high-pressure environment of the cardiology department enhances interns' skills in quick decision-making, stress management, and effective communication with patients and their families(\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTherefore, training in this department not only helps enhance their knowledge and technical skills but also paves the way for the development of professionalism, responsibility, and self-efficacy in their professional journey. The professional competence of interns in the cardiology department is influenced by a combination of individual, educational, and environmental factors, each of which can impact their performance and learning. Individual factors include theoretical knowledge, practical skills, previous clinical experiences, and the interns' confidence levels when interacting with patients. Educational factors involve the quality of the curriculum, teaching methods, the extent of interaction with faculty, and receiving constructive feedback(\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Additionally, environmental factors play a significant role in the professional competence of interns. High workload, stress from emergency situations, opportunities for practical learning, and the level of support and collaboration from the healthcare team are factors that can influence interns' performance and learning(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Despite identifying various dimensions of professional competence, comprehensive strategies that can assess multiple aspects of this competence simultaneously remain limited, especially those that reliably measure theoretical knowledge, technical skills, and interpersonal and human qualities(\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). In this context, self-assessment has emerged as one of the modern and effective approaches in educational planning. It is not only specific to the medical field but is also applicable in other academic areas. Studies have shown that students' self-assessment of practical skills can be more valuable than traditional academic evaluations. Many universities today incorporate this method alongside faculty evaluations to provide a more comprehensive and accurate assessment of students' professional competence(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTherefore, the professional competence of interns in the cardiology department plays a vital role in the quality of medical services and the improvement of patient health. This competence can be influenced by various factors, including individual characteristics, the quality of education, and the learning environment. Assessing the professional competence of interns and identifying the factors that affect it can contribute to the enhancement of medical education and help identify existing weaknesses. Thus, the aim of this study is to assess the professional competence of cardiology interns and identify the related factors through the self-assessment method at Babol University of Medical Sciences.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003cp\u003eThis study is a descriptive cross-sectional research conducted in 2023. The study population included general medicine interns from Babol University of Medical Sciences who had completed their cardiology internship by the time of the study. A convenience sampling method was used, and the sample size was determined using the Krejcie and Morgan (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e) table, with a 20% attrition rate considered for the population of 260 students (general medicine interns from the cardiology department of Babol University of Medical Sciences in 2023). The final sample size was calculated to be 153.\u003c/p\u003e \u003cp\u003eIn this study, medical interns who were either currently enrolled or had previously completed their cardiology internship at the educational and medical centers of Babol University of Medical Sciences in 2023 were asked to respond to a researcher-developed questionnaire either physically or electronically. The questionnaire provided to the participants consisted of three sections:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eDemographic Questions\u003c/b\u003e: This section included questions on age, gender, basic science/pre-internship exam scores, marital status, place of residence, overall grade point average up to the end of the apprenticeship, and the number of other internship rotations completed prior to the cardiology rotation.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eQuestions on Professional Competence Areas\u003c/b\u003e: These questions were based on the curriculum approved by the General Medicine Planning Office and the competencies of graduates from the Doctor of Medicine program. This section consisted of 68 questions, covering social skills, patient history taking and physical examination, differential diagnosis, treatment, and practical skills, with 2, 25, 6, 19, and 16 questions for each respective area. Responses to this section were recorded using a five-point Likert scale: (very good\u0026thinsp;=\u0026thinsp;5, good\u0026thinsp;=\u0026thinsp;4, average\u0026thinsp;=\u0026thinsp;3, poor\u0026thinsp;=\u0026thinsp;2, very poor\u0026thinsp;=\u0026thinsp;1).