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C - Change Medical Student Survey
A Tool Measuring Dimensions of the Existing Culture in Order to Address the Professional and Personal Development of Students in Academic Medical Centers
Development of the C - Change Surveys
The National Initiative on Gender, Culture and Leadership in Medicine, known as C - Change (for culture change) and housed at Brandeis University, is dedicated to improving the culture of academic medicine through research and action. Our objective is to promote an inclusive, affirming, relational and energizing working environment for all medical school faculty and trainees, at the same time increasing the diversity of leadership in academic medicine.
In an initial phase, C - Change has conducted in depth interviews with male and female faculty in five academic medical centers in order to document the culture and issues affecting faculty productivity and well-being.1-3,5-10 Those qualitative interview data served as basis for the construction of an extensive quantitative survey instrument, the C - Change Faculty Survey,© which systematically explores and documents the experiences of medical school faculty and the organizational culture in their academic medical centers. The faculty survey was later adapted for medical students to measure their perceptions of their learning environment and professionalism, and offers insights into the “hidden curriculum.”
The C - Change Medical Student Survey© is available for use by academic medical centers wishing to assess and improve their culture and existing practices in order to create a more academically productive, inclusive, diverse and humanistic environment where all people can thrive. The Surveys allow detailed exploration of the foundations of the development of human capital, (e.g., trust, relationships, perception of opportunity, professionalism and the learning environment) as well as the waste of such human capital. When used in parallel, the Student and Faculty Surveys provide credible and powerful tools for improvements. Survey findings can address accreditation requirements.
Content of the C - Change Medical Student Survey©
The C - Change Medical Student Survey© assesses the learning environment and the development of professionalism among medical students. It consists of 38 questions that assess relationships, trust, feelings of being valued and belonging, ethical issues, gender and diversity equity, perception of their school’s support for career development, and other constructs related to the professional development of students.
The Medical Student Survey can be used in its entirety or in short-form for the following purposes:
- assessment of the culture and medical student professional experiences and learning environment
- collection of data for accreditation purposes
- to identify areas for improvement
- program evaluation
- quality improvement
- to track the culture or special dimensions of the culture
- in modular format to focus on dimensions of particular interest
- as a pre/post measurement tool
- pulse data collection
- comparison of sub-populations
- to track changes in perceptions over the four years of medical school
Data from the C - Change Medical Student Survey© are analyzed along a subset of dimensions of the culture:
- Self-Efficacy in Career Advancement
- Perceptions of Institutional Support
- Relationships, Inclusion, Trust
- Personal and Institutional Values Alignment
- Ethical and Moral Distress
- Gender Equity
- Equity for members of groups underrepresented in medicine
- Work-Life Integration
Administration of the C - Change Survey
The C - Change Medical Student Survey© is fielded electronically, or if preferred, it can be fielded in-house and/or in paper and pencil format, and takes about 10 minutes to complete. The Survey is hosted on a secure external website and administered by the C - Change team at Brandeis University to ensure confidentiality of responses and help achieve a high response rate. Data are provided to schools in aggregate form to protect the anonymity of respondents.
C - Change works closely with medical schools to understand any unique needs they might have in survey adaptation or fielding, and administers the Survey. C - Change works in collaboration with each institution to develop a strong communications plan to enable a high response rate. Depending on the size and analytic needs of the institution, C - Change can recommend and develop a sampling plan or field the Survey to the full census of the students as appropriate.
Analysis and Reporting of Study Findings
C - Change creates the scales representing dimensions of the culture and other analytic variables of interest, and prepares data tables with frequencies for all survey variables. As optional services, C - Change can prepare a comprehensive summary of the survey data, and provide graphical display and PowerPoint presentation of the findings.
Pricing of the C - Change Student Survey depends on study specifics, such as the size of the study population, analysis of sub-populations, or customized benchmarking.
The base survey price includes:
- consultation on institutional needs
- preparation and customization of the survey
- design of a sampling plan
- cover letters
- management of e-mail communications with respondents
- electronic fielding of the survey
- follow-up reminders
- data analysis
- data tables with institutional results and national data comparisons
- compilation of respondent narrative comments
Options available at additional cost are distribution and processing of paper surveys; customized analyses based on specific institutional interests; narrative summary report and display of key findings in graphical format and PowerPoint.
C - Change will be pleased to work with you to customize a project and timeline that meets your institution’s needs.
Customization for Different Populations
The Survey can be adapted for students in other health care disciplines.
Data - Action Cycles
Assisting institutions to collect and use their survey data effectively and constructively are central elements of the services provided with the C - Change Survey. C - Change offers consultation on implementing data-action cycles, i.e., change activities that are appropriate and responsive to Survey findings.
Selected C - Change Publications
1. Pololi L, Conrad P, Knight S, Carr P. A study of the relational aspects of the culture of academic medicine. Academic Medicine. 2009;84:106-114.
2. Carr P, Pololi L, Knight S, Conrad P. Collaboration in academic medicine: Reflections on gender and advancement. Academic Medicine. 2009;84(10):1447-1453.
3. Pololi L, Kern DE, Carr P, Conrad P, Knight S. The culture of academic medicine: Faculty perceptions of the lack of alignment between individual and institutional values. Journal of General Internal Medicine. 2009;24(12):1289-95.
4. Powell D, Scott JL, Rosenblatt M, Roth PB, Pololi L. Commentary: A call for culture change in academic medicine. Academic Medicine. 2010;84:586-87.
5. Conrad P, Carr P, Knight S, Renfrew MR, Dunn M, Pololi L. Hierarchy as a barrier to advancement for women in academic medicine. Journal of Women’s Health. 2010;19(4):799-805.
6. Pololi L, Kern DE, Carr P, Conrad P. Authors’ Reply: Faculty values. Journal of General Internal Medicine. 2010;25(7):647.
7. Pololi LH. Changing the Culture of Academic Medicine. Perspectives of Women Faculty. Hanover, NH: Dartmouth College Press; 2010.
8. Pololi LH. A prescription for diversifying medical faculties. Chronicle of Higher Education. September 24, 2010. B32-34.
9. Pololi L, Cooper LA, Carr P. Race, disadvantage and faculty experiences in U.S. Academic Medicine. Journal of General Internal Medicine. 2010;25:1363-9.
10. Pololi L.H, Jones S.J. Women Faculty: An analysis of their experiences in academic medicine and their coping strategies. Gender Medicine. 2010;7:438-450.
11. Pololi, LH, Krupat E, Civian JT, Ash AS, Brennan RT. Why are a quarter of faculty considering leaving academic medicine? A study of their perceptions of institutional culture and intention to leave in 26 representative medical schools. Academic Medicine. 2012;87:859-869.
12. Pololi LH, Civian JT, Brennan RT, Dotollo AL, Krupat E. Experiencing the Culture of Academic Medicine: Gender Matters, A National Study. Journal of General Internal Medicine. 2013;28:201-207.
13. Pololi LH, Evans AT, Gibbs BK, Krupat E, Brennan RT, Civian JT. The experience of minority faculty who are underrepresented in medicine, at 26 representative U.S. medical schools. Academic Medicine, in press.