Deborah Simpson1, Matthew McDiarmid2, Tricia La Fratta3, Nicole Salvo4, Jacob L Bidwell5, Lawrence Moore6, David M Irby7. 1. is Director of Education, Academic Affairs at Advocate Aurora Health, and Clinical Adjunct Professor of Family & Community Medicine, Medical College of Wisconsin, University of Wisconsin School of Medicine and Public Health. 2. was an Interventional Cardiology Fellow, Aurora Health Care at the time of the project. 3. is Manager, Graduate Medical Education Programs, Aurora Health Care. 4. is Program Director for Obstetrics and Gynecology, Aurora Health Care. 5. is Designated Institutional Official, Vice President of Academic Affairs, and Vice President, Aurora University of Wisconsin Medical Group, Aurora Health Care. 6. is a Family Medicine Resident, Aurora Health Care. 7. is Professor Emeritus of Medicine and Education Scientist, Center for Faculty Educators, University of California San Francisco, and Affiliate Faculty Member in Learning, Informatics, Management, and Ethics, Karolinska Institute, Stockholm, Sweden.
Abstract
BACKGROUND: The clinical learning environment (CLE) is a priority focus in medical education. The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review's (CLER) recent addition of teaming and health care systems obligates educators to monitor these areas. Tools to evaluate the CLE would ideally be: (1) appropriate for all health care team members on a specific unit/project; (2) informed by contemporary learning environment frameworks; and (3) feasible/quick to complete. No existing CLE evaluation tool meets these criteria. OBJECTIVE: This report describes the creation and preliminary validity evidence for a Clinical Learning Environment Quick Survey (CLEQS). METHODS: Survey items were identified from the literature and other data sources, sorted into 1 of 4 learning environment domains (personal, social, organizational, material) and reviewed by multiple stakeholders and experts. Leaders from 6 interprofessional graduate medical education quality improvement/patient safety teams distributed this voluntary survey to their clinical team members (November 2019-mid-January 2021) using electronic or paper formats. Validity evidence for this instrument was based on the content, response process, internal structure, reliability, relations to other variables, and consequences. RESULTS: Two hundred one CLEQS responses were obtained, taking 1.5 minutes on average to complete with good reliability (Cronbach's α ≥ 0.83). The Cronbach alpha for each CE domain with the overall item ranged from 0.50 for personal to 0.79 for social. There were strong associations with other measures and clarity about improvement targets. CONCLUSIONS: CLEQS meets the 3 criteria for evaluating CLEs. Reliability data supports its internal consistency, and initial validity evidence is promising.
BACKGROUND: The clinical learning environment (CLE) is a priority focus in medical education. The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review's (CLER) recent addition of teaming and health care systems obligates educators to monitor these areas. Tools to evaluate the CLE would ideally be: (1) appropriate for all health care team members on a specific unit/project; (2) informed by contemporary learning environment frameworks; and (3) feasible/quick to complete. No existing CLE evaluation tool meets these criteria. OBJECTIVE: This report describes the creation and preliminary validity evidence for a Clinical Learning Environment Quick Survey (CLEQS). METHODS: Survey items were identified from the literature and other data sources, sorted into 1 of 4 learning environment domains (personal, social, organizational, material) and reviewed by multiple stakeholders and experts. Leaders from 6 interprofessional graduate medical education quality improvement/patient safety teams distributed this voluntary survey to their clinical team members (November 2019-mid-January 2021) using electronic or paper formats. Validity evidence for this instrument was based on the content, response process, internal structure, reliability, relations to other variables, and consequences. RESULTS: Two hundred one CLEQS responses were obtained, taking 1.5 minutes on average to complete with good reliability (Cronbach's α ≥ 0.83). The Cronbach alpha for each CE domain with the overall item ranged from 0.50 for personal to 0.79 for social. There were strong associations with other measures and clarity about improvement targets. CONCLUSIONS: CLEQS meets the 3 criteria for evaluating CLEs. Reliability data supports its internal consistency, and initial validity evidence is promising.
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