Clinical Education Environment Research Articles

Using Item Response Theory (IRT) to Assess Psychometric Properties of Undergraduate Clinical Education Environment Measure (UCEEM) among Medical Students at the Faculty of Medicine, Suez Canal University

Using Item Response Theory (IRT) to Assess Psychometric Properties of Undergraduate Clinical Education Environment Measure (UCEEM) among Medical Students at the Faculty of Medicine, Suez Canal University

Providing Clinical Safety and Security for Nursing Students: Spontaneous Learning

Background: Clinical education environment safety and security plays an important role in the learning of nursing students. Various studies and authors’ experiences show that there is a lack of learning in nursing students in the arena. The purpose of this study was to determine the effect of providing clinical safety and security on nursing students’ learning. Method: The research sample in this qualitative research consisted of 12 internship nursing students, 3 instructors and 4 nurses in one of the hospitals in Tehran, Iran. Educational intervention was conducted to empower the instructors in the areas of communication, educational strategies and physical environment reform by holding 3 workshops. After a semester, data was collected on nursing students’ learning by semi-structured interview and field note. The content analysis method with a conventional approach was used to data analysis. Results: The results revealed one main theme consisting of “spontaneous learning” and three sub themes including “learning nursing care”, “the motivation for learning nursing care”, and “effective interaction”. Conclusion: The main reason for spontaneous learning has been to improve psychological climate of the clinical environment (wards) by instructors. Acceptance of the student in the ward as a member of the care team and providing effective feedback were the most important factor in improving the psychological climate of the ward. This led to a motivation for care and spontaneous learning in students.

Hacettepe Üniversitesi’nde Tıpta Uzmanlık Öğrencilerinin Klinik Eğitim Ortamlarına İlişkin Algılarının Değerlendirilmesi

Özet Giriş: Eğitim süreçlerinin neredeyse tamamını hastaneden geçiren tıpta uzmanlık öğrencileri için eğitim ortamlarının öğrenmeye çok büyük katkısı vardır. İyi bir eğitim ortamında, hizmet sunumu için yapılan hasta odaklı tıbbi uygulamalar da eğitim fırsatına dönüşebilir. Amaç: Bu araştırmada Hacettepe Üniversitesi’nde mezuniyet sonrası tıpta uzmanlık eğitimi alan araştırma görevlilerinin içinde bulundukları kinik eğitim ortamı ile ilgili algıları ve bu algıların çeşitli değişkenlerle ilişkisinin ortaya koyulması amaçlanmıştır. Gereç-Yöntem: Hacetepe Üniversitesi cerrahi ve dahili bilimler araştırma görevlileri çalışmaya dahil edilmiştir. Katılımcıların demografik bilgilerinin alınmasının yanısıra Mezuniyet Sonrası Hastane Eğitim Ortamı Ölçeği–MSHEOÖ uygulanmıştır. Ölçek puanlarının bazı değişkenlerle ilişkisi incelenmiştir. Bulgular: Çalışmamıza 28 klinik anabilim dalından 212 kişi katılmıştır. Araştırma görevlilerinin neredeyse yarısı, alanda edindikleri bilgiyi kıdemli araştırma görevlilerinden edindiğini belirtmiştir. Kıdemin, çalışılan branşın, hizmet yoğunluğunun klinik eğitim ortamı algısında etkisi olduğu izlenmiştir. Sonuç: Klinik eğitim ortamları iyi hekimler yetiştirmede oldukça değerlidir. Hangi faktörlerin klinik eğitim ortamı algısına etkisi olduğunu ortaya çıkaracak çalışmalar yapılmalıdır. Eğitim ortamları düzenlenirken araştırma görevlilerinin çalışma şartları, akademik beklentileri, psikososyal gereksinimler gibi konular da gözönünde bulundurulmalı, sunulan hasta hizmeti eğitim fırsatına dönüştürülmelidir. Introduction: For residents who spend almost all of their education in hospital, educational environments have a great contribution to learning. In a positive educational atmosphere, patient centered medical practices can become service learning opportunities. Objective: In this study, it was aimed to reveal the perceptions of the residents at Hacettepe University about their clinical education environment and relationship with various variables. Materials and Methods: Surgical and internal sciences residents were included in the study. The demographic information questionnaire and Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire were used as data collection instruments. The relationship between the PHEEM scores and some variables was analyzed. Results: 212 participants from 28 clinical departments participated in the study. Almost half of the residents stated that they have learned clinical knowledge from senior residents. Seniority, clinical department and patient service load are some factors that have an impact in the perception of educational environment. Conclusion: Clinical education environments are valuable in educating qualified physicians. Studies should be conducted to determine which factors influence the perception of clinical educational environment. While organizing educational environments, issues such as working conditions, academic expectations and psychosocial needs of research assistants should be taken into consideration and the service provided should be transformed into educational opportunities.

