Michael J Cullen, Jessica Hane, You Zhou, Benjamin K Seltzer, Paul R Sackett, Susan M Culican, Krima Thakker, John Q Young, Taj Mustapha
{"title":"Perceptions of Justice in Clinical Learning Environments: Development and Validation of an Organizational Justice Measure for Medical Trainees.","authors":"Michael J Cullen, Jessica Hane, You Zhou, Benjamin K Seltzer, Paul R Sackett, Susan M Culican, Krima Thakker, John Q Young, Taj Mustapha","doi":"10.1097/ACM.0000000000005669","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop an instrument to measure medical trainees' perceptions of justice in clinical learning environments.</p><p><strong>Method: </strong>Between 2019 and 2023, the authors conducted a multiyear, multi-institutional, multiphase study to develop a 16-item justice measure with 4 dimensions: interpersonal, informational, procedural, and distributive. The authors gathered validity evidence based on test content, internal structure, and relationships with other variables across 3 phases. Phase 1 involved drafting items and gathering evidence that items measured intended dimensions. Phase 2 involved analyzing relevance of items for target groups, examining interitem correlations and factor loadings in a preliminary analysis, and obtaining reliability estimates. Phase 3 involved a confirmatory factor analysis and collecting convergent and discriminant validity evidence.</p><p><strong>Results: </strong>In phase 1, 63 of 91 draft items were retained following a content validation exercise gauging how well items measured targeted dimensions (mean [SD] item ratings within dimensions, 4.16 [0.36] to 4.39 [0.34]) on a 5-point Likert scale (with 1 indicating not at all well and 5 indicating extremely well). In phase 2, 30 items were removed due to low factor loadings (i.e., < 0.40), and 4 items per dimension were selected (factor loadings, 0.42-0.89). In phase 3, a confirmatory factor analysis supported the 4-dimensional model ( χ2 = 610.14, P < .001; comparative fit index = 0.90, Tucker-Lewis Index = 0.87, root mean squared error of approximation = 0.11, standardized root mean squared residual = 0.06), with convergent and discriminant validity evidence showing hypothesized positive correlations with a justice measure ( r = 0.93, P < .001), trait positive affect ( r = 0.46, P < .001), and emotional stability ( r = 0.33, P < .001) and negative correlations with trait negative affect ( r = -0.39, P < .001).</p><p><strong>Conclusions: </strong>Results indicate the measure's potential utility in understanding justice perceptions and designing targeted interventions.</p>","PeriodicalId":50929,"journal":{"name":"Academic Medicine","volume":" ","pages":"1374-1384"},"PeriodicalIF":5.3000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Medicine","FirstCategoryId":"95","ListUrlMain":"https://doi.org/10.1097/ACM.0000000000005669","RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/27 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"EDUCATION, SCIENTIFIC DISCIPLINES","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study aimed to develop an instrument to measure medical trainees' perceptions of justice in clinical learning environments.
Method: Between 2019 and 2023, the authors conducted a multiyear, multi-institutional, multiphase study to develop a 16-item justice measure with 4 dimensions: interpersonal, informational, procedural, and distributive. The authors gathered validity evidence based on test content, internal structure, and relationships with other variables across 3 phases. Phase 1 involved drafting items and gathering evidence that items measured intended dimensions. Phase 2 involved analyzing relevance of items for target groups, examining interitem correlations and factor loadings in a preliminary analysis, and obtaining reliability estimates. Phase 3 involved a confirmatory factor analysis and collecting convergent and discriminant validity evidence.
Results: In phase 1, 63 of 91 draft items were retained following a content validation exercise gauging how well items measured targeted dimensions (mean [SD] item ratings within dimensions, 4.16 [0.36] to 4.39 [0.34]) on a 5-point Likert scale (with 1 indicating not at all well and 5 indicating extremely well). In phase 2, 30 items were removed due to low factor loadings (i.e., < 0.40), and 4 items per dimension were selected (factor loadings, 0.42-0.89). In phase 3, a confirmatory factor analysis supported the 4-dimensional model ( χ2 = 610.14, P < .001; comparative fit index = 0.90, Tucker-Lewis Index = 0.87, root mean squared error of approximation = 0.11, standardized root mean squared residual = 0.06), with convergent and discriminant validity evidence showing hypothesized positive correlations with a justice measure ( r = 0.93, P < .001), trait positive affect ( r = 0.46, P < .001), and emotional stability ( r = 0.33, P < .001) and negative correlations with trait negative affect ( r = -0.39, P < .001).
Conclusions: Results indicate the measure's potential utility in understanding justice perceptions and designing targeted interventions.
期刊介绍：
Academic Medicine, the official peer-reviewed journal of the Association of American Medical Colleges, acts as an international forum for exchanging ideas, information, and strategies to address the significant challenges in academic medicine. The journal covers areas such as research, education, clinical care, community collaboration, and leadership, with a commitment to serving the public interest.
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