Focus on Quality: Investigating Residents’ Learning Climate Perceptions

Abstract

BackgroundA department’s learning climate is known to contribute to the quality of postgraduate medical education and, as such, to the quality of patient care provided by residents. However, it is unclear how the learning climate is perceived over time.ObjectivesThis study investigated whether the learning climate perceptions of residents changed over time.MethodsThe context for this study was residency training in the Netherlands. Between January 2012 and December 2014, residents from 223 training programs in 39 hospitals filled out the web-based Dutch Residency Educational Climate Test (D-RECT) to evaluate their clinical department’s learning climate. Residents had to fill out 35 validated questions using a five point Likert-scale. We analyzed data using generalized linear mixed (growth) models.ResultsOverall, 3982 D-RECT evaluations were available to investigate our aim. The overall mean D-RECT score was 3.9 (SD = 0.3). The growth model showed an increase in D-RECT scores over time (b = 0.03; 95% CI: 0.01–0.06; p < 0.05).ConclusionsThe observed increase in D-RECT scores implied that residents perceived an improvement in the learning climate over time. Future research could focus on factors that facilitate or hinder learning climate improvement, and investigate the roles that hospital governing committees play in safeguarding and improving the learning climate.

Reliability of residents’ assessments of their postgraduate medical education learning environment: an observational study

“…Moreover, research on data of 7 cohorts of medical students showed that differences between cohorts explained only 0.01% of the variance in multiple choice examination results, compared to 83% for the differences between subjects within cohorts, and 12% for random error [22]. Similarly, research among residents showed that repeated learning environment assessments by different groups of residents for quality assurance and improvement purposes did not show any meaningful changes in overall scores over time [8]. Third, leaving residents' SPEED scores could have been affected by social desirability bias, if these residents desired to stay at or return to the same department later in their career.…”

Reliability of residents’ assessments of their postgraduate medical education learning environment: an observational study

“…show any meaningful changes in overall scores over time. (8) Third, leaving residents' SPEED scores could have been affected by social desirability bias, if these residents desired to stay at or return to the same department later in their career. However, it is unlikely that this would apply to all leaving residents.…”

Reliability of residents’ assessments of their postgraduate medical education learning environment: an observational study

“…(22) Similarly, research among residents showed that repeated learning environment assessments by different groups of residents for quality assurance and improvement purposes did not show any meaningful changes in overall scores over time. (8) Third, leaving residents' SPEED scores could have been affected by social desirability bias, if these residents desired to stay at or return to the same department later in their career. However, it is unlikely that this would apply to all leaving residents.…”

“…7As a result, a healthy learning environment may not only support the professional development of residents but also improve the quality of the patient care they provide. 8The learning environment has been described as the formal and informal context in which learning takes place, (8) comprising the content, atmosphere and organization of the education program. (2,9) The Scan of Postgraduate Education Environment Domains (SPEED) was developed and validated as a concise instrument, based on a solid theoretical framework,(2) to capture residents' perceptions of these three domains of PGME programs.…”