Predictors of Employer Satisfaction (Technical and Non-Technical Skills) J. Danielson, T. Wu, A. Fales-Williams, R. Kirk, V. Preast 10 March 2012 AAVMC
Literature • Cron WL, Slocum JV Jr., Goodnight DB, et al. Executive summary of the Brakke management and behavior study. J Am Vet Med Assoc. 2000;217(3):332–8. • Brown JP, Silverman JD. The current and future market for veterinarians and veterinary medical services in the United States. J Am Vet Med Assoc. 1999;215(2):161–83. • Lewis RE, Klausner JS. Nontechnical competencies underlying career success as a veterinarian. J Am Vet Med Assoc. 2003;222(12):1690–6. • Applied Measurement Professionals. A North American study of the entry-level veterinary practitioner. Report prepared for National Board of Veterinary Medical Examiners. Bismarck, ND: Applied Measurement Professionals; 2009
Literature • Existing studies/processes have provided a variety of knowledge/skill groupings • Generally have discussed technical vs. nontechnical skills as the most broad characterizations. • Attention to non-technical skills seems warranted given skills employed by veterinarians in the workplace • Studies have not really attempted to provide estimates of the relationships between certain skills and employer satisfaction.
What matters to employers of veterinarians?
Everything!
We can’t equally emphasize everything
Our Goal • Create meaningful skill groups. (Not establish comprehensive lists) • Determine associations between skills and employer satisfaction.
Method • Survey • Employers – of ISUCVM graduates of 2007 (51% response rate), 2008 (78% response rate) and 2009 (47% response rate) – Overall, data from 75 employers were used for analysis
Method cont. . . • Graduates – All but two (97%) in private clinical practice – 75% female, 25% male – Areas of clinical practice (data only available for 08 and 09 graduates) • 49% - small animal practice exclusively, • 20% - mixed practice (predominantly small animal), • 11% - mixed practice (predominantly food animal and equine), • 11% - mixed practice (50/50 large and small animal), • 6% - equine practice (exclusively) • 4% - food animal practice (exclusively).
Employers asked to rate employees . . . 1. Overall satisfaction with the employee 2. Overall veterinary technical skills 3. Overall non-technical skills
Two Scales Satisfaction
Preparation
5 - Very Satisfied 4 - Satisfied 3 - Neither Satisfied nor Unsatisfied 2 - Unsatisfied 1 - Very Unsatisfied
5 - Very Well Prepared 4 - Well Prepared 3 - Competent 2 - Somewhat Unprepared 1 - Very Unprepared
22 technical skill areas . . . 1. Handle and restrain animals in a safe and humane manner 2. Perform a physical exam 3. Collect a medical history 4. Examine relevant production / performance records 5. Identify all problems for a given case 6. Tend to the immediate needs of animals 7. Select relevant diagnostic tests and procedures 8. Perform relevant diagnostic tests and procedures 9. Interpret relevant diagnostic tests 10. Manage cases that have common diagnoses 11. Manage cases that have uncommon diagnoses 12. Recognize the possibility of a notifiable disease and take action to contain it 13. Recognize when euthanasia is warranted, and carry it out humanely 14. Recognize when analgesia and anesthesia are warranted and perform appropriately 15. Perform common surgical procedures and implement after care 16. Perform common medical (non-surgical) procedures and implement aftercare 17. Select and prescribe appropriate pharmaceuticals 18. Assess, advise on, and modify animal behavior 19. Assess and advise on animal production 20. Assess and advise on animal performance 21. Evaluate the necessity for, and implement, health maintenance programs 22. Carry out necropsy examinations
16 non-technical skill areas . . . 1. Communicate effectively, appropriately, and empathetically with clients 2. Know when to refer 3. Know how to refer 4. Work with other veterinarians in the same workplace 5. Work with others in the same workplace (non-DVM’s) 6. Create and maintain medical records 7. Perform the business related tasks of the position 8. Control expenses and maximize revenue 9. Deal with ethical issues 10. Solve problems encountered (medical cases) 11. Solve problems encountered (non medical case issues) 12. Manage other personnel who work in supporting roles 13. Support clients in dealing with grief 14. Address the legal aspects of veterinary practice 15. Comply with the Legal requirements of drug use 16. Proactively address professional liability
Skills grouped theoretically; internal consistency of groupings tested using Cronbach’s Alpha
Subcale
Items
Cronbach’s Alpha
Technical Skills •
Perform a physical exam
•
Collect a medical history
Data
•
Identify all problems for a given case
interpretation
•
Interpret relevant diagnostic tests
Planning
•
Select relevant diagnostic tests and procedures
•
Select and prescribe appropriate pharmaceuticals
•
Perform relevant diagnostic tests and procedures
•
Perform common surgical procedures and implement
Data collection
Taking action
after care •
Perform common medical (non-surgical) procedures and implement aftercare