Exploring the challenges of professional identity formation in clinical education environment: A qualitative study.

Introduction: This study aimed to explore the challenges of professional identity formation at clinical education environments from the faculty members’ viewpoints. Methods: This is a qualitative study. The population consisted of clinical faculty members of Tehran University of Medical Sciences. In this study, 39 faculty members participated in an in-depth semi-structured interview. To analyze the data, conventional content analysis approach was used. Open coding was extracted from the participants’ statements that represented their experiences. Then, based on their similarities, the codes were classified. Subcategories were emerged and after arranging, they were classified into categories based on their relationshipsResults: Instability of professional commitment, patient-centeredness as the missing loop care and treatment, and inappropriate conductive context were explored as the challenges of professional identity in clinical educational environment. Conclusion: According to the results of the study, the formation of professional identity among the providers is not an easy task because many factors affect the formation of professional identity. Therefore, a comprehensive shift towards forming the professional identity at individual and organizational level should be planned.

The challenges of supporting nursing students in clinical education.

Clinical education requires creating a supportive atmosphere for learners and nursing students, who need support to be prepared for their future profession. The purpose of this study is to investigate the challenges of supporting the nursing students in clinical education. This article reviewed studies conducted between 2009 and 2019 with the keywords including support, challenge, students, education, and nursing using SID, Magiran, IranMedex, Google Scholar, Elsevier, and PubMed as databases. Among the 926 articles obtained during the two review stages, which were based on the inclusion and exclusion criteria and the first one analyzed the title and the abstract and the second one analyzed the whole article, ultimately 32 articles were selected for the study. The types of articles used in this study are as follows: qualitative (16 articles), descriptive analytical and cross-sectional (12 articles), review (3 articles), and mixed-methods (1 article). The focus of all studies was on the students' clinical education environment. The participants of the studies were undergraduate nursing students (in 22 articles), graduate students (in 2 articles), nursing instructors and students (in 4 articles), and nursing instructors and managers (in 1 article). Most of the challenges of supporting the students included violence, fear, and anxiety; socio-cultural challenges, environmental-organizational stresses; and ineffective clinical education. The findings of this study showed that nursing students face many challenges in the clinical setting. Therefore, the managers of educational and health-care centers should give a high priority to their students' support programs.

Impact of a Dedicated Teaching Attending Experience on a Required Emergency Medicine Clerkship.

IntroductionOne published strategy for improving educational experiences for medical students in the emergency department (ED) while maintaining patient care has been the implementation of dedicated teaching attending shifts. To leverage the advantages of the ED as an exceptional clinical educational environment and to address the challenges posed by the rapid pace and high volume of the ED, our institution developed a clerkship curriculum that incorporates a dedicated clinical educator role – the teaching attending – to deliver quality bedside teaching experiences for students in a required third-year clerkship. The purpose of this educational innovation was to determine whether a dedicated teaching attending experience on a third-year required emergency medicine (EM) clerkship would improve student-reported clinical teaching evaluations and student-reported satisfaction with the overall quality of the EM clerkship.MethodsUsing a five-point Likert-type scale (1 - poor to 5 - excellent), student-reported evaluation ratings and the numbers of graduating students matching into EM were trended for 10 years retrospectively from the inception of the clerkship for the graduating class of 2009 through and including the graduating class of 2019. We used multinomial logistic regression to evaluate whether the presence of a teaching attending during the EM clerkship improved student-reported evaluation ratings for the EM clerkship. We used sample proportion tests to assess the differences between top-box (4 or 5 rating) proportions between years when the teaching attending experience was present and when it was not.ResultsFor clinical teaching quality, when the teaching attending is present the estimated odds of receiving a rating of 5 is 77.2 times greater (p <0.001) than when the teaching attending is not present and a rating of 4 is 27.5 times greater (p =0.0017). For overall clerkship quality, when the teaching attending is present, the estimated odds of receiving a rating of 5 is 13 times greater (p <0.001) and a rating of 4 is 5.2 times greater (p=0.0086) than when the teaching attending is not present.ConclusionThe use of a dedicated teaching attending shift is a successful educational innovation for improving student self-reported evaluation items in a third-year required EM clerkship.

Relationship between Clinical Education Stressors and Coping Strategies in Paramedic Students of Hamadan University of Medical Sciences

Introduction: Clinical education is an essential element in the education of medical students. One of the problems students face in clinical education is stress. Students choose a variety of strategies to overcome clinical stresses. The aim of this study was to determine the relationship between stressors of clinical education and coping strategies.&#x0D; Methods: In this descriptive study, the population of the study was Hamedan Paramedical Students in 1396 who were studied by census method. The information was evaluated using the Stress Factor Questionnaires of Clinical Education and coping strategies for stressful endlerparer. Data were analyzed using Chi-square test, correlation analysis and nonparametric equilibrium analysis of variance.&#x0D; Result: In this study, students' stress was higher than average in all stressful areas except educational environment. The problem-oriented strategy had the highest score among the coping strategies. Among the domains of stressors among paramedical students, interpersonal communication had a direct and significant relationship with all three coping strategies (p &lt;0.05). In addition, there was no significant relationship between students' major and coping strategies (p = 0.083), while there was a significant relationship between students' interest in their field of study and problem-oriented strategy (p-value &lt;0.001).&#x0D; Conclusion: The clinical education environment is a stressful environment for the paramedical students of Hamadan University of Medical Sciences. Students usually use problem-oriented strategies to cope with the stresses of interpersonal communication, unpleasant emotions, and clinical experiences, while choosing avoidant strategies to reduce stress from the educational environment.

Percepción del estudiante sobre el entorno educativo clínico en asignaturas prácticas en programas académicos de salud: revisión bibliográfica

El ambiente educacional refleja las condiciones a las que se somete un estudiante dentro de su proceso formativo; en etapas prácticas, dada la ausencia de aulas intermediarias y contextos tradicionales de formación, habitualmente se desestima cual es el impacto de un ambiente favorecedor, e inclusive, el propio cumplimiento de los estándares de aprendizajes asociados a cada programa de asignatura dentro del proceso de enseñanza aprendizaje. Esto ocurre aun cuando su análisis positivo refleje un listado indiscutible de beneficios que trascienden al contexto educativo y que incluso puede impactar esferas personales del desarrollo profesional. El objetivo de esta revisión bibliográfica fue documentar la última evidencia disponible que refleje los datos plausibles sobre el ambiente educativo en etapas prácticas, y evidenciar instrumentos que puedan dar cuenta de la percepción del ambiente clínico educativo para estudiantes de carreras sanitarias.

Perception of clinical educational environment by student of physiotherapy based on the Educational Environment Measurement Questionnaire of the Postgraduate Hospital in Chile.

PurposeIt aimed at describing the perception of the clinical educational environment by physiotherapy students based on the Postgraduate Hospital Educational Environment Measurement Questionnaire in Chile.MethodsThe clinical education environment was evaluated according to the Postgraduate Hospital Educational Environment Measure (PHEEM) by 192 students originally enrolled in the fifth year of the physiotherapy career at 3 different headquarters of the academic institution: Santiago, Viña del Mar, and Concepcion Campus (Metropolitan, Valparaiso, and Bio Bio region, respectively), from March to October 2018. The Cronbach’s α was applied to measure the reliability of the instrument and the Student-t and analysis of variance tests were used to compare the differences of PHEEM scores by headquarters, environmental areas, and experience of internship.ResultsA total overall average score of 125.88 was obtained, which meant an excellent educational environment. The overall score was 127.6±22.7 for headquarters 1, 125.6±21.6 for headquarters 2, and 122.5±26.9 for headquarters 3. According to the type of establishment, the scores were of 127.1±22.1 for private and 123.5±26.3 for public institutes. According to the type of area, the score was cataloged as an excellent educational environment in all cases, except in the respiratory care area (lowest score, 117.5±29.1). Finally, the score was 126.9±20.5 for the first internship, 121.7±29.3 for the second, and 129.4±19.6 for the third.ConclusionThere is relative homogeneity of the clinical educational environment for different headquarters, types of establishment, or type of area; but there are significant differences in the number of the internship. The promotion of a good clinical educational environment can have an important impact on the development and performance of the future professional, being the detection of negative aspects an opportunity to improve the hidden curriculum.

