Clinical leadership training: a clinician's perspective

Collaboration cognizance: Development of a self-assessment tool to measure intra-professional collaborative practices (IPCP) in postgraduate medical residents at tertiary care hospitals

BACKGROUND

The ever-evolving healthcare system of today demands physicians who steer their roles as treatment providers, managers and collaborators. Professionals are highly interdependent due to increased complexity of health problems and risk of errors increases with transitions in care. In hospitals, the main workforce is postgraduate residents; therefore, intraprofessional collaboration amongst residents is essential. Several instruments are available to evaluate interprofessional collaboration amongst physicians, nurses and hospital teams but none specifically assessed intra-professional collaborative practices amongst residents working in tertiary care hospitals in multi-disciplinary teams. This study intends to develop and validate an instrument to self-assess intraprofessional collaborative practices in postgraduate residents undergoing residency in multiple specialties at tertiary care hospitals.

APPROACH

This study on Instrument Development employed mixed method study design executed in two phases. In phase 1, six domains of intraprofessional collaborative practices were identified from literature and 35 items were developed. Fifteen experts participated in qualitative content validation and provided comments. To establish content validity in phase 2, content validity index (CVI) and content clarity average (CCA) were assessed by seventeen experts. Response process validity was established by cognitive interviewing of 5 postgraduate residents. Pilot testing was done on a sample of 407 residents. Cronbach's alpha was determined, and confirmatory factor analysis established construct validity.

RESULTS

During phase 1, items were modified based on qualitative feedback from 15 experts. In round 2, CVI and CCA were determined based on responses of 17 experts. The items having an I-CVI greater than 0.90 were accepted and six items underwent modifications as their I-CVI fell between 0.78 and 0.90. Similarly, four items with a CCA of less than 2.4 were modified to increase clarity. Cognitive interviews of participants on 30 items resulted in the deletion of 1 item and changes in 5 items. The final instrument had 29 items categorized under six constructs. All items had good factor loadings during CFA, so none was deleted. Cronbach's Alpha α was 0.937.

CONCLUSION

Intraprofessional collaborative practices in residents is a valid and reliable self-assessment tool comprising 29 items measuring six constructs. It may be used by residents to assess their collaborative practices and incorporated in curricula to help develop collaborative practices and their assessment during training of postgraduate residents.

UK internal medicine training in the time of COVID-19

COVID-19 has had a significant impact on internal medicine training in the UK. Many unprecedented changes have been made to prioritise the care of affected patients. The medical workforce was re-shaped, training programmes were disrupted, Membership of the Royal College of Physicians (MRCP) examinations were cancelled and their format changed on re-commencement, teaching programmes were suspended and delivery methods amended, out of programme (OOP) opportunities deferred, non-COVID related research halted, trainee progression impacted and trainee mental health and wellbeing suffered. Despite this, the pandemic has undoubtedly created a plethora of unique learning opportunities for trainees that could make them better doctors and healthcare leaders in the future.