C-Change Resident Survey

How the C-Change Resident Survey© Can Be Used

Document the environment for learning and professionalism of residents
Examine associations among resident perceptions of the organizational culture and demographic characteristics such as gender, race and ethnicity, year of residency training, program specialty, and site
Research projects
Assess diversity needs
Assess the effectiveness of programmatic interventions/changes
Identify dimensions of culture requiring improvement
Address well-being
Initiate change activities for improvement

Discrete scales with demonstrated statistical reliability summarize C-Change data along important Dimensions of the Culture to allow comparison of sub-populations and investigate outcomes of interest.

The Dimensions of the Culture

Vitality
Self-efficacy in career advancement
Institutional support
Relationships/inclusion/trust
Values alignment
Ethical/moral distress
Respect
Mentoring
Leadership aspirations
Work-life integration
Gender equity
Underrepresented resident equity
Valuing diversity: attitudes and behaviors
Antisexism and antiracism skills
Change agency for equity
Institutional change efforts for diversity
Institutional change efforts for resident support

Additional Optional Dimensions

Interprofessional/interdisciplinary practices and preferences

The C-Change Resident Survey© is fielded electronically and takes about 15 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 only to protect the anonymity of respondents. Most of the time, we accomplish at least a 70% response rate because of the trust in our confidentiality procedures and record.

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 residents, as appropriate.

C-Change provides customized reports that include the scales representing Dimensions of the Culture and other analytic variables of interest, and prepares data tables with frequencies for all survey questions. Respondent data are analyzed by demographic group (e.g., gender, race and ethnicity) assuming a minimum group size is met. Our collected national resident data are also provided as comparison to help identify similarities and differences with the study institution.

Consultation on institutional needs
Customization of the C-Change Resident Survey for the institution
Drafting announcements and cover communications
Survey administration
Reminders to achieve high response rates
Management of email communications with respondents
Confidential data collection and storage
Data analysis
Reporting: summary report; detailed item report; scorecard
Comparison with national benchmark data

In an initial phase, C-Change 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. 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.

In a second phase, randomly selected faculty in each of a stratified random sample of 26 U.S. medical schools were studied using our Survey. This large, nationally representative dataset of faculty responses serves as a rigorously analytic resource to investigate important topics, such as the vitality and retention of academic faculty.^1-7 Survey findings in individual institutions provide a solid foundation for developing activities to support both an enhanced working environment and set of values in academic medicine. Our national normative C-Change Survey data allow medical schools to compare themselves with other similar institutions. Recent C-Change research⁴ identifies Dimensions of the Culture as measured by the survey that predict faculty intention to leave due to dissatisfaction.

The C-Change Faculty Survey is available for use in the health sciences and other disciplines⁷ wishing to understand and improve their culture and existing practices in order to create a more productive, inclusive, diverse, and humanistic environment where all individuals can thrive. The survey allows detailed exploration of the foundations of the development of human capital (e.g., trust, relationships, perception of opportunity, professionalism, respect, mentoring, equity, and the learning environment) as well as the waste of such human capital (e.g., disconnection, causes of dissatisfaction, burnout, harassment, discrimination and desire to leave academia).

The survey also pays particular attention to cultural awareness, including the extent to which faculty value diversity, their anti-sexism and anti-racism skills, and their change agency for equity. When used in parallel, the Student, Resident and Faculty Surveys provide credible and powerful tools for institutional improvements and for research. Survey findings can address accreditation requirements.

1. 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.

2. 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.

3. 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. 2013;88:1308-1314.

4. Pololi LH, Evans AT, Civian JT, Gibbs BK, Coplit LD, Gillum LH, Brennan RT. Faculty Vitality – Surviving the Challenges Facing Academic Health Centers: a National Survey of Medical Faculty. Academic Medicine. 2015;90(7):930-936.

5. Pololi LH, Evans AT, Civian JT, Vasiliou V, Gibbs BK, Coplit LD, Gillum LH, Brennan RT. Mentoring faculty: A U.S. national survey of its adequacy and linkage to culture in academic health centers. J. Continuing Education in the Health Professions. 2015;35:176-184.

6. Pololi LH, Evans AT, Nickell L, Reboli AC, Coplit LD, Stuber ML, Vasiliou V, Civian JT, Brennan RT. Assessing the Learning Environment for Medical Students: An Evaluation of a Novel Survey Instrument in Four Medical Schools. Academic Psychiatry. 2016;doi:10.1007/s40596-016-0620-1.

7. Pololi L, Evans A, Civian J, Gibbs B, Gillum L, Brennan R. A novel measure of “good” mentoring: Testing its reliability and validity in four academic health centers. J Continuing Education in the Health Professions. 2016; 36(4):263-268.

The National Initiative on Gender, Culture & 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, energizing and productive working environment for all medical school faculty and trainees, at the same time increasing the diversity of leadership in academic medicine.