title: Residents' perspectives on the learning environment: data from the Accreditation Council for Graduate Medical Education resident survey.
abstract: OBJECTIVE
  Residents' assessment of their learning environment is an important element of residency accreditation and a strong predictor of resident satisfaction. The authors examined the reliability and validity of a resident/fellow survey and explored the relationship between reported duty hours noncompliance and residents' perceptions of other aspects of their learning environments.
  
  
  METHODS
  The Accreditation Council for Graduate Medical Education (ACGME) administered a 29-item Web-based survey in 2007 and 2008 to 91,073 residents in 5,610 programs. Aggregate data from the survey comprised indicators of substantial compliance or noncompliance. The authors examined relationships among duty hours and aspects of the educational environment, as well as the relationship of the survey results to citations from accreditation reviews.
  
  
  RESULTS
  The survey demonstrated a high degree of internal reliability (Cronbach alpha, 0.84). Common factor analysis revealed two factors, educational environment and resident duty hours (eigenvalues of 5.49 and 2.42, respectively). Programs having resident-identified duty hours issues were more likely than those without such issues to have received duty hours citations from residency review committees (odds ratio: 2.04; 95% CI: 1.03, 3.05).
  
  
  CONCLUSIONS
  The ACGME Resident/Fellow Survey is a reliable, valid, and useful tool for evaluating residency programs. There are strong relationships between duty hours noncompliance and noncompliance in other aspects of the program environment.
authors.affiliation: Accreditation Council for Graduate Medical Education, Chicago, Illinois 60654, USA. Kholt@acgme.org
authors.forename: Kathleen D
authors.initials: KD
authors.lastname: Holt
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Miller
authors.forename: Ingrid
authors.initials: I
authors.lastname: Philibert
authors.forename: Jeanne K
authors.initials: JK
authors.lastname: Heard
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Nasca
mesh_terms: D000068:Accreditation; D000328:Adult; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D008297:Male; D010549:Personal Satisfaction; D011795:Surveys and Questionnaires; D014481:United States