Development of the clinical learning climate measure for undergraduate medical education.

This study aimed to develop an instrument to measure the clinical learning climate of undergraduate medical education in Thailand. There were 3 stages of data collection. The first stage employed qualitative inquiry to identify key attributes of the learning environment. Stage 1 output was arranged into the items in the questionnaire for Stage 2 data collection. The validating process in Stage 2 resulted in the list of factors influencing the clinical learning climate with the degree of importance of each factor. The initial version of the learning climate measure was developed based on the findings from this stage. Stage 3 aimed to collect data for further refinement of the instrument. Item analysis and factor analysis were used to explore the constructs of the climate measure. The subscales were established using both statistical and qualitative factor analysis. The final output of this study is the 43-item learning climate measure for clinical phase (10 subscales). Finally, the psychometric properties of the instrument were discussed. The utility of the learning climate measure was recommended.

Clinical reasoning of Indonesian medical students as measured by diagnostic thinking inventory.

Introduction: Clinical reasoning skill is one of the most important skills for a good physician. A number of instruments have been developed to measure this skill, including the Diagnostic Thinking Inventory (DTI). Several studies have been carried out to measure its reliability and validity; however, evidence of its construct validity is still limited. This study aims to explore the construct validity of the DTI and to measure the clinical reasoning skills of Indonesian medical students. Method: The subjects were 1135 medical students and 60 general practitioners. They were asked to complete the Indonesia version of DTI. Results: Overall reliability of the DTI was .74 and .50 for the flexibility in thinking scale and .70 for the evidence of knowledge structure scale. A one way unrelated ANOVA showed that there were significant differences in the DTI score (F = 7.097, p = .000), flexibility of thinking subscale (F = 6.111, p = .000), and the evidence of knowledge structure subscale (F = 5.306, p = .000) with the scores increasing over the period of medical training and practical experiences. The biggest proportion of subjects in all groups reached the highest level (scored between 171-246/level 5). Conclusion: This study has shown the construct validity of DTI in a different linguistic context. It also has shown the level of clinical reasoning skills of Indonesian medical students varied with year of study.

Student perceptions’ of the educational environment in the midst of curriculum change.

The Faculty of Medicine University of Indonesia underwent a major curriculum reform in 2005. There is a necessity to evaluate the new curriculum’s educational environment, as a part of the curriculum evaluation. In June 2007, the DREEM (Dundee Ready Education Environment Measure) was administered to 210 second year students with an innovative curriculum and 259 third year students with the more traditional curriculum, to measure the students’ perceptions of the educational environment. One of the most significant differences between the perceptions of the two groups is that there are less cheating problems in the second year, but the third year is better timetabled. The almost similar profiles indicate that the new curriculum’s educational environment has not improved significantly. It is related with problems in managing and organizing the new curriculum’s detail aspects. The institution needs to re-evaluate the perceptions of the educational environment when the curriculum is more internalised.