Huang Runzhi, Yang Xinyue, Yao Yuntao, Gao Yan, Xian Shuyuan, Zhang Wei, Xu Dayuan, Guo Xinya, Chen Yang, Li Yixu, Tong Xirui, Qian Weijin, Lu Bingnan, Lin Min, Gong Meiqiong, Wang Xiaonan, Wang Yue, Chen Wenfang, Zhang Chongyou, Du Erbin, Lin Qing, Huang Zongqiang, Yin Huabin, Zhang Jie, Liu Yifan, Qu Xue, Ji Shizhao
Department of Burn Surgery, The First Affiliated Hospital of Naval Medical University, Shanghai, People's Republic of China.
Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, People's Republic of China.
Med Educ Online. 2025 Dec;30(1):2542806. doi: 10.1080/10872981.2025.2542806. Epub 2025 Aug 7.
The medical learning environment (MLE) exerted a profound influence on students' physical, psychological, and professional development. University prestige and ranking significantly shape students' self-perception and self-esteem. Nevertheless, the relationship between university category and MLE perception remained unexplored. Our study collected 10,901 questionnaires from 12 universities, spanning six categories. John Hopkins Learning Environment Scale (JHLES) was administrated to assess MLE perceptions. Utilizing a cross-sectional design, we categorized participants into high or low JHLES groups. Next, we conducted Chi-square and parametric or non-parametric tests to analyze the relationship between perception of MLE and university category. Subsequently, we performed a multivariate logistic regression and developed a nomogram to predict the likelihood of low JHLES scores. And the model performance was assessed through receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves. Our study revealed a significant association between university category and MLE perception. Specifically, students from top-tier universities were prone to negative MLE perceptions. Through multivariate logistic regression analysis, we validated university category as an influencing factor ( < 0.001). Moreover, our nomogram demonstrated reliability and consistency in predicting students' MLE perspectives. The university category emerged as a predictor for perception of MLE. Students from prestigious institutions manifested an increased likelihood of negative MLE perceptions.
医学学习环境（MLE）对学生的身体、心理和职业发展产生了深远影响。大学声誉和排名显著塑造了学生的自我认知和自尊。然而，大学类别与MLE认知之间的关系仍未得到探索。我们的研究从12所大学收集了10901份问卷，涵盖六个类别。采用约翰·霍普金斯学习环境量表（JHLES）来评估对MLE的认知。利用横断面设计，我们将参与者分为JHLES高分或低分两组。接下来，我们进行卡方检验以及参数或非参数检验，以分析对MLE的认知与大学类别之间的关系。随后，我们进行了多变量逻辑回归并绘制了列线图，以预测JHLES得分低的可能性。并通过受试者工作特征（ROC）曲线、决策曲线分析（DCA）和校准曲线评估模型性能。我们的研究揭示了大学类别与MLE认知之间存在显著关联。具体而言，顶尖大学的学生更容易对MLE产生负面认知。通过多变量逻辑回归分析，我们验证了大学类别是一个影响因素（<0.001）。此外，我们的列线图在预测学生对MLE的看法方面显示出可靠性和一致性。大学类别成为了对MLE认知的一个预测因素。来自著名院校的学生表现出对MLE产生负面认知的可能性增加。
