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The Educational Climate Inventory: Measuring Students' Perceptions of the Preclerkship and Clerkship Settings
Edward Krupat1, Nicole J Borges, Richard D Brower
1E. Krupat is associate professor of psychology, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts. At the time of the research, the author was also director, Center for Evaluation, Harvard Medical School, Boston, Massachusetts. N.J. Borges is assistant dean, Medical Education Research and Scholarship, and professor, Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi. At the time of the research, the author was on the faculty of Wright State University Boonshoft School of Medicine, Dayton, Ohio. R.D. Brower is associate dean for medical education, associate professor of medical education, and clinical associate professor of neurology, Paul L. Foster School of Medicine at Texas Tech University Health Sciences Center, El Paso, Texas. P.M. Haidet is professor of medicine, humanities, and public health sciences and director of medical education research, Penn State College of Medicine, Hershey, Pennsylvania. W.S. Schroth was associate dean for administration, George Washington University School of Medicine and Health Sciences, Washington, DC, at the time of the research. T.J. Fleenor Jr is project manager, Office of Educational Quality Improvement, Harvard Medical School, Boston, Massachusetts. S. Uijtdehaage is professor of medicine and associate director, graduate programs in health professions education, Uniformed Services University of the Health Sciences, Bethesda, Maryland. At the time of the research, the author was on the faculty of the David Geffen School of Medicine at the University of California, Los Angeles, California.
Purpose:
To develop an instrument to assess educational climate, a critical aspect of the medical school learning environment that previous tools have not explored in depth.
Method:
Fifty items were written, capturing aspects of Dweck's performance-learning distinction, to distinguish students' perceptions of the educational climate as learning/mastery oriented (where the goal is growth and development) versus performance oriented (where the goal is appearance of competence). These items were included in a 2014 survey of first-, second-, and third-year students at six diverse medical schools. Students rated their preclerkship or clerkship experiences and provided demographic and other data. The final Educational Climate Inventory (ECI) was determined via exploratory and confirmatory factor analysis. Relationships between scale scores and other variables were calculated.
Results:
Responses were received from 1,441/2,590 students (56%). The 20-item ECI resulted, with three factors: centrality of learning and mutual respect; competitiveness and stress; and passive learning and memorization. Clerkship students' ratings of their learning climate were more performance oriented than preclerkship students' ratings (P < .001). Among preclerkship students, ECI scores were more performance oriented in schools with grading versus pass-fail systems (P < .04). Students who viewed their climate as more performance oriented were less satisfied with their medical school (P < .001) and choice of medicine as a career (P < .001).
Conclusions:
The ECI allows educators to assess students' perceptions of the learning climate. It has potential as an evaluation instrument to determine the efficacy of attempts to move health professions education toward learning and mastery.
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