Development of Clinical Learning Environment Measure in the Undergraduate Medical Program

Abstract

The quality of clinical training for undergraduate medical students is greatly influenced by the clinical learning environment. To our knowledge, there has been limited measurement of clinical learning environment that utilizes tools considering specific contexts for medical students in Indonesia. Objective: This study aims to develop a questionnaire to evaluate the clinial learning environment of undergraduate medical students in Indonesia. A cross sectional study was conducted with four stages: a. Development of questionnaire items, b. Review of panel experts, c. Pilot study to non-targeted medical students, and d. Administration of the questionnaire to medical students and psychometric evaluation. A qualitative analysis on the experts’ comments was conducted. An exploratory factor analysis (EFA) was also completed. A total of 29 experts provided suggestions on the clarity and relevance of the developed items. Pilot study involved 31 non-targeted medical students. A total of 253 4th and 5th year FMUI undergraduate medical students completed the questionnaire. The EFA suggested 6 components which are perceptions on: 1. Learning opportunities and engagement; 2. Interactions with patients during clinical rotation; 3. Communication and interactions with colleagues and supervisors; 4. Facility and individual treatment; 5. Supervision process; 6. Self-confidence and awareness. A total of 10 items were removed given inadequate loading on to factors and crossloadings. The reliability of the 60 item questionnaire is excellent (Cronbach alpha 0.95). The study has developed and validated a 60 item Indonesian questionnaire to measure undergraduate medical students’ perceptions on their clinical learning environment. The future use is expected to facilitate benchmarking of clinical learning environment for undergraduate medical students in Indonesia.