Abstract
Background: Psychological Ownership is the cognitive-affective state individuals experience when they come to feel they own something. The construct is context-dependent reliant on what is being owned and by whom. In medical education, this feeling translates to what has been described as “Patient Care Ownership,” which includes the feelings of responsibility that physicians have for patient care. The construct was originally validated with business employees, then recently translated into residency education where ownership behavior is expected. We adapted this instrument for a medical student population where patient ownership skills begin.Methods: Guiding our validation study was Downing’s framework, which combines theory, predicted relationships, and empirical evidence to propose the use of newly created instruments. Downing argues that assessments are not valid in and of themselves; they are the result of researchers’ evidence gathered in support of a specific interpretation. We chose to adapt this instrument because, like employees who feel that various projects belong to them, physicians share similar feelings about patients and their care. Results: The results show that the initial subscales proposed by Avey et al. (i.e. Territoriality, Accountability, Belongingness, Self-efficacy, and Self-identification) did not account for item responses in the revised instrument when administered to medical students. Instead, four subscales (Team Inclusion, Accountability, Territoriality, and Self-Confidence) better described patient care ownership for medical students, and the internal reliability of these subscales was found to be good. Using Cronbach’s alpha, the internal consistency among items for each subscale, includes: Team Inclusion (.91), Accountability (.78), Territoriality (.78), and Self-Confidence (.82). The subscales of Territoriality, Team Inclusion, and Self-Confidence were negatively correlated with the 1-item Burnout measure (P=0.01). The Team Inclusion subscale strongly correlated with the Teamwork Assessment Scale (TSA), while the subscales of Accountability correlated weakly, and Self-Confidence and Territoriality correlated moderately.Conclusions: Our study provides strong preliminary validity evidence for an adapted version of Avey et al.’s psychological ownership survey, specifically designed to measure patient care ownership in a medical student population. We expect this revised instrument to be a valuable tool to medical educators evaluating and monitoring students as they learn how to engage in patient care ownership.
A Validation Study of Homeopathic Prescribing and Patient Care Indicators
