Neary Stephanie, Doolittle Benjamin, Mueller Martina, Nichols Michelle
Yale University, PO Box 208004, New Haven, CT 06520-8004 USA.
College of Nursing, Medical University of South Carolina, Charleston, SC USA.
Med Sci Educ. 2024 Nov 7;35(1):281-291. doi: 10.1007/s40670-024-02182-x. eCollection 2025 Feb.
The purpose of this study was to investigate flourishing among medical (MD), physician assistant (PA), and nurse practitioner (NP) students, using the novel Secure Flourish Index (SFI).
MD, PA, and NP students from two institutions completed the traditional SFI (tSFI), then applied a percentage weight to each of the six domains (maximum total 100%) based on perceived relative importance to their overall flourishing, creating a novel self-weighted SFI score (swSFI). The Bland-Altman (BA) plot was used to assess the magnitude of agreement between scores.
The BA plot (n = 281) revealed a mean bias of .07(95% CI -.50,.63). Eighteen participants (6.4%) fell outside of the calculated BA limits of agreement [-9.31 [95% CI - 10.27,-8.45] and 9.45 [95% CI 8.49,10.41]]. Linear regression revealed the mean BA score is predictive of the mean difference between scores [R = 0.07, F(1,280) = 21.1, p < .001] indicating bias in agreement between the scoring systems as mean flourishing score changes.
Accounting for individual values is important when measuring student flourishing but is missing from current operant definitions. The overall mean difference (bias) in tSFI and swSFI scores is minimal (.07, possible range 0-120). However, the bias becomes larger as individual mean flourishing scores move towards both the high and low ends of the flourishing spectrum. This indicates that the influence of weighting flourishing domains is larger for individuals with high or low flourishing than those with moderate flourishing.
The online version contains supplementary material available at 10.1007/s40670-024-02182-x.
本研究旨在使用新型的安全繁荣指数（SFI）调查医学博士（MD）、医师助理（PA）和执业护士（NP）学生的繁荣状况。
来自两个机构的医学博士、医师助理和执业护士学生完成传统的SFI（tSFI），然后根据对他们整体繁荣的感知相对重要性，对六个领域中的每一个领域应用一个百分比权重（最大总计100%），从而创建一个新的自我加权SFI分数（swSFI）。使用布兰德-奥特曼（BA）图来评估分数之间的一致性程度。
BA图（n = 281）显示平均偏差为0.07（95%置信区间-0.50，0.63）。18名参与者（6.4%）落在计算出的BA一致性界限之外[-9.31 [95%置信区间-10.27，-8.45]和9.45 [95%置信区间8.49，10.41]]。线性回归显示平均BA分数可预测分数之间的平均差异[R = 0.07，F(1,280) = 21.1，p < 0.001]，表明随着平均繁荣分数的变化，评分系统之间的一致性存在偏差。
在衡量学生的繁荣状况时，考虑个人价值观很重要，但当前的操作性定义中却没有这一点。tSFI和swSFI分数的总体平均差异（偏差）很小（0.07，可能范围为0 - 120）。然而，随着个体平均繁荣分数向繁荣范围的高端和低端移动，偏差会变大。这表明，对于繁荣程度高或低的个体，对繁荣领域进行加权的影响比对繁荣程度中等的个体更大。
在线版本包含可在10.1007/s40670 - 024 - 02182 - x获取的补充材料。
