Frequently Asked Questions (SUC-Prof and SUC-Safe)

I want to use your SUC-Prof and SUC-Safe scales, but my space is limited. Do I have to administer all items in each scale? Rather than eliminating items from both scales. You may wish to use one complete scale (e.g., SUC-Prof) and not the other. It is perfectly appropriate to measure one speaking up climate and not the other.

I read the answer to question 1 above, but I’d like to assess both the speaking up climates for professionalism and for patient safety. Can I cut back the number of items in each scale? You can but you do so at your own risk. We are interested in reducing response burden and aim to create instruments with the least number of items possible. However, as rigorous researchers we worry about such things as internal reliability and validity of the metrics we create. We feel that the SUC scales, none of which is longer than five items, are “lean” enough. We continue to study alternative versions of the scale to find the smallest set of items that can be used to reliability to measure these constructs.

Occasionally, a survey participant will not respond to some of the items on the SUC-Prof or SUC-Safe scales. What do you recommend I do with missing data? In our research, when participant do not respond to all of the items in a particular scale, we generally treat the whole scale as missing and do not use the participant’s data in our analysis. Another rule of thumb used with other scales is that a scale score is calculated as long as at least 2/3rds of the items are completed (i.e., if no more than one item on a 4 to 5-item scale are missing) The mean score for the scale items that are completed is used in calculating the summary score. You are free to do whatever you think best in this situation.

I notice that the SUC-Prof and SUC-Safe scales were developed on a resident physician sample. Can it be used with other health professionals (e.g., nurse, staff physicians, pharmacists, etc.)? We have no reason to believe that the scales cannot be used with other health professionals, and healthcare organizations have in fact used it with their clinical staff including health professionals in various roles including nurse and staff physicians. However, we have not assessed the psychometrics of the scales in these groups. We hope to publish the psychometrics of scales in these groups in the near future.

I know you’ve written that the SUC-Prof and SUC-Safe scales are independent of one another, but I’d still like to combine them to come up with a speaking up climate total score. How do I do this? You can’t and you shouldn’t.

Is it OK if I translate the SUC-Prof and/or SUC-Safe scales into another language? We hope to make the SUC scales available to the greatest number of individuals as possible. We appreciate your interest in translating the scale into another language and encourage you to do so. We ask that you use the best practices for translating a patient safety culture scale outlined by Agency for Healthcare Research and Quality for its Surveys on Patient Safety Culture, click here. If you successfully translate the scale please let us know so that we can make others aware of translated versions.

William Martinez, MD, MS