Measuring the Learning Orientation Fostered by Pediatric Residency Programs With the Graduate Medical Education Learning Environment Inventory Instrument.

Abstract

Mastery learning orientation, conceptualized as a growth mindset, can be beneficial to learners in medical education and is supported by a program's learning environment. Currently, there are no instruments which reliably assess the learning orientation of a graduate medical education program's learning environment. To explore the reliability and validity of the Graduate Medical Education Learning Environment Inventory (GME-LEI). Leaders of the Education in Pediatrics Across the Continuum (EPAC) project revised Krupat's Educational Climate Inventory to create the GME-LEI. We investigated the GME-LEI's reliability and validity through confirmatory factor and parallel factor analyses and calculated Cronbach's alpha for each subscale. We compared mean subscale scores between residents in traditional programs and the EPAC project. As EPAC is known to foster a mastery-focused learning orientation, we hypothesized differences detected between resident groups would strengthen the instrument's validity. One hundred and twenty-seven pediatric residents completed the GME-LEI. The final 3-factor model was an acceptable fit to the data, and Cronbach's alpha for each subscale was acceptable (Centrality: 0.87; Stress: 0.73; Support: 0.77). Mean scores on each subscale varied by program type (EPAC vs traditional) with EPAC residents reporting statistically significant higher scores in the Centrality of Learning subscale (2.03, SD 0.30, vs 1.79, SD 0.42; P=.023; scale of 1-4). The GME-LEI reliably measures 3 distinct aspects of the GME learning environment with respect to learning orientation. The GME-LEI may be used to help programs better monitor the learning environment and make changes to support mastery-oriented learning.