Jennifer C Kesselheim1, Anurag K Agrawal2, Nita Bhatia3,4, Angel Cronin4, Rima Jubran5, Paul Kent6, Leslie Kersun7, Amulya Nageswara Rao8, Melissa Rose9, Stephanie Savelli10, Mukta Sharma11, Evan Shereck12, Clare J Twist13, Michael Wang14. 1. Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts. 2. Children's Hospital and Research Center Oakland, Oakland, California. 3. Department of Psychological and Brain Sciences, University of Iowa. 4. Dana-Farber Cancer Institute, Boston, Massachusetts. 5. Children's Hospital of Los Angeles, Los Angeles, California. 6. Rush University Medical Center, Chicago, Illinois. 7. The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. 8. Mayo Clinic, Rochester, Minnesota. 9. Nationwide Children's Hospital, Columbus, Ohio. 10. Akron Children's Hospital, Akron, Ohio. 11. Children's Mercy Hospital, Kansas City, Missouri. 12. Doernbecker Children's Hospital, Oregon Health Sciences University, Portland, Oregon. 13. Lucile Packard Children's Hospital at Stanford University, Palo Alto, California. 14. Children's Hospital Colorado, Aurora, Colorado.
Abstract
BACKGROUND: Educators in pediatric hematology-oncology lack rigorously developed instruments to assess fellows' skills in humanism and professionalism. PROCEDURE: We developed a novel 15-item self-assessment instrument to address this gap in fellowship training. Fellows (N = 122) were asked to assess their skills in five domains: balancing competing demands of fellowship, caring for the dying patient, confronting depression and burnout, responding to challenging relationships with patients, and practicing humanistic medicine. An expert focus group predefined threshold scores on the instrument that could be used as a cutoff to identify fellows who need support. Reliability and feasibility were assessed and concurrent validity was measured using three established instruments: Maslach Burnout Inventory (MBI), Flourishing Scale (FS), and Jefferson Scale of Physician Empathy (JSPE). RESULTS: For 90 participating fellows (74%), the self-assessment proved feasible to administer and had high internal consistency reliability (Cronbach's α = 0.81). It was moderately correlated with the FS and MBI (Pearson's r = 0.41 and 0.4, respectively) and weakly correlated with the JSPE (Pearson's r = 0.15). Twenty-eight fellows (31%) were identified as needing support. The self-assessment had a sensitivity of 50% (95% confidence interval [CI]: 31-69) and a specificity of 77% (95% CI: 65-87) for identifying fellows who scored poorly on at least one of the three established scales. CONCLUSIONS: We developed a novel assessment instrument for use in pediatric fellowship training. The new scale proved feasible and demonstrated internal consistency reliability. Its moderate correlation with other established instruments shows that the novel assessment instrument provides unique, nonredundant information as compared to existing scales.
BACKGROUND: Educators in pediatric hematology-oncology lack rigorously developed instruments to assess fellows' skills in humanism and professionalism. PROCEDURE: We developed a novel 15-item self-assessment instrument to address this gap in fellowship training. Fellows (N = 122) were asked to assess their skills in five domains: balancing competing demands of fellowship, caring for the dying patient, confronting depression and burnout, responding to challenging relationships with patients, and practicing humanistic medicine. An expert focus group predefined threshold scores on the instrument that could be used as a cutoff to identify fellows who need support. Reliability and feasibility were assessed and concurrent validity was measured using three established instruments: Maslach Burnout Inventory (MBI), Flourishing Scale (FS), and Jefferson Scale of Physician Empathy (JSPE). RESULTS: For 90 participating fellows (74%), the self-assessment proved feasible to administer and had high internal consistency reliability (Cronbach's α = 0.81). It was moderately correlated with the FS and MBI (Pearson's r = 0.41 and 0.4, respectively) and weakly correlated with the JSPE (Pearson's r = 0.15). Twenty-eight fellows (31%) were identified as needing support. The self-assessment had a sensitivity of 50% (95% confidence interval [CI]: 31-69) and a specificity of 77% (95% CI: 65-87) for identifying fellows who scored poorly on at least one of the three established scales. CONCLUSIONS: We developed a novel assessment instrument for use in pediatric fellowship training. The new scale proved feasible and demonstrated internal consistency reliability. Its moderate correlation with other established instruments shows that the novel assessment instrument provides unique, nonredundant information as compared to existing scales.
Authors: Hao Wang; Jeffrey A Kline; Bradford E Jackson; Jessica Laureano-Phillips; Richard D Robinson; Chad D Cowden; James P d'Etienne; Steven E Arze; Nestor R Zenarosa Journal: PLoS One Date: 2018-09-13 Impact factor: 3.240