Background Assessments of the clinical learning environment could allow early interventions to improve graduate medical education. To date, measurement tools for this have not been identified.Objective We established the concurrent validity of 2 instruments that assess cultural facets of the clinical learning environment by correlating them with external program evaluation data.Methods In 2017 we surveyed residents across 19 training programs on their perceptions of organizational support by using the Short Survey of Perceived Organizational Support (SPOS), and psychological safety by using the Psychological Safety Scale (PSS). Data were aggregated to the program level and correlated with results from the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey. ResultsOf 511 residents, 322 (63%) completed the survey, and 496 of 516 residents (96%) completed the ACGME Resident Survey. Perceived organizational support correlated positively with overall program evaluation score (r ¼ 0.75, P , .001); faculty (r ¼ 0.72, P , .001); evaluation (r ¼ 0.73, P , .001); educational content (r ¼ 0.52, P ¼ .022); and resources domains (r ¼ 0.55, P ¼ .014). Psychological safety had a positive correlation with overall program evaluation (r ¼ 0.57, P ¼ .011); faculty (r ¼ 0.50, P ¼ .028); and evaluation (r ¼ 0.62, P , .005). ConclusionsThe SPOS and PSS correlated with key ACGME Resident Survey domains. Programs showing greater support of residents were likely to show more positive ratings on program evaluation metrics. Teaching institutions may benefit from actively monitoring and improving aspects of their learning environment through internal assessments.

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In a sample of community-based internal medicine and family practice residents, unsupervised prescription writing by residents for individuals who are not their patients is a common occurrence. Since residency training is a time when practice habits are established, it is important that all residents learn about the ethical, legal, and liability implications of writing prescriptions for nonpatients.

Despite medical society policies, many physicians would be willing to be involved in the execution of adults. The medical profession needs to be better informed about the ethical issues involved in physician participation in capital punishment.