The Educational Climate Inventory: Measuring Students' Perceptions of the Preclerkship and Clerkship Settings.

PURPOSE:To develop an instrument to assess educational climate, a critical aspect of the medical school learning environment that previous tools have not explored in depth. METHOD:Fifty items were written, capturing aspects of Dweck's performance-learning distinction, to distinguish students' perceptions of the educational climate as learning/mastery oriented (where the goal is growth and development) versus performance oriented (where the goal is appearance of competence). These items were included in a 2014 survey of first-, second-, and third-year students at six diverse medical schools. Students rated their preclerkship or clerkship experiences and provided demographic and other data. The final Educational Climate Inventory (ECI) was determined via exploratory and confirmatory factor analysis. Relationships between scale scores and other variables were calculated. RESULTS:Responses were received from 1,441/2,590 students (56%). The 20-item ECI resulted, with three factors: centrality of learning and mutual respect; competitiveness and stress; and passive learning and memorization. Clerkship students' ratings of their learning climate were more performance oriented than preclerkship students' ratings (P < .001). Among preclerkship students, ECI scores were more performance oriented in schools with grading versus pass-fail systems (P < .04). Students who viewed their climate as more performance oriented were less satisfied with their medical school (P < .001) and choice of medicine as a career (P < .001). CONCLUSIONS:The ECI allows educators to assess students' perceptions of the learning climate. It has potential as an evaluation instrument to determine the efficacy of attempts to move health professions education toward learning and mastery.