.85
.73
.80
.87
Subcale
Items
Cronbach’s Alpha
Technical Skills •
Perform a physical exam
•
Collect a medical history
Data
•
Identify all problems for a given case
interpretation
•
Interpret relevant diagnostic tests
Planning
•
Select relevant diagnostic tests and procedures
•
Select and prescribe appropriate pharmaceuticals
•
Perform relevant diagnostic tests and procedures
•
Perform common surgical procedures and implement
Data collection
Taking action
after care •
Perform common medical (non-surgical) procedures and implement aftercare
.85
.73
.80
.87
Subcale
Items
Cronbach’s Alpha
Technical Skills •
Perform a physical exam
•
Collect a medical history
Data
•
Identify all problems for a given case
interpretation
•
Interpret relevant diagnostic tests
Planning
•
Select relevant diagnostic tests and procedures
•
Select and prescribe appropriate pharmaceuticals
•
Perform relevant diagnostic tests and procedures
•
Perform common surgical procedures and implement
Data collection
Taking action
after care •
Perform common medical (non-surgical) procedures and implement aftercare
.85
.73
.80
.87
Subcale
Items
Cronbach’s Alpha
Technical Skills •
Perform a physical exam
•
Collect a medical history
Data
•
Identify all problems for a given case
interpretation
•
Interpret relevant diagnostic tests
Planning
•
Select relevant diagnostic tests and procedures
•
Select and prescribe appropriate pharmaceuticals
•
Perform relevant diagnostic tests and procedures
•
Perform common surgical procedures and implement
Data collection
Taking action
after care •
Perform common medical (non-surgical) procedures and implement aftercare
.85
.73
.80
.87
Subcale
Items
Cronbach’s Alpha Non-technical Skills
Interpersonal
•
Skills
Communicate effectively, appropriately, and Empathetically with clients,
•
Work with other DVM's in the same workplace
•
Work with others in the same workplace (non-DVM’s)
Ability to deal
•
Address the legal aspects of veterinary practice
with legal
•
Comply with the legal requirements of drug use
•
Proactively address professional liability
•
Perform the business related tasks of the position
•
Control expenses and maximize revenue
Making
•
Know when to refer
referrals
•
Know how to refer.
Problem
•
Solve problems encountered (medical cases)
solving
•
Solve problems encountered (non medical case
issues
Business skills
.86
issues)
.89
.87
.89
.73
Subcale
Items
Cronbach’s Alpha Non-technical Skills
Interpersonal
•
Skills
Communicate effectively, appropriately, and Empathetically with clients,
•
Work with other DVM's in the same workplace
•
Work with others in the same workplace (non-DVM’s)
Ability to deal
•
Address the legal aspects of veterinary practice
with legal
•
Comply with the legal requirements of drug use
•
Proactively address professional liability
•
Perform the business related tasks of the position
•
Control expenses and maximize revenue
Making
•
Know when to refer
referrals
•
Know how to refer.
Problem
•
Solve problems encountered (medical cases)
solving
•
Solve problems encountered (non medical case
issues
Business skills
.86
issues)
.89
.87
.89
.73
Subcale
Items
Cronbach’s Alpha Non-technical Skills
Interpersonal
•
Skills
Communicate effectively, appropriately, and Empathetically with clients,
•
Work with other DVM's in the same workplace
•
Work with others in the same workplace (non-DVM’s)
Ability to deal
•
Address the legal aspects of veterinary practice
with legal
•
Comply with the legal requirements of drug use
•
Proactively address professional liability
•
Perform the business related tasks of the position
•
Control expenses and maximize revenue
Making
•
Know when to refer
referrals
•
Know how to refer.
Problem
•
Solve problems encountered (medical cases)
solving
•
Solve problems encountered (non medical case
issues
Business skills
.86
issues)
.89
.87
.89
.73
Subcale
Items
Cronbach’s Alpha Non-technical Skills
Interpersonal
•
Skills
Communicate effectively, appropriately, and Empathetically with clients,
•
Work with other DVM's in the same workplace
•
Work with others in the same workplace (non-DVM’s)
Ability to deal
•
Address the legal aspects of veterinary practice
with legal
•
Comply with the legal requirements of drug use
•
Proactively address professional liability
•
Perform the business related tasks of the position
•
Control expenses and maximize revenue
Making
•
Know when to refer
referrals
•
Know how to refer.
Problem
•
Solve problems encountered (medical cases)
solving
•
Solve problems encountered (non medical case
issues
Business skills
.86
issues)
.89
.87
.89
.73
Subcale
Items
Cronbach’s Alpha Non-technical Skills
Interpersonal
•
Skills
Communicate effectively, appropriately, and Empathetically with clients,
•
Work with other DVM's in the same workplace
•
Work with others in the same workplace (non-DVM’s)
Ability to deal
•
Address the legal aspects of veterinary practice
with legal
•
Comply with the legal requirements of drug use
•
Proactively address professional liability
•
Perform the business related tasks of the position
•
Control expenses and maximize revenue
Making
•
Know when to refer
referrals
•
Know how to refer.
Problem
•
Solve problems encountered (medical cases)
solving
•
Solve problems encountered (non medical case
issues
Business skills
.86
issues)
.89
.87
.89
.73
Question What is the relationship between technical veterinary skills and employer satisfaction?
Zero-Order Correlations – Technical Skills 2
3
4
5
6
M (SD)
Sample Possible Range Range
1.Employer satisfaction
.56
.46 .45 .45 .52
4.47(0.81)
1-5
1-5
2.Overall Technical Skills
---
.62 .63 .68 .73
3.88(0.90)
2-5
1-5
---
.81 .74 .67
8.49(1.47)
3-10
2-10
---
.75 .73
7.85(1.49)
4-10
2-10
---
.80
7.96(1.55)
4-10
2-10
---
11.92(2.34)
6-15
3-15
3.Data collection 4.Data interpretation 5.Planning 6.Taking action
Note. N = 75. Overall Veterinary Skills = the score of the single item for the overall preparation of various veterinary skills; Overall Non-Veterinary skills = the score of the single item for the overall preparation of various non-technical veterinary skills. The significant levels of all correlation coefficients were all p < .001 except the correlation coefficient between employer satisfaction and making referrals (p = .005).
Question What is the relationship between nontechnical skills and employer satisfaction?
Zero-Order Correlations – Non Technical Skills 7
8
9
10
11
12
M (SD)
Sample Possible Range Range
1.Employer satisfaction
.70
.75 .37
.58
.32 .65
4.47(0.81)
1-5
1-5
7.Overall Non-Technical Skills 8.Interpersonal skills
---
.78 .44
.67
.50 .71
3.83(0.86)
2-5
1-5
---
.48
.62
.57 .70 12.17(2.59)
3-15
3-15
---
.62
.65 .68 11.91(2.37)
6-15
3-15
---
.62 .72
6.81(1.93)
2-10
2-10
---
.63
8.08(1.52)
5-10
2-10
---
7.52(1.60)
2-10
2-10
9.Legal Issues 10.Business skills 11.Making referrals 12.Problem solving
Note. N = 75. Overall Veterinary Skills = the score of the single item for the overall preparation of various veterinary skills; Overall Non-Veterinary skills = the score of the single item for the overall preparation of various non-technical veterinary skills. The significant levels of all correlation coefficients were all p < .001 except the correlation coefficient between employer satisfaction and making referrals (p = .005).
Question What technical skills are most important for predicting employer satisfaction?
Simultaneous Regression of Four Veterinary Technical Skills on Employer Satisfaction
Variable
B
SEB
β
Four Veterinary Technical Skills Data collection
0.12
0.10
.21
Data interpretation
0.01
0.10
.02
Planning
-0.02
0.10
-.05
Taking action
0.14
0.06
.40*
Note. N = 75. * p < .05. ** p < .01. *** p < .001.
R2
Adjusted R2
.29***
.25***
Question What non-technical skills are most important for predicting employer satisfaction?
Simultaneous Regression of Five Non-Veterinary Skills on Employer Satisfaction
Variable
B
SEB
β
Five Non-Technical Skills Interpersonal skills
0.19
0.03
.62***
Ability to deal with legal issues
-0.02
0.04
-.05
Business skills
0.09
0.05
.22*
Making referrals
-0.17
0.05
-.32**
Problem solving
0.15
0.06
.29*
Note. N = 75. * p < .05. ** p < .01. *** p < .001
R2
Adjusted R2
.66***
.64***
Question What is going on with “making referrals?”
5
High referrals: B = .47, β = .58***
Employer Satisfaction
4.5
4
3.5
Low referrals: B = .79, β = .97***
Low Making referrals
3
2.5
High Making referrals
2
1.5
1
Low Interpersonal skills
High Interpersonal skills
Questions What is the role of non-technical skills in predicting employer satisfaction after technical skills have been controlled for?
Hieratical Regression Analyses Using Veterinary Technical Skills and NonTechnical Skills to Predict Employer Satisfaction Variable
B
SE B
β
Step 1 (Four Technical Skills) Data collection
0.12
0.10
.21
Data interpretation
0.01
0.10
.02
Planning
-0.02 0.10
-.05
Taking action
0.14
.40*
0.06
Step 2 (Five Non-technical Skills) Interpersonal skills Ability to deal with legal issues Business skills
0.20
0.03 .64***
-0.03
0.04
-.08
0.11
0.05
.26*
Making referrals
-0.19
Problem solving
0.13
Note. N = 75. * p < .05. ** p < .01. *** p < .001.
0.05 -.35** 0.07
.25
R2
Adjusted R2
∆R2
F change in R2
.29
.25
.25
7.24***
.72
.68
.42
19.22***
Conclusions Technical Skills Taking Action
Non Technical Skills • Interpersonal Skills • Business Skills • Problem Solving • (Making Referrals Interaction)
Questions? Jared Danielson
[email protected]