Evaluation of Students' Perceptions of Clinical Education Environment and Academic Self-Sufficiency: a cross-sectional study*

Aim: Clinical learning environments are important for education of health care professionals. Students’ satisfaction with, motivation about and self-confidence in clinical environments, as part of their education, can be related to their academic self-efficacy. The aim of this cross-sectional study is to evaluate perceptions of clinical education environments and perception of academic self-efficacy in second-, third- and fourth-year students in the health sciences and nursing departments of Adnan Menderes UniversityMaterial and Methods :The study included a total of 678 students voluntarily accepting to participate in the study. Data were collected with a self-report questionnaire composed of three sections. The first section included questions about socio-demographic features, perceived success and career choices. The second section included Academic Self-Efficacy Scale. The third section included Clinical Learning Environment Scale.Results: Most of the students were female and from the nursing department. The mean academic self-efficacy score was 18,66±3,09 (range: 7-28). The nursing students, the male students, the students with higher perceived success and the students planning to attend a PhD program after graduation had significantly higher scores. The mean score for Clinical Environment Scale was 127,42±21,56. The students planning to follow a post-graduate career path, those having higher perceived success, those not missing a term, the nursing students, the female students and the second-year students had higher scores.Conclusions: More positive clinical environments as practice areas of the schools which offer education for students who will become health care providers will increase their academic self-efficacy.

Relationships between incivility and stress and self-efficacy among nursing students in clinical settings

Background: In nursing education, clinical practice is a crucial process for students to learn and practice knowledge and skills for becoming healthcare professionals.Objective: To investigate the effects of the experience of incivility on nursing students’ stress and self-efficacy in clinical settings.Methods: A descriptive cross-sectional study was conducted using self-administered surveys by a convenience sample of 195 nursing students in South Korea. The surveys included sociodemographic questions, the 13-item Korean version of Uncivil Behavior in Clinical Nursing Education (K-UBCNE), the 24-item Korean versions of Beck-Srivastava Stress Inventory (K-BSSI), and the 24-item of Academic Self-Efficacy (ASE).Results: The average age of our sample was 22.33 years (± 2.39). Among 195 study participants, junior students were 123 (63.1%) and senior students were 72 (36.9%). Mean score of total incivility by the K-UBCNE among the seniors was significantly higher than the juniors (t = -2.985, p = .002). Pearson correlations results indicated that the nursing students’ incivility experience was positively correlated with the K-BSSI (r = .679, p &lt; .01), and the ASE (r = .680, p &lt; .01). Lastly, Clinical Education Environment (t = 1.985, p = .049), Undesired Role Model (t = 6.650, p = .000) and Interpersonal Conflict (t = 2.486, p = .014) from K-BSSI were the predictors for incivility, F(7, 195) = 28.110, p = 000.Conclusions: Incivility adversely influences students’ learning. Nurse educators and RNs should recognize the serious implications of incivility and develop effective interventions to combat incivility. Further studies of stress, self-efficacy, and incivility in the clinical sites are warranted.

Transforming the Role of the Clinical Faculty Coordinator in the Dedicated Education Unit.

The dedicated education unit (DEU) clinical education model has been identified nationally as an innovative model for clinical nursing education. This article identifies the core values of the DEU clinical faculty coordinator role and describes the transformation of this role across three clinical models. The role has been adapted to fit the needs of acute care, post-acute care, and community nursing DEU models, meeting the needs of the clinical educational environment and clinical staff as well as student learning outcomes.

Factors affecting the clinical education of rehabilitation students in Iran: A systematic review.

Background: Clinical education is one of the main parts in medical education, and rehabilitation sciences are not exception. Through clinical education programs, students gain required qualifications to enter professional life. Several factors impact on students' clinical education, and identifying these factors could help in the improvement of clinical education and could improve knowledge transferring to clinical practice especially in rehabilitation sciences in Iran. The purpose of present review study is identifying the factors potentially affecting the clinical education of rehabilitation students in Iran. Methods: A systematic review study conducted based on the evidence-based method on published articles from 2000 to 2017. The search process was carried out on MEDLINE, CINAHL, PsycINFO, and EMBASE databases. Results: A total of 167 papers were selected. Given identical findings and considering eligibility criteria, 12 articles in the fields of clinical education, clinical competence, professional ethics education, and clinical reasoning were ultimately chosen. Conclusion: The results indicate that many factors might influence the clinical education of rehabilitation science students. Environmental factors (including ministry policies, educational curriculums, clinical education environments, and educational facilities/equipment) and individual factors (the knowledge and skills of students and characteristics of clinical trainers) were identified as the most influential factors in clinical education.

