Kroth, Philip J.

English

University of New Mexico

University of New Mexico
UNM Digital Repository
MS-Squared Biomedical Informatics
9-16-2014
MS-Squared Focus Group Survey Instrument
Philip J. Kroth
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Recommended Citation
Kroth, Philip J.. "MS-Squared Focus Group Survey Instrument." (2014). https://digitalrepository.unm.edu/ms2/1
Disclaimer for MS-Squared focus group survey tool (a modified version of the Mini-Z): 
This survey tool is a slightly modified version of the Mini-Z Worklife Questionnaire, from the Physician 
Worklife Study, MEMO study, Healthy Workplace study, and teamwork and stress literature. Other 
questions were developed as part of the MS-Squared Study -- the Minimizing Stress, Maximizing Success 
of Clinicians’ Use of Health Information and Communications Technologies Study (Dr. Philip Kroth, 
University of New Mexico).  MS-Squared is funded by a grant from the Agency for Healthcare Research 
and Quality. The survey is free to use; however we respectfully ask you to cite the MS-Squared study 
when using the survey (see below). We would also like to know your thoughts about the tool; please 
contact us with your comments, edits, and survey findings. This survey tool has not yet been fully 
validated so you should consider this carefully when analyzing any results. If you would like to be part of 
the validation process please contact us at pkroth@salud.unm.edu. Thank you! 
Citation: 
*This survey tool is part of the Minimizing Stress, Maximizing Success of HICT Study (MS-Squared), Dr.
Philip Kroth, PI, University of New Mexico.  Design and testing of this Survey was funded by grant 
number R18HS022065 from the Agency for Healthcare Research and Quality (AHRQ).  The content is 
solely the responsibility of the authors and does not necessarily represent the official views of AHRQ. 
This work is licensed under a Creative Commons Attribution-Noncommercial-No 
Derivatives 4.0 International License. 
V1.1 (16 Sept 2014) 
The Mini-Z Clinician Worklife Questionnaire 
For questions 1-10, please circle the best answer. 
1. Overall, I am satisfied with my current job:
Strongly disagree   Disagree Neither agree nor disagree Agree Agree strongly 
2. I feel a great deal of stress because of my job:
 Strongly disagree Disagree Neither agree nor disagree Agree Agree strongly 
3. Using your own definition of “burnout”, please circle one of the answers below:
1. I enjoy my work. I have no symptoms of burnout.
2. I am under stress, and don’t always have as much energy as I did, but I don’t feel burned out.
3. I am definitely burning out and have one or more symptoms of burnout, e.g.  emotional exhaustion.
4. The symptoms of burnout that I’m experiencing won’t go away. I think about work frustrations a lot.
5. I feel completely burned out. I am at the point where I may need to seek help.
4. My control over my workload is:
1 – Poor 2 – Marginal 3 – Satisfactory 4 – Good 5 – Optimal 
5. Sufficiency of time for documentation is:
1 – Poor 2 – Marginal 3 – Satisfactory 4 – Good 5 – Optimal 
6. Which number best describes the atmosphere in your primary work area?
Calm   Busy, but reasonable   Hectic, chaotic 
1 2 3 4 5 
7. My professional values are well aligned with those of my department leaders:
Strongly disagree Disagree Neither agree nor disagree Agree Agree strongly 
8. The degree to which my care team works efficiently together is:
1 – Poor 2 – Marginal 3 – Satisfactory 4 – Good 5 – Optimal 
9. The amount of time I spend on the electronic medical record (EMR) at home is:
1 – Excessive 2 – Moderately high 3 – Satisfactory 4 – Modest 5 – Minimal/none 
10. My proficiency with EMR use is:
1 – Poor 2 – Marginal 3 – Satisfactory 4 – Good 5 – Optimal 
11. Tell us more about your stresses and what we can do to minimize them:
Please tell us about yourself: 
Gender: ______ Female ______ Male    Number of years in current practice:  _______ 
Are you: ___ MD    ___ NP   ___PA  Other (Specify:_______________________) 
Practice type: ____ Primary care ____ Non-procedural specialist (Specify:_______________________) 
____Procedural specialist (Specify:_________________________) 
% of time you do: 
___Clinical Practice ____Research ____Teaching ____Administrative ____Office time 
*Questions drawn from the Physician Worklife Study, MEMO study, Healthy Workplace study, and teamwork and stress literature. Other
questions developed at Hennepin County Medical Center. For more information contact mark.linzer@hcmed.org. 


MS-Squared Focus Group Survey Instrument

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MS-Squared Focus Group Survey Instrument

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