Presented By: Stephanie Neary, Yale University; Medical University of South Carolina
Co-Authors: Benjamin Doolittle, Yale University
Martina Mueller, Medical University of South Carolina
Michelle Nichols, Medical University of South Carolina
Purpose
The purpose of this study was to investigate flourishing among medical (MD), physician assistant (PA), and nurse practitioner (NP) students, using a novel Secure Flourish Index (SFI) and other validated instruments.
Methods
PA, NP, and MD students from two institutions completed an online survey. Participants first completed the traditional SFI and then applied a percentage weight to each of the six flourishing domains (maximum total 100%) based on perceived relative importance to their overall flourishing to create a novel self-weighted SFI score (swSFI). The Bland-Altman (BA) plot was used to assess the magnitude of agreement or disagreement between the two scoring approaches.
Results
For the 281 students included in the study, BA plot revealed a mean bias of .07 (95% CI -.50,.63). Eighteen participants (6.4%) fell outside of the calculated BA Limits of Agreement [-9.3 [95% CI -10.3, -8.5] and 9.5 [95% CI 8.5, 10.4]. Linear regression revealed that mean BA score is significantly predictive of the mean difference between the scores [R2 = 0.07, F(1, 280) = 21.1, p <.001] indicating bias in agreement between the two scoring systems as mean flourishing score changes. The resulting regression equation is predicted mean difference = 6.9 - 0.8(mean flourishing score).
Conclusion
Accounting for individual values is an important piece of measuring student flourishing that 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. Further exploration of how student demographics, life experiences, and values influence perceived relative weights of flourishing domains is needed to promote learning environments that foster individual flourishing.