Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool

Objective: The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. Design: Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. Setting: Four residency training institutions in Washington state between February 2016 and March 2017. Participants: General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. Results: The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. Conclusions: Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation.