Higher Learning Commission

Core Professional Attributes in Health Professions Education: Developing Institutional-level Assessment

Melanie J. Davis and Jane Hawthorne


When A. T. Still University (ATSU) received the Higher Learning Commission’s (HLC) report after a comprehensive evaluation visit in 2009, the university recognized that it did not have institutional student learning outcomes. In response to the need to assess such outcomes, ATSU’s president convened the University-wide Assessment Committee (UWAC) to develop and implement an integrated assessment plan for the university and develop a set of attributes that would define skills every ATSU student should have on graduation. These attributes were to be similar to the concept of core curriculum and general education at the undergraduate level, a foundational set of knowledge, skills and values common to all health professions graduates at ATSU. After approximately two years of research, communications and campus meetings, UWAC introduced eight overarching professional goals known as Transferable Skills: Critical Thinking, Cultural Competence, Interprofessional Collaboration, Ethical and Legal Understanding, Leadership, Positive Interpersonal Communication, Self-Assessment and Reflective Practice and Wellbeing.

A small group of administrators and staff members collected program and course outcomes to map to the Transferable Skills, but the efforts produced minimal progress. A total of 47 key constructs were identified for the eight skills, which proved an untenable and difficult task to measure. One issue impeding buy-in was the lack of active community engagement, particularly that of faculty members, during the development process. In 2012 the administration changed, and, with the new personnel, efforts to incorporate institutional outcomes were revitalized. After the university was accepted into the HLC Assessment Academy in 2013, the implementation of Transferable Skills became the Quality Initiative (QI) project for the Open Pathway. As a result of revisiting this project, the QI Team quickly recognized that the Transferable Skills were unwieldy. The QI Team then proposed five measurable Core Professional Attributes (CPAs) with fewer key constructs, still closely aligned to the university’s mission: Critical Thinking, Cultural Proficiency, Interpersonal Skills, Interprofessional Collaboration and Social Responsibility. QI Team members presented the work-in-progress to the deans, college and school faculty members, faculty senate and the UWAC to solicit feedback. After modification based on feedback, UWAC approved both the transition in terminology from Transferable Skills to Core Professional Attributes and the newly defined five attributes.

The QI Team continued to solicit feedback on the proposed CPAs university-wide during an Assessment Week town hall in 2015. Because of the breadth and depth of each CPA, three more town hall sessions were held to actively engage university stakeholders in selecting a limited number of measurable indicators for each CPA, termed “key elements.” The outcome of those sessions reduced the key elements to three for each CPA. One additional virtual town hall was held to further refine the key elements and discuss possible measures. The QI Team is now working with units across the university to identify course and program outcomes to map to the CPAs. Table 1 lists the CPAs and the associated key elements.

Table 1. ATSU Core Professional Attributes and Key Elements

Core Professional Attribute Key Element 1 Key Element 2 Key Element 3

Critical Thinking

The ability to find, appraise and apply evidence consistent with best practice in the process of health-care decision-making process

Evidence-based Decision Making

Defines the issue or problem and gathers evidence to inform decision making in selecting options for the best health-care outcomes and conclusions

Critical Appraisal

Assesses evidence used in decision making and draws inferences and conclusions based on valid, reliable and relevant information

Evaluation and Reflection
Determines consequences of the reasoning and decisions

Analyzes the implications of assumptions, contexts and inferences on current and future decisions

Cultural Proficiency

The ability to value and respect differences, as evidenced by knowledge, attitudes and behaviors that enable effective interactions in all situations

Cultural Knowledge

Demonstrates understanding of the complex elements inherent to culture in relation to history, values, politics, communication styles, economy, beliefs and practices and their impact on health and healthcare delivery

Cultural Differences

Participates in diverse cultural experiences and opportunities

Applies understanding of cultural differences in verbal and nonverbal communication and is able to skillfully negotiate a shared understanding based on those differences

Adaptation to Diversity

Interprets intercultural experience from perspectives beyond one’s personal worldview.

Communicates and acts in a supportive manner that recognizes the perspectives of other cultural groups

Interpersonal Skills

The ability to interact successfully with others throughout the health-care delivery process

Communication Skills

Utilizes appropriate oral/written/nonverbal presentation skills to communicate effectively

Active Listening and Questioning

Listens and responds to improve mutual understanding

Asks questions that effectively elicit the desired information and promote understanding

Conflict Management/


Identifies the basic issues in a conflict and develops an effective approach to achieve resolution

Interprofessional Collaboration

The ability to work effectively with others on an interprofessional team to improve health outcomes and deliver the highest quality of care

Scopes of Practice

Recognizes the scopes of practice and values the unique roles and responsibilities each profession contributes to whole-person health care

Collaboration and Consultancy

Includes other health-care professionals, patients and family members in planning and implementing care to achieve the best health-care outcome


Applies concepts of team development, interaction and teamwork
Shares responsibility for team actions

Social Responsibility

The ability to recognize the moral responsibility to engage in initiatives and activities that positively impact the health and well-being of the individuals, communities and professions served


Advocates for health and wellness through engagement with community, profession and/or scholarship

Engages with the profession through membership and/or scholarship that advances society’s general welfare

Responsibility and Accountability

Participates in community health and wellness activities and in service-learning projects focusing on the underserved, i.e., locally, nationally and globally

Advocates for equal access to quality and cost effective health care

Ethics and Code of Conduct

Demonstrates an understanding of the ethical standards and code of conduct governing their profession and a commitment to practicing within the legal statutes

Continuous Quality Improvement

The assessment of CPAs across the curriculum has resulted in enhanced examination and review of all program curricula. Programs are in the process of identifying and revising curricular and outcome gaps and redundancies.

Challenges and Solutions

To inculcate a culture of assessment across the university, the QI Team has to obtain administrative, faculty and staff buy-in. The previous attempt to review assessment at the university level had stalled, creating ambivalence among these stakeholders. Working with the senior vice president of Academic Affairs and the associate vice president of Academic Affairs and Innovation, the QI Team has been resolute in communications with the community, especially the faculty and administration. The Team has actively involved stakeholders in decisions and returned to the various groups once decisions were made.

Multiple campus locations and multiple disciplines created silos throughout the university. Even though university processes and policies may have transcended locations, there was a tendency for departments to look inward, citing disciplinary accreditation. Along with concurrent initiatives by various units, communications became better, allowing for more dialogue among the constituencies. Although still not optimal, there is more information exchanged interprofessionally, raising the awareness of the QI Team’s messages.

University leadership gained buy-in and participation from the academic deans of each college/school at the university from the beginning of the QI project. A crosswalk document was developed to facilitate communication and mapping in Tk20, ATSU’s assessment software. The crosswalk allows each program to maintain its individual terminology while providing common nomenclature for university purposes. Keeping each unit involved and updated with data pertaining to their units as well as to the university’s data created goodwill as well as more acceptance.

Working with the Office of Assessment and Accreditation and the University-wide Assessment Committee, the QI Team holds annual assessment days, workshops, webinars and “lunch and learn activities” to present relevant assessment topics. These events have garnered more notice and participation with each activity.

Next Steps

While the QI Team and the ATSU units are identifying various potential assessment instruments, the Team anticipates gathering results within the next six months, allowing Team members to begin measuring the impact of the QI project on student learning outcomes. The QI Team is confident that assessment of the CPAs in the curriculum and cocurriculum will foster improvement of student learning outcomes for all ATSU graduates.


About the Authors

Melanie J. Davis is Assistant Director for Assessment and Accreditation and Jane Hawthorne is University Data Manager at A. T. Still University of Health Sciences in Kirksville, Missouri, and Mesa, Arizona.

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