Factor Structure, Reliability and Validity of the Institutional Culture Assessment Scale (ICAS)

Introduction: Work environment can affect the employees, fostering well-being versus emotional burden. The aim of this study was to develop the Institutional Culture Assessment Scale (ICAS), and evaluate its Factor Structure, Reliability and Validity in a Brazilian sample of medical students and physicians in different settings and phases of the medical career. Method: 2537 individuals were evaluated by an online questionnaire. The sample was split in half for independent testing of Exploratory Factor Analysis and Confirmatory Factor Analysis. We then used Confirmatory Factor Analysis (CFA) to test the best solutions in the second half of the sample. Then, considering a unidimensional model solution, an item response theory (IRT) analysis was conducted. Simple linear regression analysis was performed to investigate associations between ICAS factor scores and internal validators (burnout scores), using again the second half of the sample. Result: Parallel analysis revealed two factors. The first factor encompassed items involving the institution and supervisors. The second factor encompassed items involving peers. We decided to performed the next analysis with a unidimensional construct based solely on institution/supervisor items. A unidimensional model including the remaining seven items from the ICAS instrument revealed an excellent fit with the data. All items loaded significantly on the unidimensional latent trait with factor loadings ranging from 0.583 to 0.869. McDonalds Omega was 0.89, showing a high internal consistency. Conclusion: This study presents a valid and reliable scale to assess aspects of institutional culture connected to the relationships with superiors/supervisors and to the relation to the institutions themselves.