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eQuestions on the Impact of Related Factors on Professional Competence\u003c/b\u003e: This section assessed the interns' views on the factors influencing their professional competence in the cardiology internship program. It included 19 questions: 10 questions regarding the educational program and 3 questions each regarding student-related factors, educational resources, and faculty-related factors. The responses to this section were also recorded using a five-point Likert scale: (completely effective\u0026thinsp;=\u0026thinsp;5, effective\u0026thinsp;=\u0026thinsp;4, average effect\u0026thinsp;=\u0026thinsp;3, low effect\u0026thinsp;=\u0026thinsp;2, no effect\u0026thinsp;=\u0026thinsp;1) (supplementary).\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDesign of the Second and Third Sections of the Questionnaire\u003c/h2\u003e \u003cp\u003eIn this study, the content of the educational program for the cardiology rotation in the general medicine internship, as approved by the Ministry of Health, Treatment, and Medical Education, and the competencies for graduates of the Doctor of Medicine program in the country, were used to design questions relevant to the research goal, based on the 5-point Likert scale. This was done with the guidance of the cardiology department faculty at Babol University of Medical Sciences, and the items were reviewed by experts.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eValidity and Reliability of the Questionnaire\u003c/h3\u003e\n\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eFace Validity\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eQualitative Method\u003c/b\u003e: The questionnaire was distributed to 10 medical interns, who provided feedback on the difficulty level, relevance, and clarity of the items. Revisions were made based on their suggestions.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eQuantitative Method\u003c/b\u003e: The questionnaire was sent to the same 10 medical interns, who were asked to rate the importance of each item on a 5-point scale (5\u0026thinsp;=\u0026thinsp;Very Important, 4\u0026thinsp;=\u0026thinsp;Somewhat Important, 3\u0026thinsp;=\u0026thinsp;Moderately Important, 2\u0026thinsp;=\u0026thinsp;Slightly Important, 1\u0026thinsp;=\u0026thinsp;Not Important). The impact score for each item was then calculated using a specific formula, and any item with a score above 1.5 was retained (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Ultimately, all items were retained.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eContent Validity\u003c/h3\u003e\n\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eQualitative Method\u003c/b\u003e: The questionnaire was sent to 10 experts, including 6 cardiologists and 4 medical education specialists with experience in designing and psychometric testing of tools. They were asked to review the scale for linguistic accuracy, the appropriateness of wording, and the placement of items.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eQuantitative Method\u003c/b\u003e: Then, to determine the quantitative validity of this questionnaire, the Content Validity Ratio (CVR) and Content Validity Index (CVI) indices were used. For CVR, the 10 previous experts rated the items based on their necessity using a 3-point Likert scale (1\u0026thinsp;=\u0026thinsp;not necessary, 2\u0026thinsp;=\u0026thinsp;useful but not essential, 3\u0026thinsp;=\u0026thinsp;essential). The score was calculated using the following formula:\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eCVR = (ne\u0026thinsp;\u0026minus;\u0026thinsp;N/2) / (N/2)\u003c/p\u003e \u003cp\u003eWhere:\u003c/p\u003e \u003cp\u003ene\u0026thinsp;=\u0026thinsp;the number of experts (faculty members) who selected \"essential\"\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;total number of experts (faculty members)\u003c/p\u003e \u003cp\u003eThe responses were analyzed based on the Lawshe table, and the minimum acceptable value according to the Lawshe table was set to 0.62(\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). At this stage, all items were retained. After calculating the CVR, the CVI was assessed. For this purpose, the same 10 specialists who participated in determining the CVR were asked to rate the items using a Likert scale (completely relevant, relevant, somewhat relevant, not relevant). According to Polit et al. (2007), a minimum CVI of 0.78 is considered excellent for at least six specialists. In this study, the minimum acceptable CVI was set at 0.78, and all items met this threshold(\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The S-CVI/Ave index was calculated with a minimum acceptable value of 0.90, resulting in a value of 0.898 (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eReliability\u003c/h3\u003e\n\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eICC (Intraclass Correlation Coefficient)\u003c/b\u003e: After validating the content, the reliability of the questionnaire was tested using the ICC, which was found to be 87%.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eCronbach\u0026rsquo;s Alpha\u003c/b\u003e: The internal consistency of the questionnaire was evaluated using Cronbach's alpha. For the second section (competency evaluation items), the alpha was 97%, and for the third section (factors affecting professional competency), it was 90%.