Development and Validation of the Foundational Healthcare Leadership Self-assessment.

BACKGROUND AND OBJECTIVES: We sought to develop and validate a self-assessment of foundational leadership skills for early-career physicians. METHODS: We developed a leadership self-assessment from a compilation of materials on health care leadership skills. A sequential exploratory study was conducted using qualitative and quantitative analysis for face, content, and construct validity of the self-assessment. First, two focus groups were conducted with leaders in medicine and family medicine residents, to refine the pilot self-assessment. The self-assessment pilot was then tested with family medicine residents across the country, and the results were quantitatively evaluated with principal component analysis. This data was used to reduce and group the statements into leadership domains for the final self-assessment. RESULTS: Twenty-two invited family medicine residency programs agreed to distribute the survey. A total of 163 family medicine residents completed the survey, representing 16 to 20 residency programs from 12 states (response rate 28.9% to 34.8%). Analysis showed important differences by residency year, with more advanced residents scoring higher. The analysis reduced the number of items from 33 on the pilot assessment to 21 on the final assessment, which the authors titled the Foundational Healthcare Leadership Self-assessment (FHLS). The 21 items were grouped into five leadership domains: accountability, collaboration, communication, team management, and self-management. CONCLUSIONS: The FHLS is a validated 21-item self-assessment of foundational leadership skills for early career physicians. It takes less than 5 minutes to complete, and quantifies skill within five domains of foundational leadership. The FHLS is a first step in developing educational and evaluative assessments for training medical residents as clinician leaders.

A picture of Indian adolescent mental health: an analysis from three urban secondary schools.

Purpose Mental health disorders are a pressing issue among adolescents around the world, including in India. A better understanding of the factors related to poor mental health will allow for more effective and targeted interventions for Indian adolescents. Methods The Indian Adolescent Health Questionnaire (IAHQ), a validated questionnaire designed specifically for use in schools, was administered to approximately 1500 secondary students in three private urban Indian schools in 2012. The Strengths and Difficulties Questionnaire (SDQ) module assessed mental health. Linear regression was used to predict SDQ scores. The biopsychosocial framework was used as an organizing framework to understand how each explanatory variable in the final model might impact the SDQ score. Results One thousand four hundred and eight students returned IAHQ surveys (93.9% response rate); 1102 students completed questions for inclusion in the regression model (78.3% inclusion rate). Statistically significant (p < 0.05) independent variables associated with SDQ scores were gender, level of overall health, negative peer pressure, insults from peers, kindness of peers, feeling safe at home, at school, or with friends, and grades. Discussion Schools have a role to play in improving adolescent mental health. Many of the significant variables in our study can be addressed in the school environment through school-wide, long-term programs utilizing teachers and lay counselors. The IAHQ and SDQ can be used by schools to identify factors that contribute to poor mental health among students and then develop targeted programs to support improved mental health.

Building Successful Relationships in the PLCO Cancer Screening Trial.

Biomedical research cannot succeed without funding, knowledgeable staff, and appropriate infrastructure. There are however equally important but intangible factors that are rarely considered in planning large multidisciplinary endeavors or evaluating their success. The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial required extensive collaborations between individuals from many fields, including clinicians, clinical trialists, and administrators; it also addressed questions across the spectrum of cancer prevention and control. In this manuscript, we examine the experiences and opinions of trial staff regarding the building of successful relationships in PLCO. We summarize, in narrative form, data collected using open-ended questionnaires that were administered to the National Cancer Institute project officers, coordinating center staff, screening center principal investigators, and screening center coordinators in 2015, about 3 years after publication of the final primary trial manuscript. Trust, respect, listening to others, and in-person interaction were frequently mentioned as crucial to building successful relationships.

Differences in reporting serious adverse events in industry sponsored clinical trial registries and journal articles on antidepressant and antipsychotic drugs: a cross-sectional study.

OBJECTIVE: To examine the degree of concordance in reporting serious adverse events (SAEs) from antidepressant and antipsychotic drug trials among journal articles and clinical trial summaries, and to categorise types of discrepancies. DESIGN: Cross-sectional study of summaries of all antidepressant and antipsychotic trials included in an online trial registry and their first associated stand-alone journal articles. SETTING: Clinicalstudyresults.org, sponsored by Pharmaceutical Research and Manufacturers of America; clinicaltrials.gov, administered by the US National Institutes of Health. MAIN OUTCOME MEASURE: 3 coders extracted data on the numbers and types of SAEs. RESULTS: 244 trial summaries for six antidepressant and antipsychotic drugs were retrieved, 142 (58.2%) listing an associated article. Of 1608 SAEs in drug-treated participants according to trial summaries, 694 (43.2%) did not appear in associated articles. Nearly 60% of SAEs counted in articles and 41% in trial summaries had no description. Most cases of death (62.3%) and suicide (53.3%) were not reported in articles. Half or more of the 142 pairs were discordant in reporting the number (49.3%) or description (67.6%) of SAEs. These discrepancies resulted from journal articles' (1) omission of complete SAE data, (2) reporting acute phase study results only and (3) more restrictive reporting criteria. Trial summaries with zero SAE were 2.35 (95% CI, 1.58 to 3.49; p<0.001) times more likely to be published with no discrepancy in their associated journal article. Since clinicalstudyresults.org was removed from the Internet in 2011, only 7.8% of retrieved trial summaries appear with results on clinicaltrials.gov. CONCLUSIONS: Substantial discrepancies exist in SAE data found in journal articles and registered summaries of antidepressant and antipsychotic drug trials. Two main scientific sources accessible to clinicians and researchers are limited by incomplete, ambiguous and inconsistent reporting. Access to complete and accurate data from clinical trials of drugs currently in use remains a pressing concern.