Validation and use of an instrument to measure the learning environment as perceived by medical students.

BACKGROUND Aiming to inform curriculum changes in medical school, we developed, administered, and validated a 31-question survey to measure the learning environment as perceived by medical students. DESCRIPTION We administered the survey annually in 4 medical school classes in a Southeastern medical school from May 1994 through May 1997 (N = 619). EVALUATION The survey responses reflected 3 dimensions of the medical school learning environment: the teacher-learner relationship (T-L R), the physician-patient relationship (Phys-Pt R), and self-efficacy. We found that the 3 dimensions are equally valid and reliable for all students, but that the mean values on all 3 dimensions differed by year in school and number of survey responses. CONCLUSIONS As students progress through school, they perceive deteriorating T-L Rs, feel diminishing self-efficacy, and accord less value to the Phys-Pt R. Based on these results, we developed training programs for faculty members to promote teaching attributes known to facilitate relationship formation between teacher and learner, and learner-centered and self-directed learning.