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Medical Student Perceptions of the Learning Environment at the End of the First Year: A 28-Medical School
Susan E Skochelak1, R Brent Stansfield, Lisette Dunham
1S.E. Skochelak is group vice president, Medical Education, American Medical Association, Chicago, Illinois. R.B. Stansfield is assistant professor, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan. L. Dunham is data analyst, Medical Education Outcomes, American Medical Association, Chicago, Illinois. M. Dekhtyar is senior research assistant, Medical Education Outcomes, American Medical Association, Chicago, Illinois. L.D. Gruppen is professor, Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan. C. Christianson is associate dean for clinical education and associate professor, Department of Family Medicine, University of North Dakota School of Medicine and Health Science, Grand Forks, North Dakota. W. Filstead is former director, Initiative to Transform Medical Education, American Medical Association, and currently instructor, Chicago School of Professional Psychology, Chicago, Illinois. M. Quirk is former vice president, Medical Education Outcomes, American Medical Association, and currently professor, Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts.
Purpose:
Accreditation and professional organizations have recognized the importance of measuring medical students' perceptions of the learning environment, which influences well-being and professional competency development, to optimize professional development. This study was conducted to explore interactions between students' perceptions of the medical school learning environment, student demographic variables, and students' professional attributes of empathy, coping, tolerance of ambiguity, and patient-centeredness to provide ideas for improving the learning environment.
Method:
Twenty-eight medical schools at 38 campuses recruited 4,664 entering medical students to participate in the two-cohort longitudinal study (2010-2014 or 2011-2015). The authors employed chi-square tests and analysis of variance to examine the relationship between Medical School Learning Environment Survey (MSLES) scores and student characteristics. The authors used mixed-effects models with random school and campus effects to test the overall variances accounted for in MSLES scores at the end of the first year of medical school.
Results:
Student attributes and demographic characteristics differed significantly across schools but accounted for only 2.2% of the total variance in MSLES scores. Medical school campus explained 15.6% of the variance in MSLES scores.
Conclusions:
At year's end, students' perceptions toward the learning environment, as reported on the MSLES, differed significantly according to the medical school campus where they trained. Further studies are needed to identify specific factors, such as grading policies, administrative support, and existence of learning communities, which may influence perceptions of the learning environment at various schools. Identifying such variables would assist schools in developing a positive learning environment.
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