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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
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Disclosures None of the presenters or researchers have financial conflicts of interest
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Audience Needs Raise of hands: Formal leadership curriculum?
Doing research on your curriculum? Process to assess resident leadership skills? Validated assessment tool?
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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
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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
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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.”
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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
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The Gap Validated tools to assess FM resident skills IOM ACGME
Picture of a Canyon here
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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
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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
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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
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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
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Validation Study Results
Foundational Healthcare Leadership Self-assessment National Averages* *FHLS validation study data
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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
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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
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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?
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Program Overview R1
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Program Overview R2
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Program Overview R3
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FHLS Mentoring Data
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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 interest & suggestions:
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