The Development and Evaluation of a Comprehensive Well-being Instrument for Health Professionals - The CoreWellness Index

Introduction: Healthcare worker wellness has received increasing attention from medical educators and healthcare systems given its importance to provider longevity and patient care. Wellness is multidimensional, and very few instruments evaluate all domains of wellness. Our team developed a comprehensive measure to evaluate the multi-dimensional nature of wellness. The purposes of this study were divided into four phases: phase 1) detail the development, design, and initial dissemination of the instrument, phase 2) collect feasibility and normative data for a diverse sample of healthcare workers, phase 3) evaluate the internal reliability of the measure and its component domains, and phase 4) evaluate the validity of our instrument compared to an existing tool designed to assess burnout. Methods: The CoreWellness Index (CWI) is a 42-item instrument that evaluates wellness in general and eight specific domains of wellness. We aimed to collect normative data from a robust sample of healthcare workers. A confirmatory factor analysis was performed to assess how items fit within CWI domains and intercorrelations between domains. Internal consistency of the CWI domains was evaluated with McDonald’s omega. We aimed to establish validity by comparing the CWI to the Copenhagen Burnout Inventory (CBI), a commonly used tool to assess burnout. Results: The CWI was completed by 1143 participants (53% medical students, 84% were between the ages of 20 and 30 years old, 57% female) from 26 institutions. All items had a moderate to strong fit within their domains and had a moderate correlation with each other. Regarding internal consistency, McDonald’s omega of the CWI was 0.92 and all wellness domains had an omega above 0.65. The CWI demonstrated significant negative correlations with all CBI subscales. Conclusions: The CWI is a unique assessment tool designed to assess the multidimensional nature of wellness. The instrument exhibited high completion feasibility, and strong reliability and validity evidence when evaluating its internal consistency and relationship to other established measures. The CWI may prove to be a useful tool for assessing wellness and can be used in organizations and institutions to identify areas of need for their learners in conjunction with initiatives to enhance wellness.