title: The educational environment and self-perceived clinical competence of senior medical students in a Malaysian medical school.
abstract: BACKGROUND
  The educational environment is widely considered to be a major factor affecting students' motivation and learning outcomes. Although students' perceptions of their educational environment are often reported, we are unaware of any published reports that relate this information to students' clinical competence, either self-perceived or objectively measured.
  
  
  OBJECTIVE
  We aimed to correlate students' perceptions of their learning environment and their self-perceived competence in clinical, practical and personal skills, using validated scales.
  
  
  METHODS
  Subjects included a cohort of 71 final-year medical students who were posted to a peripheral campus affiliated with a district hospital. Two questionnaires were administered concurrently: a modified DREEM (50 items) to assess the learning environment and an abbreviated IMU Student Competency Survey (29 items) to examine self-perceived competence across a wide range of skills and work-readiness. We correlated the major domains in both surveys using Spearman's Correlation.
  
  
  RESULTS
  Fifty-nine students (83%) completed the questionnaires. Comparing correlations of the five major domains of the modified DREEM questionnaire ("Perception of learning", "Perception of teachers", "Academic self-perception", "Perception of atmosphere" and "Social self-perception") with all subscales in the abbreviated IMU Student Competency Survey (clinical, practical, personal skills and overall work-readiness), we found that academic self-perception domain had the strongest correlations (r:0.405 to 0.579, p:0.002 to < 0.001) and perception of teachers bears the weakest correlations (r:0.171 to 0.284, p:0.254 to 0.031). Self-perceived competence in practical skills in the IMU Student Competency Survey correlated the weakest with all domains of the modified DREEM (r:0.206 to 0.405, p:0.124 to 0.002).
  
  
  CONCLUSIONS
  The overall weak-to-moderate correlations between perceptions of learning environment and self-perceived clinical competence suggest that other factors might interact with the learning environment to determine students' confidence and achievements.
authors.affiliation: Clinical School Batu Pahat, International Medical University, 12 Jalan Indah, Taman Sri Kenangan, Batu Pahat, 83000 Johor Darul Takzim, Malaysia. naiming_lai@imu.edu.my
authors.forename: N
authors.initials: N
authors.lastname: Lai
authors.forename: S
authors.initials: S
authors.lastname: Nalliah
authors.forename: R C
authors.initials: RC
authors.lastname: Jutti
authors.forename: Y
authors.initials: Y
authors.lastname: Hla
authors.forename: V K E
authors.initials: VK
authors.lastname: Lim
mesh_terms: D002983:Clinical Competence; D003258:Consumer Behavior / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008296:Malaysia; D008297:Male; D012577:Schools, Medical; D020377:Self Efficacy; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires