Department of Family Medicine, King Saud Ben Abdul-Aziz University for Health Sciences, PO Box: 69416, Riyadh 11547, Saudi Arabia.
BMC Med Educ. 2014 Mar 4;14:44. doi: 10.1186/1472-6920-14-44.
Teaching and learning of clinical skills for undergraduate medical students usually takes place during the clinical clerkship. Therefore, it is of vital importance to ensure the effectiveness of the rotations within this clerkship. The aims of this study were to develop an instrument that measures the effectiveness of the clinical learning environment, to determine its factor structure, and to find first evidence for the reliability and validity of the total scale and the different factors.
The Clinical Learning Evaluation Questionnaire (CLEQ) is an instrument, consisting of 40 items, which have been developed after consideration of the results of a qualitative study that investigated the important factors influencing clinical learning, both from the perspective of students, as well as teachers. Results of relevant literature that investigated this issue were also incorporated in the CLEQ. This instrument was administered to a sample of students (N = 182) from three medical colleges in Riyadh city, the capital of Saudi Arabia. The factor structure of the CLEQ (Principal component analysis, Oblimin rotation) and reliability of the factor scales (Cronbach's α) were determined. Hypotheses concerning the correlations between the different factors were tested to investigate their convergent and divergent validity.
One hundred and nine questionnaires were returned. The factor analysis yielded six factors: F1 Cases (8 items), F2 Authenticity of clinical experience (8 items), F3 Supervision (8 items), F4 Organization of the doctor-patient encounter (4 items), F5 Motivation to learn (5 items), and F6 Self awareness (4 items). The overall internal consistency (α) of the CLEQ was 0.88, and the reliabilities (Cronbach's α) of the six factors varied from .60 to .86. Hypotheses concerning the correlations between the different factors were partly confirmed, which supported the convergent validity of the factors, but not their divergent validity. Significant differences were found between the scores of the students of the three different schools on the factors Supervision and Organization of patient-doctor encounter.
The results of this study demonstrated that CLEQ is a multidimensional and reliable instrument. It can be utilized as an evaluation tool for clinical teaching activities, both by educators as well as students. Further research is needed into the validity of the CLEQ.
本科医学生的临床技能教学和学习通常在临床实习期间进行。因此，确保实习期间轮转的有效性至关重要。本研究旨在开发一种测量临床学习环境有效性的工具，确定其因素结构，并首次为总量表和不同因素的信度和效度提供证据。
临床学习评估问卷（CLEQ）是一种工具，由 40 个项目组成，这些项目是在考虑一项定性研究的结果后制定的，该研究调查了影响临床学习的重要因素，包括学生和教师的观点。还纳入了有关该问题的相关文献的结果。该工具在沙特阿拉伯首都利雅得市的三所医学院的学生样本（N=182）中进行了管理。确定了 CLEQ 的因素结构（主成分分析，斜交旋转）和因素量表的可靠性（Cronbach's α）。测试了不同因素之间相关性的假设，以研究它们的收敛和发散有效性。
有 109 份问卷被退回。因子分析产生了六个因素：F1 病例（8 项）、F2 临床经验的真实性（8 项）、F3 监督（8 项）、F4 医患相遇的组织（4 项）、F5 学习动机（5 项）和 F6 自我意识（4 项）。CLEQ 的整体内部一致性（α）为 0.88，六个因素的可靠性（Cronbach's α）从 0.60 到 0.86 不等。不同因素之间相关性的假设得到了部分验证，这支持了因素的收敛有效性，但不支持其发散有效性。在监督和医患相遇组织这两个因素上，三个不同学校的学生得分存在显著差异。
本研究结果表明，CLEQ 是一个多维且可靠的工具。它可以作为教育者和学生临床教学活动的评估工具。需要进一步研究 CLEQ 的有效性。