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eMcDonald\u0026rsquo;s Omega\u003c/b\u003e: The McDonald\u0026rsquo;s omega coefficient was calculated, yielding values of 0.97 for the second section and 0.89 for the third section, both indicating high reliability.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003e The research protocol for this study was approved by the Ethics Committee of Babol University of Medical Sciences under the code IR.MUBABOL.HRI.REC.1402.061. Participants' information remained confidential and was not shared with any third parties. No additional costs were incurred by the participants. In case of any withdrawal, participants were free to exit the study at any stage. The study\u0026rsquo;s objectives and procedures were explained to the participants, and they were assured that their data would only be used for research purposes and that their dignity and privacy would be upheld throughout the study.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Analysis Method\u003c/h3\u003e\n\u003cp\u003eMean, standard deviation (SD), count and percentage were used to describe the ability fields between participant\u0026rsquo;s features. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Independent sample\u0026rsquo;s t-test, One-way ANOVA followed by Tukey\u0026rsquo;s test, and Welch One-way ANOVA followed by Games-Howell\u0026rsquo;s test was used. Univariate linear regression was used to determine the relationship between participant\u0026rsquo;s features and ability fields. Multiple linear regression was used to adjust potential confounders. All analyses were performed by SPSS version 26 software (IBM Corp.). The significant level of the tests was considered less than 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn this study, there were 153 participants, including 74 males (48.4%) and 79 females (51.6%). The mean age was 25.39±1.25 years. 129 participant fill in the electronic version and 24 participant fill in the paper version of questionnaire.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe baseline features of study participants and comparison ability fields between them are reported in Table 1. The number of Top students in relation to the “Total grade point average until the end of the internship”, “Comprehensive test score of the preliminary education course”, and “comprehensive test score before entering the internship course” were 38 (24.8%), 35 (22.9%), and 21 (13.7%), respectively. The mean values of Treatment area differed significantly between rotation number (\u003cem\u003eP\u003c/em\u003e-value=0.043), so that Tukey’s test reveal that mean of Treatment area in “\u0026gt;5 rotation number” group is larger than “2-5 rotation number”. Additionally, there were significant differences in the Treatment area (\u003cem\u003eP\u003c/em\u003e-value=0.040), Practical skills area (\u003cem\u003eP\u003c/em\u003e-value=0.037), and Total ability field (\u003cem\u003eP\u003c/em\u003e-value=0.032) across the “comprehensive test score before entering the internship course”.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDescriptive statistics of standardized Influencing Factors and Ability Fields based on study participants are presented in \u003cstrong\u003eTable 2\u003c/strong\u003e. The results revealed that, overall, 51% of the interns rated their competence as average. Additionally, the interns achieved the highest scores in the following order: Social field, Differential diagnosis scope, History and physical examination area, Practical skills area, and Treatment area.\u003c/p\u003e\n\u003cp\u003eAssociations between baseline features of study participants and ability fields are shown in \u003cstrong\u003eTable 3\u003c/strong\u003e. More than five rotation number group compare to two to five rotation number group, higher mean of Treatment Area (beta (β)=5.486, \u003cem\u003eP\u003c/em\u003e-value=0.014, 95% confidence interval (CI):1.110, 9.861) and Total Ability Field (β=13.142, \u003cem\u003eP\u003c/em\u003e-value=0.041, 95% CI:0.522, 25.762) was observed. In comprehensive test score before entering the internship course, Poor group compared to Intermediate group, lower mean of Treatment Area (β=-6.783, \u003cem\u003eP\u003c/em\u003e-value=0.044, 95% CI: -13.240, -0.326) was observed. In comprehensive test score before entering the internship course, Top group compared to Intermediate group, lower mean of History and Physical Examination Area (β=-6.304, \u003cem\u003eP\u003c/em\u003e-value=0.040, 95% CI: -12.436, -0.171), Practical skills area (β=-5.301, \u003cem\u003eP\u003c/em\u003e-value=0.019, 95% CI: -9.727, -0.874), Total Ability Field (β=-17.914, \u003cem\u003eP\u003c/em\u003e-value=0.041, 95% CI:-35.119, -0.708) was observed.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAssociations between influencing factors and ability fields are presented in\u003cstrong\u003e\u0026nbsp;Table 4\u003c/strong\u003e. In the crude model, Social Field was associated with each unit increase of Curriculum Area (β=0.061, \u003cem\u003eP\u003c/em\u003e-value\u0026lt;0.001, 95% CI:0.031, 0.090), The Field Related to The Student (β=0.121, \u003cem\u003eP\u003c/em\u003e-value=0.039, 95% CI:0.006,0.236), Educational Facilities Area (β=0.136, \u003cem\u003eP\u003c/em\u003e-value=0.001, 95% CI:0.058, 0.214), and The Field Related to The Teacher (β=0.167, \u003cem\u003eP\u003c/em\u003e-value\u0026lt;0.001, 95% CI:0.087, 0.247). After adjusting for potential confounders, The Field Related to The Teacher (β=0.123, \u003cem\u003eP\u003c/em\u003e-value=0.026, 95% CI:0.015, 0.231) remained significantly associated with Social Field.