title: Evaluation of self-directed clinical education: validation of an instrument.
abstract: OBJECTIVE
  To explore the evaluation of self-directed, integrated clinical education.
  
  
  METHODS
  We delivered a quantitative and qualitative, self-report questionnaire to students through their web-based learning management system. The questionnaire was distributed 4 times over 1 year, each time in 2 parts. A generic part evaluated boundary conditions for learning, teaching activities and "real patient learning". Factor analysis with varimax rotation was used to validate the constructs that made up the scale and to stimulate hypotheses about how they interrelated. A module-specific part evaluated real patient learning of the subject matter in the curriculum.
  
  
  RESULTS
  A total of 101 students gave 380 of a possible 404 responses (94%). The generic data loaded onto 4 factors, corresponding to: firm quality; hospital-based teaching and learning; community and out-patient learning, and problem-based learning (PBL). A 5-item quality index had content, construct and criterion validity. Quality differed greatly between firms. Self-evaluation of module-specific, real patient learning was also valid. It was strongly influenced by the specialty interests of hospital firms.
  
  
  CONCLUSIONS
  Quality is a multidimensional construct. Self-report evaluation of real patient learning is feasible, and could be capitalised on to promote reflective self-direction. The social and material context of learning is an important dimension of educational quality.
authors.affiliation: Hope Hospital, University of Manchester School of Medicine, Stott Lane, Salford, Manchester M6 8HD, UK. tim.dornan@man.ac.at
authors.forename: T
authors.initials: T
authors.lastname: Dornan
authors.forename: H
authors.initials: H
authors.lastname: Boshuizen
authors.forename: L
authors.initials: L
authors.lastname: Cordingley
authors.forename: S
authors.initials: S
authors.lastname: Hider
authors.forename: J
authors.initials: J
authors.lastname: Hadfield
authors.forename: A
authors.initials: A
authors.lastname: Scherpbier
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003625:Data Collection; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D004521:Educational Measurement / Q000592:standards; D004739:England; D006801:Humans; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires