Evaluation of Out-Patient Care Educational Environment of National Defence University, Malaysia utilizing the ACLEEM Inventory

Abstract

Purpose: A friendly educational environment is required for optimal learning, and students should be asked to provide feedback on their experiences to improve curriculum. Moreover, students’ academic progress, mental growth, and physical well-being are influenced by the educational and clinical environment of the institute. Essential constituents of the educational climate include atmosphere, number of proper teaching-learning sessions and available amenities. Primary health care and ambulatory settings allow students ample opportunities to interact with patients and observe health promotional activities more often practiced at the community levels. The study aims to evaluate the outpatient care educational environment of National Defense University of Malaysia by seeking feedback from medical students using Ambulatory Care Educational Environment Measure ACLEEM instrument.Methods: This was a cross-sectional study. The study participants were medical students of the earlier mentioned university. The universal sampling method was adopted. The ACLEEM validated instrument was utilized for the data collection. The instrument was developed on the basis of 5-point Likert Scale Minimum: 0, and Maximum: 4 .Results: The response rate 100%. Most respondents were male, Malay and Muslim. The total mean score was 1.0±0.4. The domain mean scores for clinical teaching, clinical training, and support were 0.8±0.4, 1.1±0.4, and 1.1±0.5, respectively.Conclusions: The ACLEEM questionnaire was found to be valid and reliable for local UPNM, Malaysian context. However, the overall ACLEEM scores reported for the present study is low, and some areas that could be improved. The UPNM authority should take appropriate measures to improve the educational environment to enhance the academic experiences of the medical students

Keywords

• ACLEEM,Medical Students,Outpatient setting,Primary health care,Educational environment

References

1. 1. De Houwer J, Barnes-Holmes D, Moors A. What is learning? On the nature and merits of a functional definition of learning. Psychon Bull Rev 2013;20:631–642. [CrossRef]
2. 2. Barron AB, Hebets EA, Cleland TA, Fitzpatrick CL, Hauber ME, Stevens JR. Embracing multiple definitions of learning. Trends Neurosci 2015;38:405–407. [CrossRef]
3. 3. Smith MK. What is teaching? In: The Encyclopedia of Informal Education; 2016. Available at http://infed.org/mobi/what-isteaching/ [Accessed September 2, 2017]
4. 4. Roff S, McAleer S, Skinner A. Development and validation of an instrument to measure the postgraduate clinical learning and teaching educational environment for hospital-based junior doctors in the UK. Med Teach 2005;27:326–331. [CrossRef]
5. 5. Genn JM. AMEE Medical Education Guide No. 23 (part 1): Curriculum, environment, climate, quality and change in medical education –a unifying perspective. Med Teach 2001;23:337–344. [CrossRef]
6. 6. Wilson MR. The New ACGME Resident Duty Hours: Big Changes, Bigger Challenges. Ochsner J 2003;5:3–5.
7. 7. Mohd Said N, Rogayah J, Hafizah A. A study of learning environments in the kulliyyah (faculty) of nursing, international islamic university malaysia. Malay J Med Sci 2009;16:15–24.
8. 8. Remesh A. Microteaching, an efficient technique for learning effective teaching. J Res Med Sci 2013;18:158–163.