\u003c/p\u003e\n\u003cp\u003eIn the crude model, History and Physical Examination Area was associated with Curriculum Area (β=0.601, \u003cem\u003eP\u003c/em\u003e-value\u0026lt;0.001, 95% CI:0.303, 0.899), The Field Related to The Student (β=1.721, \u003cem\u003eP\u003c/em\u003e-value=0.003, 95% CI:0.593, 2.848), Educational Facilities Area (β=1.010, \u003cem\u003eP\u003c/em\u003e-value=0.013, 95% CI:0.217, 1.803), and The Field Related to The Teacher (β=1.052, \u003cem\u003eP\u003c/em\u003e-value=0.013, 95% CI:0.230, 1.874). However, after adjusting for potential confounders, no significant associations were found between influencing factors and the History and Physical Examination Area.\u003c/p\u003e\n\u003cp\u003eIn the crude model, The Scope of Differential Diagnosis was associated with each unit increase of The Field Related to The Student (β=0.421, \u003cem\u003eP\u003c/em\u003e-value=0.013, 95% CI:0.089, 0.752). However, after adjusting for potential confounders, no significant associations were found between the influencing factors and The Scope of Differential Diagnosis.\u003c/p\u003e\n\u003cp\u003eIn the crude model, Treatment Area was associated with each unit increase of Curriculum Area (β=0.437, \u003cem\u003eP\u003c/em\u003e-value=0.001, 95% CI:0.192, 0.754) and The Field Related to The Student (β=1.611, \u003cem\u003eP\u003c/em\u003e-value=0.003, 95% CI:0.563, 2.658). After adjusting for potential confounders, significant association remained between the Curriculum Area (β=0.432, \u003cem\u003eP\u003c/em\u003e-value=0.030, 95% CI:0.043, 0.821) and The Field Related to The Student (β=1.330, \u003cem\u003eP\u003c/em\u003e-value=0.038, 95% CI:0.078, 2.583) with the Treatment Area.\u003c/p\u003e\n\u003cp\u003eIn the crude model, Practical Skills Area was associated with each unit increase of Curriculum Area (β=0.501, \u003cem\u003eP\u003c/em\u003e-value\u0026lt;0.001, 95% CI:0.302, 0.700), The Field Related to The Student (β=1.229, \u003cem\u003eP\u003c/em\u003e-value=0.002, 95% CI:0.458, 2.000), Educational Facilities Area (β=0.689, \u003cem\u003eP\u003c/em\u003e-value=0.013, 95% CI:0.145, 1.232), and The Field Related to The Teacher (β=0.848, \u003cem\u003eP\u003c/em\u003e-value=0.003, 95% CI:0.289, 1.407). After adjusting for potential confounders, Practical Skills Area remained significantly associated with the Curriculum Area (β=0.440, \u003cem\u003eP\u003c/em\u003e-value=0.003, 95% CI:0.156, 0.724).\u003c/p\u003e\n\u003cp\u003eIn the crude model, the Total Ability was associated with each unit increase of Curriculum Area (β=1.718, \u003cem\u003eP\u003c/em\u003e-value\u0026lt;0.001, 95% CI:0.929, 2.506), The Field Related to The Student (β=5.102, \u003cem\u003eP\u003c/em\u003e-value=0.001, 95% CI:2.117, 8.087), Educational Facilities Area (β=2.586, \u003cem\u003eP\u003c/em\u003e-value=0.017, 95% CI:0.468, 4.704), and The Field Related to The Teacher (β=2.636, \u003cem\u003eP\u003c/em\u003e-value=0.019, 95% CI:0.438, 4.834). After adjusting for potential confounders, Total Ability Field remained significantly associated with the Curriculum Area (β=1.407, \u003cem\u003eP\u003c/em\u003e-value=0.015, 95% CI:0.275, 2.538).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study was conducted to assess professional competence and its related factors among interns in the cardiology educational department at Babol University of Medical Sciences. In this study, five domains were examined and evaluated, including social skills, history-taking and physical examination skills, differential diagnosis skills, clinical management and treatment skills, and practical skills.\u003c/p\u003e \u003cp\u003eIn current study, we evaluated the relationship between influencing factors and ability fields in medical students. We found positive associations between them. After adjusting for potential confounders, The Field Related to The Teacher (β\u0026thinsp;=\u0026thinsp;0.123, \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;=\u0026thinsp;0.026, 95% CI:0.015, 0.231) was significantly associated with Social Field. There was significant association between the Curriculum Area (β\u0026thinsp;=\u0026thinsp;0.432, \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;=\u0026thinsp;0.030, 95% CI:0.043, 0.821) and The Field Related to The Student (β\u0026thinsp;=\u0026thinsp;1.330, \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;=\u0026thinsp;0.038, 95% CI:0.078, 2.583) with the Treatment Area. Practical Skills Area remained significantly associated with the Curriculum Area (β\u0026thinsp;=\u0026thinsp;0.440, \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;=\u0026thinsp;0.003, 95% CI:0.156, 0.724). Total Ability Field remained significantly associated with the Curriculum Area (β\u0026thinsp;=\u0026thinsp;1.407, \u003cem\u003eP\u003c/em\u003e-value\u0026thinsp;=\u0026thinsp;0.015, 95% CI:0.275, 2.538). We found that curriculum area is significantly associated with medical student professional abilities in the treatment area, practical skills and total professional ability field. According to our results the curriculum area plays a pivotal role in shaping medical students' professional abilities. Several factors outlined in medical education publications account for the association between the curriculum and the professional capabilities of medical students in both social and treatment settings. According to Xu et al., a well-structured curriculum enhances students' self-guided learning abilities, which are pivotal for lifelong learning and professional growth. This aligns with the findings of the present study, where the quality and structure of the educational program were identified as influential factors in the professional competency of cardiology interns(\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Additionally, Schmoyer et al. emphasizes that interprofessional education fosters teamwork and collaboration skills, essential for effective patient care by integrating these components into the curriculum, medical schools can better prepare students to excel in both social interactions and clinical treatment, ultimately lead to better outcomes for patients (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur results suggest that the curriculum area has a significant impact on professional ability in the fields of treatment skills and practical skills, but not in social field, history taking, physical examination, and differential diagnosis. Our findings were in line with the results of Khanna et al.'s study. They highlighted the importance of a well-structured curriculum in equipping students for practice, particularly in domains such as social skills, treatment skills, and practical skills. This further supports the notion that a comprehensive and well-organized educational framework plays a crucial role in enhancing professional competency among medical trainees(\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Moreover, another study underscored the value of curriculum integration in enhancing professional abilities, particularly in practical and social fields. This suggests that incorporating interdisciplinary and structured educational approaches can significantly contribute to the development of essential competencies among medical trainees(\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). The study by Moatari et al. also stated that strengthening the medical competencies required by society necessitates greater attention throughout the academic curriculum and continuous education programs(\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). Given that the educational curriculum in Iran has remained largely unchanged for years, various studies, including Yazdani et al., have recommended revising teaching methods in alignment with the clinical curriculum(\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Matlabe-Nejad et al. reported that graduates' perceptions of their professional competencies largely reflected dissatisfaction with their acquired practical skills, indicating weaknesses in clinical teaching methods(\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Similarly, Soodagar et al. found that although students self-reported an acceptable level of practical skills, the educational program had not fully achieved its intended learning objectives. Consequently, their study emphasized the need for modifications in training to enhance competencies that had received lower ratings(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnother aspect of our finding was that in addition to curriculum area the field related to students was also significantly associated with treatment area. There are some possible reasons. In treatment area, students might have more hands-on experience and direct patient interaction, which could improve their professional ability more significantly than theoretical knowledge alone. Treatment area often include immediate feedback from patients and supervisors, allowing students to reflect and improve their skills more rapidly (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). The treatment area might involve more complex and high-stakes situations, making the student's role and their related parameters more critical to their professional development. On the other hand, the significant relationship between the instructor-related domain and the social skills domain indicates that the instructor\u0026rsquo;s approach can enhance students\u0026rsquo; social skills. This finding highlights the crucial role of instructors in teaching social skills to students. One of the questions in the social skills domain assessed confidence in various clinical situations. Similarly, the study by N.S. Bashkirova et al. demonstrated that differences exist between students' self-esteem and their ideal versus actual self-perceptions(\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Given these findings, there is a need to enhance students\u0026rsquo; confidence through practical, experience-based training and active instructor engagement.