Myers, Kara Lynn Fincher and Baskette, Kim Value-Based Care: The Nephrology Clinicians’ Experience. 2025. Radford University, Doctoral Capstone Project. Radford University Scholars' Repository.
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Abstract
Chronic kidney disease (CKD) remains a significant public health challenge that necessitates effective management strategies. Value-Based Care (VBC) models, guided by the Quadruple Aim, are increasingly advocated to improve healthcare outcomes, reduce costs, and enhance patient and clinician satisfaction. Despite this shift, limited attention has been given to how nephrology clinicians experience their work within these evolving models of care. Objective: This study aimed to evaluate the experiences of nephrologists and advanced practice providers (APPs) in VBC settings using the Clinician Experience Measure (CEM-10), exploring how professional role, years in practice, age, and gender influence their perceptions and engagement with VBC. Methodology: Thirteen nephrology clinicians completed the Clinician Experience Measure (CEM-10), a validated instrument that captures four distinct domains of clinician experience: (1) psychological safety, (2) quality of collaboration, (3) perceived care effectiveness, and (4) engagement in care delivery. Factorial ANOVA and Pearson correlation were used to test associations between demographic variables and the four outcome domains. Results: Statistically significant differences were found in clinician experience by professional role (p < .001) and gender (p < .001), particularly within the domains of psychological safety and collaboration. No significant associations were found with age or years of experience. These findings support the Job Demands-Resources (JD-R) model, which suggests that discrepancies in workplace experiences arise from the balance, or imbalance, between job demands (workload, role strain) and job resources (support, recognition, autonomy). APPs and female clinicians reported lower scores in areas tied to psychological safety and collaboration, indicating higher job demands or reduced access to key resources. Conclusion: The study underscores the relevance of the JD-R framework in understanding clinician experience in nephrology VBC settings. Results suggest that role and gender may significantly shape access to workplace resources, which in turn influences clinician perceptions across CEM-10 domains. Addressing these disparities through organizational strategies that bolster psychological safety, strengthen collaboration, enhance perceived effectiveness, and deepen engagement may improve clinician well-being and support sustainable implementation of VBC models. Keywords: CKD, nephrology, VBC, clinician experience, CEM-10, Quadruple Aim
| Item Type: | Doctoral Capstone Project |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Divisions: | Radford University > Waldron College of Health and Human Services |
| Date Deposited: | 03 Dec 2025 06:56 |
| Last Modified: | 16 Apr 2026 19:25 |
| URI: | http://wagner.radford.edu/id/eprint/1282 |
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