Jones Alexander, Hartley James, Jones Nicola
Royal Papworth Hospital, Cambridge, UK.
J Med Educ Curric Dev. 2023 Sep 29;10:23821205231202335. doi: 10.1177/23821205231202335. eCollection 2023 Jan-Dec.
Improving medical student placements relies on being able to reliably evaluate how students experience clinical learning environments. The Undergraduate Clinical Education Environment Measure (UCEEM) is an increasingly used validated tool designed to allow such evaluations. This study aims to further characterize how the UCEEM relates to qualitative evaluation.
Students on placement at one hospital were invited to complete the UCEEM before and after the implementation of an innovative new placement structure. Additionally, focus groups were employed to collect qualitative data on their experiences. a novel protocol to triangulate the output of the UCEEM with the qualitative data was developed.
The UCEEM showed good internal consistency (Cronbach's Alpha 0.79-0.91) and internal correlation. Implementation of the intervention created significant improvements in the overall UCEEM scores ( = .008) and in the "Learning in and through work and quality of supervision" ( = .048), "Preparedness for student entry" ( = .033) and "Workplace interaction patterns and student inclusion" ( = .039) domains. The triangulation of qualitative data with UCEEM output showed that the UCEEM allowed evaluation of some perceptions not reached through open questioning. However, mixed interpretations of UCEEM items by students led to the conflation of themes and challenges in deriving the meaning behind the score. This appeared to be the case for 14 of the 24 UCEEM items.
This investigation adds to the literature supporting the UCEEM as a validated tool. It also elucidates the limitations and relationships to qualitative data that investigators need to be aware of in its use.
改善医学生实习安排依赖于能够可靠地评估学生如何体验临床学习环境。本科临床教育环境测评（UCEEM）是一种越来越多地被用于此类评估的经过验证的工具。本研究旨在进一步描述UCEEM与定性评估之间的关系。
邀请在一家医院实习的学生在实施创新的新实习结构之前和之后完成UCEEM。此外，采用焦点小组收集他们对实习经历的定性数据。开发了一种新方案，将UCEEM的结果与定性数据进行三角互证。
UCEEM显示出良好的内部一致性（克朗巴哈系数为0.79 - 0.91）和内部相关性。干预措施的实施使UCEEM的总体得分（P = 0.008）以及“在工作中及通过工作学习与监督质量”（P = 0.048）、“学生入学准备”（P = 0.033）和“工作场所互动模式与学生融入”（P = 0.039）领域有了显著改善。定性数据与UCEEM结果的三角互证表明，UCEEM能够评估一些通过开放式提问无法获得的认知。然而，学生对UCEEM项目的不同解读导致在推导分数背后的含义时主题和挑战相互混淆。在UCEEM的24个项目中，有14个项目似乎存在这种情况。
本调查为支持将UCEEM作为一种经过验证的工具的文献增添了内容。它还阐明了在使用该工具时调查人员需要注意的局限性以及与定性数据的关系。
