Patient care ownership in medical students: a validation study

Area of Science:

• Medical Education
• Psychology
• Healthcare Professions Education

Background:

• Psychological Ownership (PO) is a cognitive-affective state of feeling ownership.
• In medical education, PO relates to "Patient Care Ownership" (PCO), encompassing physician responsibility for patient care.
• Existing PO instruments require adaptation for medical student populations.

Purpose of the Study:

• To adapt and validate a Psychological Ownership survey for medical students.
• To assess the instrument's fit for measuring Patient Care Ownership in this population.

Main Methods:

• A revised PO survey was administered to 182 medical students alongside the Teamwork Assessment Scale (TSA) and Maslach Burnout Inventory (MBI).
• Confirmatory Factor Analysis (CFA) revealed poor fit; Exploratory Factor Analysis (EFA) was conducted.
• Validity evidence was gathered for the adapted instrument.

Main Results:

• The original PO subscales (Territoriality, Accountability, Belongingness, Self-efficacy, Self-identification) did not fit the medical student data.
• Four new subscales (Team Inclusion, Accountability, Territoriality, Self-Confidence) demonstrated a better fit for PCO.
• These subscales showed good internal reliability (Cronbach's alpha: 0.91–0.78).
• Territoriality, Team Inclusion, and Self-Confidence subscales negatively correlated with burnout.
• Team Inclusion strongly correlated with TSA; Accountability weakly; Self-Confidence and Territoriality moderately.

Conclusions:

• Preliminary validity evidence supports the adapted PO survey for measuring PCO in medical students.
• The revised instrument is a potentially valuable tool for medical educators.
• This tool can aid in evaluating and monitoring students' development of patient care ownership.