283 - Use of the Educational Climate Inventory in Graduate Medical Education: Measuring Pediatric Residents’ Learning Orientation

Poster Number: 283
Publication Number: 283.420

Jonathan Sawicki, University of Utah School of Medicine, Salt Lake City, UT, United States; Boyd Richards, University of Utah, Salt Lake City, UT, United States; Alan Schwartz, University of Illinois College of Medicine, Chicago, IL, United States; Dorene F. Balmer, University of Pennsylvania, Philadelphia, PA, United States

Background: An essential component of an educational program’s learning environment is its learning orientation. Dweck purports that a mastery vs. performance orientation is associated with resilience in learning and academic success. Several instruments attempt to measure the learning environment in graduate medical education (GME) but none focus on learning orientation. Thus, it is challenging to know if competency-based educational interventions, such as Education in Pediatrics Across the Continuum (EPAC), are achieving their objective of supporting mastery learning.

Objective: To revise Krupat’s Educational Climate Inventory (ECI), originally designed for medical students, and determine the modified instrument’s psychometric properties when used to measure the learning orientation in GME programs.

Design/Methods: We included 12 items from the original ECI in our GME ECI and added 10 additional items. We hypothesized a three-factor structure, consisting of two scales from the original ECI (learning orientation; competition and stress) and a support in the learning environment scale. We administered the GME ECI electronically to all residents (EPAC and traditional) in 4 pediatric GME programs across the United States. We performed confirmatory factor analyses, calculated Cronbach’s alpha for each scale, and compared scale scores between EPAC and traditional residents, adjusting for program site with a random effects model.

Results: The original ECI items loaded significantly onto their two expected factors. Of the 10 new items, 2 related to relationships with interprofessional teams loaded significantly onto the orientation factor; 7 related to support in the learning environment loaded significantly onto the support factor. Follow up analyses showed that each scale was well-described as a single factor. Cronbach’s alpha for each scale was acceptable (Table 1). A parallel factor analysis suggested that each scale was best interpreted as unidimensional. Controlling for program site, EPAC residents reported higher mean orientation scores but not significantly different stress or support scores (Table 2).Conclusion(s): Our analysis suggests that the GME ECI reliably measures three distinct aspects of the GME learning environment, including learning orientation. GME ECI scores are sensitive to detecting differences in learning orientation of EPAC and traditional pediatric residents. The GME ECI can be used to identify areas of improvement in GME and help programs better support mastery learning of residents.
Table 1- Cronbach's Alpha for Each Scale in the GME ECIGME, Graduate Medical Education; ECI, Educational Climate Inventory
Table 2- Adjusted Mean Scores by Type of Residency ProgramEPAC, Education in Pediatrics Across the Continuum; SE, standard error
Mean scores are adjusted for program site using a random effects model