Measuring psychological flexibility in medical students and residents: a psychometric analysis.
OBJECTIVE
Psychological flexibility involves mindful awareness of our thoughts and feelings without allowing them to prohibit acting consistently with our values and may have important implications for patient-centered clinical care. Although psychological flexibility appears quite relevant to the training and development of health care providers, prior research has not evaluated measures of psychological flexibility in medical learners. Therefore, we investigated the validity of our learners' responses to three measures related to psychological flexibility.


METHODS
Fourth-year medical students and residents (n=275) completed three measures of overlapping aspects of psychological flexibility: (1) Acceptance and Action Questionnaire-II (AAQ-II); (2) Cognitive Fusion Questionnaire (CFQ); and (3) Mindful Attention and Awareness Questionnaire (MAAS). We evaluated five aspects of construct validity: content, response process, internal structure, relationship with other variables, and consequences.


RESULTS
We found good internal consistency for responses on the AAQ (α=0.93), MAAS (α=0.92), and CFQ (α=0.95). Factor analyses demonstrated a reasonable fit to previously published factor structures. As expected, scores on all three measures were moderately correlated with one another and with a measure of life satisfaction (p<0.01).


CONCLUSIONS
Our findings provide preliminary evidence supporting validity of the psychological flexibility construct in a medical education sample. As psychological flexibility is a central concept underlying self-awareness, this work may have important implications for clinical training and practice.
Communication Research Working Group, Educational Innovation Institute, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA. cpalladino@gru.edu
Christie L
CL
Palladino
Brittany
B
Ange
Deborah S
DS
Richardson
Rhonda
R
Casillas
Matt
M
Decker
Ralph A
RA
Gillies
Amy
A
House
Michael
M
Rollock
William H
WH
Salazar
Jennifer L
JL
Waller
Ronnie
R
Zeidan
Lara
L
Stepleman
D000223:Adaptation, Psychological; D003430:Cross-Sectional Studies; D004503:Education, Medical, Graduate; D004504:Education, Medical, Undergraduate; D006801:Humans; D007396:Internship and Residency; D008505:Medical Staff, Hospital / Q000523:psychology*; D011594:Psychometrics; D013337:Students, Medical / Q000523:psychology*
assessment; mindfulness; psychological flexibility; psychological well-being; psychometrics; validity