\u003c/p\u003e \u003cp\u003eSince age, gender, marital status, place of residence, cumulative Grade Point Average by the end of the internship, and basic sciences exam score showed no significant relationship with interns\u0026rsquo; professional competency, it can be concluded that demographic characteristics and theoretical education and assessments do not significantly influence students\u0026rsquo; perceived competency. In contrast, readiness for clinical evaluations, such as the number of rotations and the pre-internship exam, plays a more critical role in students\u0026rsquo; empowerment. In terms of theoretical education, the study by Moti et al. indicated that while students possess adequate theoretical knowledge, their inability to bridge theory with practice results in a lack of competence in fundamental nursing skills. They found discrepancies between what newly registered nurses learned in the classroom and what they observed in clinical practice, which aligns with the present study\u0026rsquo;s findings(\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). Another key finding of this study was that students with moderate pre-internship exam scores reported higher satisfaction with their professional competency, particularly in the treatment domain, compared to those with weak or strong scores. This suggests that students who are either exceptionally strong or weak in theoretical subjects may be less satisfied with their perceived competency. This aligns with previous studies that found a weak correlation between theoretical and practical performance(\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAdditionally, the results indicate that students exhibit higher confidence and perceive themselves as more competent in areas they frequently encounter and study theoretically, such as history-taking and formulating differential diagnoses. Conversely, in domains where they have limited exposure or are newly introduced during their internship, such as disease management and practical skills, lower self-assessment scores are expected. Mirzadeh et al. also identified a lack of competence in patient management and rational drug prescription as challenges reported by students(\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). Furthermore, the perception of students, especially in professional and public settings, is highly significant, as reflected in the present findings. The instructor-related domain had the highest mean score among all domains, emphasizing the importance of communication with other healthcare team members in fostering competency. Similarly, the study by Khorramand et al., which explored the interaction between interns and nurses, highlighted that weak communication could negatively impact patient management and teamwork. Their study recommended integrating training on effective communication with the nursing team into internship objectives, content, and teaching methods(\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study revealed that medical interns in the cardiology department assess their professional competencies at a moderate level, with certain skills, such as history-taking and physical examination, receiving higher scores compared to clinical management and practical skills. These findings highlight the importance of designing structured educational programs that can enhance clinical decision-making and patient management skills. Moreover, the significant relationship between the curriculum and professional competency suggests that modifying educational approaches can have a substantial impact on the clinical performance of interns.\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy Limitations\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003ePopulation Limitation\u003c/b\u003e: This study was conducted solely on interns from a single university, which may restrict the generalizability of the results.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eReliance on Self-Assessment\u003c/b\u003e: The data in this study were collected based on students\u0026rsquo; self-assessment, which may introduce bias in evaluating their actual competencies.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eLack of Consideration for Other Influential Factors\u003c/b\u003e: Key variables such as prior clinical experiences, individual learning strategies, and interactions with faculty members were not thoroughly examined.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003e \u003cb\u003eFocus on a Single Specialty\u003c/b\u003e: This study focused only on the cardiology department and did not consider other medical fields.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations for Future Studies\u003c/h2\u003e \u003cp\u003eTo enhance the generalizability of the findings, similar studies should be conducted in other internship departments and medical universities. Additionally, incorporating objective assessment methods, such as clinical simulations and practical examinations, alongside self-assessment could improve the accuracy of professional competency evaluations. Examining the impact of different teaching methods, including problem-based learning and simulation-based education, could contribute to optimizing educational programs. Furthermore, analyzing the role of individual and environmental factors, such as previous clinical experiences, the level of interaction with faculty members, and the structure of clinical learning environments, is crucial for enhancing interns' professional competencies. Finally, conducting longitudinal studies to assess the impact of educational interventions on graduates' performance in real-world clinical settings could help develop sustainable and effective educational strategies.