Validation of the Foundational Healthcare Leadership Self-assessment (FHLS)© #41862 Sonja Van Hala, MD, MPH, FAAFP Susan Cochella, MD, MPH Susan Pohl, MD University of Utah Family Medicine Residency

Disclosures None of the presenters or researchers have financial conflicts of interest

Audience Needs Raise of hands: Formal leadership curriculum? Doing research on your curriculum? Process to assess resident leadership skills? Validated assessment tool?

Objectives Participants will be able to: Describe the process used to validate the FHLS (Foundational Healthcare Leadership Self-assessment) Describe how the FHLS is used in one residency program’s leadership curriculum Explore how the FHLS might be used in your residency curriculum

Agenda Overview of research process Lessons learned Qualitative and quantitative Validation Lessons learned Description of the improved FHLS Demonstration of FHLS output Exploration of uses

The Need IOM: “Graduate Medical Education that Meets the Nation’s Health Needs” recommended changing GME financing to “encourage production of a physician work­force better prepared to work in, help lead, and continually improve an evolving health care delivery system that can provide better individual care, better population health, and lower cost.”

The Need ACGME: Milestones for Family Medicine Challenge residency programs to provide training for competencies in: team leadership collaboration with public health and community agencies advocacy leadership of systems and quality improvement processes

The Gap Validated tools to assess FM resident skills IOM ACGME Picture of a Canyon here

What is already out there? Theoretical models, opinions, curricula Non Technical Skills for Surgeons Includes assessment frameworks Systematic review of leadership training in healthcare action teams: Defining best practices is difficult due to lack of a standard definition of leadership, supporting frameworks, and robust assessments Academic Med 2014, Rosenman

Research team Initial assessment developed by SVH and Bernadette Kiraly, MD Our Team needed experts in validation, qualitative & quantitative research Lisa Gren, PhD, MSPH Caren Frost, PhD, MPH Rachel Jaggi, MA

Validation Process Qualitative Quantitative Developed a self-assessment (SA) Expert focus group FM resident focus group Quantitative 163 residents from 16 programs completed SA 12 states: CA, CO, IL, MI, MN, MO, NC, NY, PA, TX, UT, WA Principal Component Analysis 21 Items in 5 Leadership Domains

Validation Study Results Focus group transcripts Honed the FHLS Add/remove/rephrase questions Clarify response options Quantitative analysis of responses Further honed the FHLS Removed questions Identified domains

Validation Study Results Foundational Healthcare Leadership Self-assessment National Averages* *FHLS validation study data

Impact Validation data shortened the survey Identified 5 Leadership Domains: Engagement Team Management Self Management Accountability Communication Foundational Healthcare Leadership Self-assessment (FHLS) GME leadership assessment validated with FM residents

Next Steps Web-based tool for programs Improve national normative data Currently, based on validation study participants As programs use the FHLS, dataset will expand Hone curricula Define non-foundational skills

FHLS Product to Programs What data is helpful to you? How will you use this information? Is there other information you want? What barriers would you have to using it?

Program Overview R1

Program Overview R2

Program Overview R3

FHLS Mentoring Data

Suggestions? What data is helpful to you? How will you use this information? Is there other information you want? What barriers would you have to using it? Please email interest & suggestions: Sonja.Vanhala@hsc.utah.edu Susan.Cochella@hsc.utah.edu Susan.Pohl@hsc.utah.edu

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