Ashmore Jamile A, Waddimba Anthony C, Douglas Megan E, Coombes Stacey V, Shanafelt Tait D, DiMaio J Michael
Office of Professionalism and Well-Being, Baylor Scott & White-The Heart Hospital, Plano, TX, USA.
College of Medicine, Texas A&M University, Dallas, TX, USA.
J Healthc Leadersh. 2024 Aug 14;16:315-327. doi: 10.2147/JHL.S465170. eCollection 2024.
Physician burnout has reached crisis levels. Supportive leadership is one of the strongest drivers of physician well-being, and monitoring supervisor support is key to developing well-being focused leadership skills. Existing measures of leader support were designed within "direct report" supervision structures limiting their applicability to matrixed leadership reporting structures where direct reports are not the predominant norm. Antecedently, no measure of leadership support is validated specifically for implementation in matrixed leadership structures.
Adapt and validate the Mayo Leadership Impact Index (MLII) for settings with matrixed leadership structures.
A psychometric validation study utilizing classical test theory and item response theory.
A tripartite hospital system in the southwestern US.
Physician-respondents to a 2023 cross-sectional survey.
After pilot testing, the adapted MLII was examined using a unidimensional graded response model and confirmatory factor analyses. Convergent validity was investigated via correlations with professional fulfillment, perceived autonomy support, self-valuation, and peer connectedness/respect. Divergent validity was tested via correlations with burnout.
Of the three candidate revisions of the MLII, the 9-item adaptation was selected for its superior validity/reliability indices. Standardized Cronbach's and Ordinal alpha coefficients were 0.958 and 0.973, respectively. CFA loadings exceeded 0.70 (p < 0.001), and coefficients of variation (R) exceeded 0.60 for all items. GRM slope parameters indicated "high" to "very high" item discrimination. Items 2, 5, and 8 were the most informative. Positive correlations of the adapted MLII with professional fulfillment, perceived autonomy support, and peer connectedness/respect were observed, supporting convergent validity. Negative correlation with overall burnout supports divergent validity.
The findings provide evidence of the adapted MLII's validity, reliability, and appropriateness for implementation within matrixed leadership settings. Prior to this study, no leadership support measure had been validated for use among the growing number of healthcare systems with matrixed leadership reporting structures.
医生职业倦怠已达到危机程度。支持型领导是医生幸福感的最强驱动因素之一，监测上级支持是培养以幸福感为重点的领导技能的关键。现有的领导支持衡量标准是在“直接下属”监督结构中设计的，限制了其在矩阵式领导汇报结构中的适用性，在这种结构中，直接下属并非主要常态。此前，没有专门针对矩阵式领导结构实施而验证的领导支持衡量标准。
针对具有矩阵式领导结构的环境，对梅奥领导影响力指数（MLII）进行改编和验证。
一项利用经典测试理论和项目反应理论的心理测量学验证研究。
美国西南部的一个三方医院系统。
对2023年横断面调查做出回应的医生。
经过预测试后，使用单维分级反应模型和验证性因素分析对改编后的MLII进行检验。通过与职业成就感、感知到的自主支持、自我价值感以及同伴联系/尊重之间的相关性来研究收敛效度。通过与职业倦怠的相关性来测试区分效度。
在MLII的三个候选修订版中，9项改编版因其卓越的效度/信度指标而被选中。标准化克朗巴哈系数和序数阿尔法系数分别为0.958和0.973。验证性因素分析的载荷超过0.70（p < 0.001），所有项目的变异系数（R）超过0.60。分级反应模型斜率参数表明项目区分度为“高”到“非常高”。项目2、5和8提供的信息最多。观察到改编后的MLII与职业成就感、感知到的自主支持以及同伴联系/尊重呈正相关，支持收敛效度。与总体职业倦怠呈负相关支持区分效度。
研究结果为改编后的MLII在矩阵式领导环境中的效度、信度和适用性提供了证据。在本研究之前，没有针对越来越多具有矩阵式领导汇报结构的医疗系统验证过领导支持衡量标准。
