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Evaluating the Clinical Learning Environment for Competency-based Postgraduate Education in a Low-Middle income

Qamar Riaz1, Muhammad Rizwan Khan2, Sadia Masood3

  • 1Department for Educational Development, Aga Khan University, Karachi, Pakistan.

Journal of Advances in Medical Education & Professionalism
|November 11, 2025
PubMed
Summary

Trainee perceptions of the clinical learning environment (CLE) indicate a favorable postgraduate medical education setting, though areas for improvement exist. Identifying strengths and weaknesses in the CLE is crucial for enhancing competency-based medical education (CBME).

Keywords:
Educational environmentMedical educationPerceptionPostgraduate

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Area of Science:

  • Medical Education
  • Postgraduate Training
  • Healthcare Quality Improvement

Background:

  • The clinical learning environment (CLE) is integral to competency-based postgraduate medical education (CBME).
  • Trainee perceptions of the CLE serve as a key quality indicator for workplace education and training.
  • Understanding these perceptions is vital for optimizing CBME implementation.

Purpose of the Study:

  • To assess resident perceptions of their clinical learning environment.
  • To identify specific strengths and weaknesses within the CLE.
  • To inform strategies for enhancing postgraduate medical education and CBME.

Main Methods:

  • A cross-sectional survey utilizing the Postgraduate Hospital Educational Environment Measure (PHEEM) inventory.
  • Electronic distribution of the PHEEM survey to residents across 35 university residency programs.
  • Universal sampling strategy to maximize participation.

Main Results:

  • A total of 347 residents responded, reporting a generally favorable CLE (mean score 66.8%).
  • Significant variations in perceptions were observed across different residency programs and years of training.
  • Autonomy, Teaching, and Social Support subscale scores indicated positive aspects but also areas needing enhancement.

Conclusions:

  • The current clinical learning environment is largely supportive of competency-based medical education implementation.
  • Targeted improvements in specific areas are recommended to further enhance the educational experience.
  • Continuous evaluation of the CLE is essential for quality assurance in postgraduate medical training.