Rethinking Education Environment: The Clinical Education Environment Framework

Rethinking Education Environment: The Clinical Education Environment Framework

The Impact of Tacit Knowledge Transfer Through Storytelling on Nurses’ Clinical Decision Making

Background: Clinical Decision Making (CDM) is the foremost aspect of caring for patients. Storytelling can enhance skills such as judging, and problem-solving among people, especially in clinical education environments. Objectives: The current study aimed at investigating the impact of tacit knowledge transfer through storytelling on CDM by nurses. Methods: The current quasi-experimental study was conducted on 61 nurses. The participants were selected by convenience sampling method and randomly assigned into experimental and control groups. An eight-hour storytelling session was held for the experimental group, but not for the control group. The assessment tool was the Jenkins’ CDM in nursing scale. Results: The mean scores of CDM pre-intervention were 146.80 ± 12.68 and 138.42 ± 12.64 in the experimental and control groups, respectively (P = 0.012). The mean scores of CDM post-intervention were 163.43 ± 18.45 and 139.10 ± 11.78 for the experimental and control groups, respectively (P < 0.001). The gain scores were 28.74 ± 38.90 and 0.78 ± 3.84 in the intervention and control groups, respectively. The difference was statistically significant (P < 0.001). Conclusions: The obtained results showed that the transfer of knowledge and experiences through storytelling significantly enhanced CDM score.

Investigating Factors Affecting Pharmaceutical Care Learning in Clinical Education in the View of Nursing Students in 2016 - 2017

Background: Pharmacological knowledge learning is of great importance to nursing students. The views of nursing graduates in this regard are acknowledged because this will lead to identifying the strengths and weaknesses of educational programs, resources, and trainers. Objectives: Therefore, the aim of this study was to investigate the factors affecting pharmaceutical care learning in clinical education from the viewpoint of nursing students in 2016 - 2017. Methods: A descriptive cross-sectional study was conducted on nursing students (n = 120) recruited through a census method. The data collection tool was a self-administered questionnaire consisting of two parts. The first part was to gather demographic information including age, sex, semester, history of student work, and written score of the pharmacology course, and the second part was related to the areas affecting the learning process including professional competence of the instructor (11 items), teaching ability of the instructor (13 items), interpersonal communications of the instructor (5 items), clinical teaching environment (11 items), course plan (3 items), and learner characteristics (8 items). The collected data from 100 students were analyzed by SPSS16 software using descriptive statistics. Results: 47 (47%) male students participated in the study and most of the participants (59%) were aged 20 - 21 years. From the viewpoint of the students, the variables related to the areas of the clinical instructor, learner characteristics, and educational environment were the first to third factors affecting the pharmacological care learning, in sequence. Conclusions: Paying attention to the characteristics of the instructor, adaptation of clinical environment, characteristics and motivators of the students in gaining experience, and understanding the importance and necessity of learning the knowledge and practice of medicines can facilitate and strengthen the pharmaceutical care learning.

Identifying the Presence of Cognitive Apprenticeship in the Layered Learning Practice Model

Objective. To identify the presence of cognitive apprenticeship themes in the layered learning practice model (LLPM). Methods. Attending pharmacists who had implemented an LLPM completed an individual 90-minute face-to-face semi-structured interview. Three researchers independently reviewed transcripts to identify cognitive apprenticeship themes according to the framework's dimensions and sub-dimensions. Results. Of 25 eligible attending pharmacists, 24 (96%) agreed to participate. All core dimensions of the cognitive apprenticeship framework emerged during the interviews; however, preceptors varied in how they used the framework in the training of pharmacy learners at different levels. This variability was especially apparent within the sub-dimensions of the content and method domains. Conclusion. This study demonstrates that all four cognitive apprenticeship principles are being used in the clinical environments operationalizing the LLPM. These findings suggest that cognitive apprenticeship is an applicable and relevant educational framework when engaging multiple learners in clinical education environments.

Medical school clinical placements \u2013 the optimal method for assessing the clinical educational environment from a graduate entry perspective

