Personal-Organizational Values Alignment

Physicians’ perspectives of the extent to which their personal values aligned well with the values of their institutions was assessed with the 3-item Stanford Values Alignment scale. This instrument was developed through a multistep process by one of the authors (M.T.). The initial scale was refined with feedback from a group of approximately 30 physicians interested in physician wellness prior to initial pilot testing. A preliminary set of 6 items was subsequently tested in a sample of more than 600 physicians in 2016. The scale was then shortened to 3 items found to render good internal consistency, the expected association with professional fulfillment, and inverse correlation with burnout.²² The 3 items are: (1) My input is valued in important administrative decisions, (2) Our organizational goals and values fit well with my goals and values, and (3) Administration values my clinical work. Items are scored on a 5-point Likert scale with options ranging from not at all true (score = 0) to completely true (score = 4). Aggregate scores are determined by summing the 0 to 4 score for each of the individual items to yield a total score ranging from 0 to 12. Subsequent to the 2016 study, the instrument has been used by a large number of health care organizations across the US.

To evaluate whether any of the 3 values alignment items assessed themes similar to the construct of the 9 items in the Mayo Clinic Participatory Management Leadership Index, we conducted a principal component analysis with Oblimin rotation and Kaiser normalization to determine underlying patterns between these 12 items (the 3 items from the Values Alignment Scale and 9 items from the Leadership Scale). Two components emerged from these 12 items: all 3 values alignment items clustered as 1 component, and all 9 of the leadership items clustered as the other component, suggesting these domains are distinct constructs (eTable 2 in the Supplement).