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;This article was derived from a Doctor of Medicine \u0026nbsp;thesis. The authors would like to thank the research deputy at Babol University of Medical Sciences for their support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMehrdad Saravi \u0026nbsp;and Maryam Ghaemi-Amiri collaborated on designing the study with input from all authors. Mohammad Ali Ghasemi-Darzi collected the data, while Hemmat Gholinia conducted the statistical analysis. Maryam Ghaemi-Amiri drafted the initial manuscript. All authors contributed to finalizing the manuscript, interpreting results, and critically revising it for important intellectual content. The final manuscript was reviewed and approved by all authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study were used under license for the current study, and so are not publicly available.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCarraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. 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Helpful and hindering factors in psychodrama field training: A longitudinal mixed methods study of student development. Front Psychol. 2018;9:196.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBashkirova N, Kramarchuk V, Rosytska O. SELF-EVALUATION OF PROFESSIONAL COMPETENCIES AMONG MEDICAL INTERNS. Věda a perspektivy. 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoeti MR. Perceptions of the clinical competence of newly registered nurses in the North West province. University of Pretoria; 2005.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaupt F, Kanzow P. The Relation Between Students' Theoretical Knowledge and Practical Skills in Endodontics: Retrospective Analysis. Interact J Med Res. 2023;12:e46305.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMirzadeh M-s, Soleymani-Salehabadi H, Akhondi-Meybodi M. Self-Assessment of Medical Interns on Their Ability to Management of Inpatients in the Internal Department at Shahid Sadoughi University of Medical Sciences. J Med Educ Dev. 2021;16(1):55\u0026ndash;65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShams B, Kheradmand A, Mahmoodi M, Hosseini SF, Rafaie E, Vaghef Davari F. Interns\u0026rsquo; Viewpoints About Nurses\u0026rsquo; Capability And Behavior Towards Patients And Interns. Iran J Med Educ. 2004;4(2):63\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTables 1 to 4 are available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Professional Competence, Self-Assessment, Internship, Residency","lastPublishedDoi":"10.21203/rs.3.rs-6321710/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6321710/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground and Objectives:\u003c/h2\u003e \u003cp\u003eThe professional competence of medical interns in specialized fields such as cardiology plays a crucial role in the quality of healthcare services. This study aimed to assess the level of professional competence among cardiology interns and explore its related factors.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis descriptive cross-sectional study was conducted in 2023 on 153 medical interns at Babol University of Medical Sciences. Participants completed a researcher-developed questionnaire consisting of three sections: demographic characteristics, domains of professional competence, and related factors. Data were analyzed using independent t-tests, one-way ANOVA, and univariate and multivariate linear regression in SPSS version 26.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe findings revealed that more than half of the interns rated their professional competence as moderate. The highest scores were observed in history-taking, physical examination, and differential diagnosis skills, while the lowest scores were reported in treatment management and practical skills. Regression analysis indicated that the educational program and interaction with faculty members had the most significant impact on professional competence, whereas demographic variables showed no significant effect.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eEducational programs play a key role in enhancing interns' professional competence. Strengthening practical training and educational interactions can positively influence their clinical performance. It is recommended that educational programs incorporate simulation-based learning, problem-based learning, and increased clinical experience. Additionally, further research should be conducted in other internship departments and on the impact of training during professional practice.\u003c/p\u003e","manuscriptTitle":"Assessment of Professional Competency and Its Related Factors in Cardiology Interns Using a Self-Assessment Method","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-08 18:18:00","doi":"10.21203/rs.3.rs-6321710/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d7b740e9-9ff3-4372-83b7-b2d7f90e6bf5","owner":[],"postedDate":"May 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-18T12:38:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-08 18:18:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6321710","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6321710","identity":"rs-6321710","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}