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A Comparative, Individual Values-Based Scoring Approach to the Secure Flourish Index Among Clinical Health

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This study found that while the Secure Flourish Index (SFI) and a self-weighted version (swSFI) show minimal overall bias, the differences in scores become more pronounced for students with very high or very low flourishing.

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Area of Science:

  • Health Professions Education
  • Psychological Well-being Measurement
  • Student Health

Background:

  • Assessing student flourishing is crucial for understanding well-being in medical, physician assistant, and nurse practitioner programs.
  • Current measures may not fully capture individual differences in perceived importance of flourishing domains.

Purpose of the Study:

  • To investigate flourishing among medical (MD), physician assistant (PA), and nurse practitioner (NP) students.
  • To compare the traditional Secure Flourish Index (tSFI) with a novel self-weighted SFI (swSFI).

Main Methods:

  • MD, PA, and NP students (n=281) from two institutions completed both tSFI and swSFI.
  • The swSFI involved students assigning percentage weights to six flourishing domains.
  • Bland-Altman plots and linear regression were used to assess agreement between tSFI and swSFI scores.

Main Results:

  • The Bland-Altman analysis showed a minimal mean bias of 0.07 between tSFI and swSFI.
  • A small percentage of participants (6.4%) fell outside the limits of agreement.
  • Linear regression indicated that the mean difference between scores was influenced by the scoring system, with bias increasing at the extremes of the flourishing spectrum.

Conclusions:

  • Individual weighting of flourishing domains is important but often overlooked in current definitions.
  • The overall bias between tSFI and swSFI is small, but the impact of weighting is greater for students with high or low flourishing.
  • The swSFI may offer a more personalized measure of flourishing for health profession students.