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Background In increasingly complex and stressed health environments, medical practice requires more from doctors than just knowledge and skills. Much has been written of wisdom, although there is a striking absence of reflection on its potential occupational application, particularly in medicine. This study aimed to adapt the wisdom construct to the medical professional setting and develop a new scale, the Medical Wisdom Scale (MD-WISE). Method We developed a prototype questionnaire based on domains and items from an existing validated tool—the San Diego Wisdom Scale (SD-WISE) (Thomas et al., 2019)—and a Delphi-style consensus process with a diverse range of selected subject matter experts, yielding a 56-item prototype scale. These candidate items mapped to nine putative domains of medical wisdom. The scale was tested on two independent samples of doctors recruited from a large urban health district in Sydney, Australia: Sample 1 completed the 56-item prototype for initial item screening; Sample 2 completed a reduced item set alongside the Authentic Leadership Self Assessment Questionnaire (ALSAQ) as part of assessing construct validity. Results Despite extensive recruitment strategies, Sample 1 data (n=64) precluded explorative factor analysis (EFA) and items were screened using alternative validated qualitative and quantitative approaches to generate a 20-item scale. From the 20-item version tested in Sample 2 (n=174), EFA supported a four-factor structure. Iterative refinement yielded a final 13-item scale (MD-WISE-13) comprising four factors: (i) Clinical Composure, (ii) Insightful and Reflective Practice, (iii) Self and Family Care, (iv) Respect for Patient Autonomy. The 13-item model demonstrated good fit in CFA (χ² = 66.42, p = .003; CFI = .965; TLI = .950; RMSEA = .066). Furthermore, the final MD-WISE scale demonstrated convergent validity with ALSAQ total scores (Pearson’s coefficient r =0.53, p <0.001, 95% Confidence Interval: 0.414-0.630). Conclusions We developed a pragmatic Medical Wisdom scale (MD-WISE-13) with a stable four-factor structure and evidence of good construct validity, measuring items that resonate with contemporary medical practice, with potential use for professional development.
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