Preliminary Evidence Supporting a Novel 10-Item Clinical Learning Environment Quick Survey (CLEQS)

Abstract

Background The clinical learning environment (CLE) is a priority focus in medical education. The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review's (CLER) recent addition of teaming and health care systems obligates educators to monitor these areas. Tools to evaluate the CLE would ideally be: (1) appropriate for all health care team members on a specific unit/project; (2) informed by contemporary learning environment frameworks; and (3) feasible/quick to complete. No existing CLE evaluation tool meets these criteria. Objective This report describes the creation and preliminary validity evidence for a Clinical Learning Environment Quick Survey (CLEQS). Methods Survey items were identified from the literature and other data sources, sorted into 1 of 4 learning environment domains (personal, social, organizational, material) and reviewed by multiple stakeholders and experts. Leaders from 6 interprofessional graduate medical education quality improvement/patient safety teams distributed this voluntary survey to their clinical team members (November 2019–mid-January 2021) using electronic or paper formats. Validity evidence for this instrument was based on the content, response process, internal structure, reliability, relations to other variables, and consequences. Results Two hundred one CLEQS responses were obtained, taking 1.5 minutes on average to complete with good reliability (Cronbach's α ≥ 0.83). The Cronbach alpha for each CE domain with the overall item ranged from 0.50 for personal to 0.79 for social. There were strong associations with other measures and clarity about improvement targets. Conclusions CLEQS meets the 3 criteria for evaluating CLEs. Reliability data supports its internal consistency, and initial validity evidence is promising.

A scoping review of the questionnaires used for the assessment of the perception of undergraduate students of the learning environment in healthcare professions education programs

“…Furthermore, the PLCS has the highest Beckman et al (2005) total validity score among other questionnaires, followed by the Johns Hopkins Learning Environment Scale (JHLES). Evaluating the validity evidence of the questionnaires in the included articles based on the profession for which they were originally developed demonstrated that Clinical Learning Environment Quick Survey (CLEQS) (Simpson et al, 2021), followed by DREEM (Roff et al, 1997) scored the highest among the questionnaires developed for the medical profession. Whereas the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) Scale (Saarikoski et al, 2008), the Clinical Learning Environment and Supervision (CLES) instrument (Saarikoski & Leino-Kilpi, 2002), and the Clinical Learning Environment Diagnostic Inventory (CLEDI) (Hosoda, 2006) scored the highest among questionnaires developed for the nursing profession, followed by the Clinical Learning Environment Comparison Survey (CLECS) (Leighton, 2015).…”

The figured world of medical education senior leaders: Making meaning and enacting agency

“…Although the practice of thoughtfully educating future physicians has a history dating back to Hippocrates, medical education as a field where the scholarship of teaching and learning is debated, studied and implemented has yet to develop firm foundational principles. For instance, the field's literature offers many examinations of the complexities shaping every level of the educational continuum-from preclinical to clinical undergraduate medical education (UME) [19][20][21][22] and from the clinical learning environment in graduate medical education (GME) [22][23][24] to the varied practices addressed by continuing professional development (CPD). 25 Furthermore, as recently as 2022, Maggio et al 3 reported their efforts, and indeed their struggles, to delineate the field of medical education via the use of three bibliometric approaches.…”