Short-Form Measures of Well-Being Centered Leadership for Matrixed Healthcare Systems

Anthony C Waddimba,1– 3 Rahul R Gunukula,2,4 Megan E Douglas,5 Tait D Shanafelt,6 J Michael DiMaio,2,7,8 Jamile A Ashmore3,9 1Department of Surgery, Baylor University Medical Center, Dallas, TX, USA; 2Research Development & Analytics Core, Baylor Scott and White Research Institute, Dallas, TX, USA; 3Department of Medical Education, College of Medicine, Texas A&M University, Dallas, TX, USA; 4Academic Research Team, Baylor Scott & White-The Heart Hospital, Plano, TX, USA; 5Trauma Research Consortium, Baylor Scott and White Research Institute, Dallas, TX, USA; 6Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA; 7Division of Cardiothoracic Surgery, Baylor Scott & White-The Heart Hospital, Plano, TX, USA; 8Department of Biomedical Engineering, College of Medicine, Texas A&M University, College Station, TX, USA; 9Office of Professionalism and Well-Being, Baylor Scott & White-The Heart Hospital, Plano, TX, USACorrespondence: Anthony C Waddimba, Department of Surgery, Baylor University Medical Center, 3500 Gaston Avenue, Dallas, Texas, 75246, USA, Tel +1-214-820-0291, Email [email protected]; [email protected]: This study extracted the empirically strongest short-form abbreviations of the adapted Mayo Leadership Impact Index (MLII) and evaluated their comparative validity and reliability versus the full-length reference scale.Participants and Methods: Data were sourced from physician-respondents to the 2023 (n=158) and 2024 (n=112) annual “well-being” surveys in a tri-hospital Cardiovascular healthcare system in Texas. Priority ranking of the full-length scale’s items based on factor loadings from single-factor confirmatory factor analysis and information function plots from unidimensional graded response model analysis yielded single-, 3-, and 4-item short-form scales. Convergent validity of short-form versus full-length scales was compared using Spearman correlations with professional fulfillment, self-valuation, autonomy support, peer connectedness, and peer respect measures. Divergent validity was tested via correlations with occupational burnout. Internal consistency was based on Cronbach’s and ordinal reliability coefficients. Inter-rater reliability was based on areas under the ROC curve, accuracy, precision, sensitivity, specificity, and Cohen’s kappa coefficient.Results: Single-item, 3-item, and 4-item short-form scales, from the four highest ranked items, had similar convergent and divergent validity indexes plus inter-rater reliability to the 9-item adapted MLII. Internal consistency reliabilities for the 9-item, 4-item, and 3-item versions of the adapted MLII were > 0.900. Sensitivity/specificity ratios and kappa coefficients for MLII-4, MLII-3, and MLII-1 extracts versus the adapted MLII-9 were all > 0.700.Conclusion: Findings verify the reliability and validity of short-form abbreviations of the adapted MLII as lower-burden options for assessing well-being centered leadership within matrixed healthcare systems.Plain Language Summary: Question: What are the most valid and reliable short-form versions of the revised Mayo Leadership Impact Index adapted for healthcare systems with matrixed reporting structures?Findings: Classical test theory and item response theory analyses of cross-sectional survey data from 2023 and 2024 physician-respondents supported the comparative validity and reliability of 4-item, 3-item, and single-item short-form scales. The parent scale and its short-form proxies had similar positive correlations with professional fulfillment, autonomy support, self-valuation, plus peer connectedness/respect, and negative correlations with burnout.Meaning: Findings affirm the short-form scales’ validity and reliability, supporting use of these abbreviated measures to capture well-being centered leadership within matrixed healthcare systems.Keywords: physicians, occupational well-being, well-being centered leadership, abbreviated measures, psychometric validity, reliability