BackgroundEducational environment is a strong determinant of student satisfaction and achievement. The learning environments of medical students on clinical placements are busy workplaces, composed of many variables. There is no universally accepted method of evaluating the clinical learning environment, nor is there consensus on what concepts or aspects should be measured. The aims of this study were to compare the Dundee ready educational environment measure (DREEM - the current de facto standard) and the more recently developed Manchester clinical placement index (MCPI) for the assessment of the clinical learning environment in a graduate entry medical student cohort by correlating the scores of each and analysing free text comments. This study also explored student perceptionof how the clinical educational environment is assessed.MethodsAn online, anonymous survey comprising of both the DREEM and MCPI instruments was delivered to students on clinical placement in a graduate entry medical school. Additional questions explored students’ perceptions of instruments for giving feedback. Numeric variables (DREEM score, MCPI score, ratings) were tested for normality and summarised. Pearson’s correlation coefficient was used to measure the strength of the association between total DREEM score and total MCPI scores. Thematic analysis was used to analyse the free text comments.ResultsThe overall response rate to the questionnaire was 67% (n = 180), with a completed response rate for the MCPI of 60% (n = 161) and for the DREEM of 58% (n = 154). There was a strong, positive correlation between total DREEM and MCPI scores (r = 0.71, p < 0.001). On a scale of 0 to 7, the mean rating for how worthwhile students found completing the DREEM was 3.27 (SD 1.41) and for the MCPI was 3.49 (SD 1.57). ‘Finding balance’ and ‘learning at work’ were among the themes to emerge from analysis of free text comments.ConclusionsThe present study confirms that DREEM and MCPI total scores are strongly correlated. Graduate entry students tended to favour this method of evaluation over the DREEM with the MCPI prompting rich description of the clinical learning environment. Further study is warranted to determine if this finding is transferable to all clinical medical student cohorts.

Athletic Training Students Demonstrate Supplemental Oxygen Administration Skill Decay, but Retain Knowledge Over Six Months

Purpose: Research suggests skill decay occurs with emergency skills, such as supplemental oxygen administration (OA), since the frequency of medical emergencies in clinical settings is low. Identifying the presence and timeline for skill decay allows educators to employ strategies to prevent this occurrence. Therefore, this study evaluated retention of knowledge and clinical skills associated with supplemental oxygen administration, specifically nasal cannula (NC) and non-rebreather mask (NrM) usage in professional athletic training students. Methods: Cross-sectional study. Twenty-nine athletic training students (males=11, females=18; age=21.03+1.38) enrolled in a Commission on Accreditation of Athletic Training Education (CAATE)-accredited professional athletic training programs. Participants’ supplemental oxygen administration knowledge and skills was assessed five times (baseline-T4). The baseline assessment was followed by an educational review session. Participants’ knowledge and skills were re-assessed (T1) and then randomly assigned to two groups. The experimental group’s supplemental oxygen administration knowledge and skills were re-evaluated at 1-month (T2), 3-months (T3), and 6-months (T4). The control at 6-months (T4). Results: Analysis revealed no significant differences between the groups on knowledge (F2,54=.15, P=.86) and overall clinical skills (F2,54=1.52, P=.23). A significant main effect for time on knowledge (F2,54=65.30, P1.89,50.98=112.55, P1.55,41.88=108.03, P Conclusions: Both groups retained supplemental oxygen administration knowledge over 6-months. Conversely, nasal cannula and non-rebreather mask skills decayed from review session to 6-month follow-up. Regular rehearsal and practice of acute care clinical skills should be integrated into educational programs to avoid decay of skills. Since these skills are not frequently utilized in the clinical education environment, integrating opportunities to practice these skills to maintain the competence level of students and prepare them for clinical practice is warranted.

Medical students' views of clinical environments.

Monitoring the quality of clinical learning environments (CLEs) is immensely important in medical education. Objective indicators of the quality of the CLE can be used to measure learner perceptions and to inform educational improvements; however, many established tools were not designed foruse in clinical settings andare not theoretically grounded. Our aim was to apply anew tool to the new context ofa UK setting to explore the perceptions of senior medical students in a number of differentCLEs. Monitoring the quality of clinical learning environments isimmensely important in medical education METHODS: The four-factor Undergraduate Clinical Education Environment Measure (UCEEM) was translated into English, and used to gather final-year medical students' perceptions of four different specialties they had rotated through: Emergency Medicine (EM), General Surgery (GS), Medicine for the Elderly (ME), and Obstetrics and Gynaecology (O&G). The UCEEM was distributed in paper form. Students were asked to complete it in relation to two of the four specialties. Year-5 medical students (n=132) returned a completed UCEEM. For opportunities to learn in and through work experience EM was reported the most positively. ME was perceived to be the most prepared for student entry. Students reported being well received by staff and made to feel part of the team within GS, EM and ME, but less so in O&G. UCEEM appears to be a useful tool for evaluating medical student perceptions of CLEs. Theoretically robust, UCEEM is straightforward to administer and to score. It has the potential to be used by time-pressured educators to collect baseline and comparative data for evaluation and improvement purposes.