9. 9. Karagiannopoulou E, Christodoulides P. The Impact of Greek University Students’ Perceptions of Their Learning Environment on Approaches to Studying and Academic Outcomes. Int J Educ Res 2005;43:329–350.
10. 10. Müller FH, Louw J. Learning Environment, Motivation, and Interest: Perspectives on Self-Determination Theory. S Afr J Psychol 2004;34:169–190. [CrossRef]
11. 11. Williams KC, Williams CC. Five Key Ingredients for Improving Student Motivation. Res High Educ J 2011;12:1–23.
12. 12. Schönrock-Adema J, Visscher M, Raat AN, Brand PL. Development and Validation of the Scan of Postgraduate Educational Environment Domains (SPEED): A Brief Instrument to Assess the Educational Environment in Postgraduate Medical Education. PLoS One 2015;10:e0137872. [CrossRef]
13. 13. Tsai JC, Chen CS, Sun IF, Liu KM, Lai CS. Clinical learning environment measurement for medical trainees at transitions: relations with sociocultural factors and mental distress. BMC Med Educ 2014;14:226. [CrossRef]
14. 14. Roff S, McAleer S, Harden RM, et al. Development and validation of the Dundee Ready Education Environment Measure (DREEM). Med Teach 1997;19:295–299. [CrossRef]
15. 15. World Health Organization and the United Nations Children’s Fund. Alma-Ata 1978, Primary Health Care - Report of the International Conference on Primary Health Care Alma-Ata, USSR, 6–12 September 1978. Geneva: World Health Organization; 1978.
16. 16. Ward PR. The relevance of equity in health care for primary care: creating and sustaining a ‘fair go, for a fair innings’. Qual Prim Care 2009;17:49–54.
17. 17. Shi L. The impact of primary care: a focused review. Scientifica (Cairo) 2012;2012:432892. [CrossRef]
18. 18. Majumder MAA, D’Souza U, Rahman S. Trends in medical education: challenges and directions for need-based reforms of medical training in South-East Asia. Indian J Med Sci 2004;58:369–380.
19. 19. Lee SW, Clement N, Tang N, Atiomo W. The current provision of community-based teaching in UK medical schools: an online survey and systematic review. BMJ Open 2014;4:e005696. [CrossRef]
20. 20. Settersten RA Jr, Mayer KU. The Measurement of Age, Age Structuring, and the Life Course. Annu Rev Sociol 1997;23:233–261.
21. 21. Andermann A, Pang T, Newton JN, Davis A, Panisset U. Evidence for Health II. Overcoming barriers to using evidence in policy and practice. Health Res Policy Syst 2016;14:17. [CrossRef]
22. 22. Holt MC, Roff S. Development, and validation of the Anesthetic Theatre Educational Environment Measure (ATEEM). Med Teach 2004;26:553–558. [CrossRef]
23. 23. Cassar K. Development of an instrument to measure the surgical operating theatre learning environment as perceived by basic surgical trainees. Med Teach 2004;26:260–264. [CrossRef]
24. 24. Naghizadeh Moogari Z, Koohpayehzadeh J, Roff S, et al. Psychometric analysis of the ambulatory care learning education environment measure (ACLEEM) in Iran. Med J Islam Repub Iran 2015;29:299.
25. 25. Riquelme A, Padilla O, Herrera C, et al. Development of ACLEEM questionnaire, an instrument measuring residents’ educational environment in the postgraduate ambulatory setting. Med Teach 2013;35:e861–e866. [CrossRef]
26. 26. Riquelme A, Padilla O, Herrera C, Olivos T, Roman JA, Sarfatis A, Solís N, Pizarro M, Díaz LA, Torres P, Roff S. Measuring the educational environment in ambulatory settings. Educación Médica 2015;16:131– 140. [CrossRef]
27. 27. Caroline Sprake C, Peter Cantillon P, Metcalf J, Spencer J. Teaching in an ambulatory care setting. BMJ 2008;337:a1156. [CrossRef]
28. 28. Bland JM, Altman DG. Statistics notes: Cronbach’s alpha. BMJ 1997;314:572. [CrossRef]
29. 29. Parvizi MM, Amini M, Dehghani MR, Jafari P, Parvizi Z. Psychometric properties of the Persian version of the Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, Shiraz, Iran. Adv Med Educ Pract 2016 29;7:559–566. [CrossRef]
30. 30. Faruque M, Haque M, Islam S, Shihab SF, Kamal ZM. Outpatient Educational Environment of Dental-Medical Colleges of Bangladesh Utilizing ACLEEM Questionnaire. J Global Pharm Tech 2017;09:41–47.
31. 31. Riley MW, Foner A, Waring J. Sociology of Age. In: Smelser NJ, Editor. Handbook of Sociology. Newbury Park, CA. Sage; 1988. pp.243–290.
32. 32. Bowling A, See-Tai S, Ebrahim S, Gabriel Z, Solanki P. Attributes of age-identity. Aging Soc 2005;25:479–500. [CrossRef]
33. 33. Montepare JM, Lachman ME. “You’re only as old as you feel”: self-perceptions of age, fears of aging, and life satisfaction from adolescence to old age. Psychol Aging 1989;4:73–78.
34. 34. Neugarten BL, Hagestad G. Age, and the Life Course. In: Binstock RH, Shanas E, editors. Handbook of Aging and the Social Sciences. New York: Van Nostrand Reinhold; 1976. pp.35–55.
35. 35. Barrett AE. Gendered experiences in midlife: Implications for age identity. J Aging Studies 2005;19:163–183. [CrossRe