[Resident and supervisor perception of learning climate in public health resident training in the Netherlands]. / Leerklimaat perceptie van aios en supervisors binnen de vernieuwde medische vervolgopleiding arts Maatschappij + Gezondheid.

Introduction: The purpose of this study was to evaluate the perceived quality of the learning climate by public health residents in the Netherlands and compare residents' and supervisors' perceptions. Methods: Residents of five public health subfields, who started their residency programs in 2019 and onwards, as well as supervisors involved in the residency program, were invited to complete a web-based survey based on an adapted version of the D­RECT questionnaire. Answers of residents and supervisors of the same training site and public health subfield were matched to compare perceived quality of the learning climate. Results: One hundred fourteen residents responded (response rate 50.9%). Residents' overall assessment of the learning climate showed a mean score of 4.19 on a 5-point-scale. Thirty-eighth supervisor-resident matches were formed. There were no notable differences in the perception of residents and supervisors. Conclusion: Residents' overall assessment of the learning climate was positive. Supervisors and residents' perception of learning climate is equal. Our adapted version of D­RECT seems to be suitable to evaluate the learning climate for public health residency programs in the Netherlands. Further research is necessary to validate our questionnaire and to confirm our findings.

The Dutch residency educational climate test: construct and concurrent validation in Spanish language.

OBJECTIVES: To translate the 35-item version of the Dutch Residency Educational Climate Test (D-RECT), and assess its reliability, construct validity and concurrent validity in the Spanish language. METHODS: For this validation study, the D-RECT was translated using international recommendations. A total of 220 paper-based resident evaluations covering two Colombian universities were cross-sectionally collected in 2015. A Confirmatory Factor Analysis (CFA) was used to assess the internal validity of the instrument using the Comparative fit index (CFI), Tucker-Lewis index (TLI), Standardized root mean square residual (SRMSR), and Root mean square error of approximation (RMSA). Cronbach's α was used to assess reliability. The concurrent validity was investigated through Pearson correlations with the Spanish version of the Postgraduate Hospital Educational Environment Measure (PHEEM). RESULTS: The original 9-factor structure showed an appropriate fit for the Spanish version of the instrument (CFI = 0.84, TLI = 0.82, SRMSR = 0.06, and RMSA = 0.06). The reliability coefficients were satisfactory (>0.70). The mean total scores of the D-RECT and the PHEEM showed a significant correlation (r = 0.7, p<0.01). CONCLUSIONS: This study confirms the validity and reliability of the Spanish version of the Dutch Residency Educational Climate Test, indicating that the instrument is suitable for the evaluation of departments' learning climate in the Spanish context. Future research is needed to confirm these findings in other Spanish speaking countries.

Learning climate and quality of Italian training courses in gynecology and obstetrics.

OBJECTIVES: To evaluate the learning climate (LC) and quality of training in postgraduate training courses in gynecology and obstetrics in Italy, as essential element to improve the training quality of future medical specialists. STUDY DESIGN: Web-based anonymous survey sent to all Italian trainees in gynecology and obstetrics to assess LC and quality of postgraduate training courses. This included sociodemographic information, details regarding training positions, and a 50-item validated Dutch Residency Educational Climate Test (D-RECT) questionnaire with 11 subscales (1-5 Likert scale). At the same time, the 24-items Fifth Year Training Questionnaire (FYT-Q) was submitted to all trainees at the fifth year of training to assess quality of life (burnout and depression), quality of training and final achieved competency level. Descriptive statistics were used to describe the main characteristics of the study population and for the D-RECT and the FYT-Q results. RESULTS: One hundred seventy-eight trainees' responses were included from 13 departments, yielding a department response rate of 33%. The mean composite score of the D-RECT was 3.185 (SD 0.305). The subscales "Formal education" and "Role of specialty tutor" scored a mean of 2.751 (SD 0.123) and 2.757 (SD 0.130), respectively. Sixty-four FYT-Q evaluations were completed. The 33% of trainees reported more than 56 weekly working hours. At least one burnout episode during the training was reported by 61% of the trainees, and the 45% of them reported one or more episode of depression. More than 50% of trainees reported adequate autonomy for gynecologic ultrasound, obstetrics first level ultrasound, hysteroscopy, and cesarean section. In FYT-Q adequacy of training, teaching, surgical teaching, and tutoring values resulted equal to or less than 3 in a 1-5 Likert scale. CONCLUSIONS: D-RECT and FYT-Q questionnaires show a training that requires improvement, although the results do not seem to be completely consistent. D-RECT emphasizes the need for a better formal teaching and specialty tutors to ensure training with better LC. Interventions are needed to improve LC and quality of training in postgraduate training courses in gynecology and obstetrics in Italy.

The Questionnaire D-RECT German: Adaptation and testtheoretical properties of an instrument for evaluation of the learning climate in medical specialist training.

AIM: Boor et al developed and validated the questionnaire D-RECT (Dutch Residency Educational Climate Test ) to measure the clinical learning environment within the medical specialist training. In this study, a German version of this questionnaire (D-RECT German) is analyzed regarding testtheoretical properties. PROBLEM: Are the results of Boor et al replicable as a proof for validity of the questionnaire D-RECT? MATERIAL & METHODS: The study was performed as online survey using the questionnaire D-RECT German (50 items in 11 subscales). To determine item characteristics and internal consistency (Cronbach's α), item- and reliability analyses were performed. Furthermore, a confirmatory factor analysis was performed using a model for maximum-likelihood estimation to evaluate validity. RESULTS: This replication study on the psychometric properties of the D-RECT with 255 residents at 17 German hospitals revealed heterogeneous discriminatory power for all items and an internal consistency of Cronbach's α between 0.57 and 0.85. Within the confirmatory factor analysis, 6 items showed standardized regression coeffizients <0.5, two of them in the subscale "Attendings role". Furthermore, strong interdependencies (>0.7) were found between the subscales "Supervision", "Coaching" and "Attendings role". CONCLUSION: The present replication study with the D-RECT German showed structural differences with respect to factorial validity underpinning the need of further validation studies.