title: Training satisfaction for subspecialty fellows in internal medicine: findings from the Veterans Affairs (VA) Learners' Perceptions Survey.
abstract: BACKGROUND
  Learner satisfaction assessment is critical in the design and improvement of training programs. However, little is known about what influences satisfaction and whether trainee specialty is correlated. A national comparison of satisfaction among internal medicine subspecialty fellows in the Department of Veterans Affairs (VA) provides a unique opportunity to examine educational factors associated with learner satisfaction. We compared satisfaction across internal medicine fellows by subspecialty and compared factors associated with satisfaction between procedural versus non-procedural subspecialty fellows, using data from the Learners' Perceptions Survey (LPS), a validated survey tool.
  
  
  METHODS
  We surveyed 2,221 internal medicine subspecialty fellows rotating through VA between 2001 and 2008. Learners rated their overall training satisfaction on a 100-point scale, and on a five-point Likert scale ranked satisfaction with items within six educational domains: learning, clinical, working and physical environments; personal experience; and clinical faculty/preceptor.
  
  
  RESULTS
  Procedural and non-procedural fellows reported similar overall satisfaction scores (81.2 and 81.6). Non-procedural fellows reported higher satisfaction with 79 of 81 items within the 6 domains and with the domain of physical environment (4.06 vs. 3.85, p <0.001). Satisfaction with clinical faculty/preceptor and personal experience had the strongest impact on overall satisfaction for both. Procedural fellows reported lower satisfaction with physical environment.
  
  
  CONCLUSIONS
  Internal medicine fellows are highly satisfied with their VA training. Nonprocedural fellows reported higher satisfaction with most items. For both procedural and non-procedural fellows, clinical faculty/preceptor and personal experience have the strongest impact on overall satisfaction.
authors.affiliation: Department of Medicine, Duke University, Durham, NC, USA. Catherine.Kaminetzky@va.gov
authors.forename: Catherine P
authors.initials: CP
authors.lastname: Kaminetzky
authors.forename: Sheri A
authors.initials: SA
authors.lastname: Keitz
authors.forename: T Michael
authors.initials: TM
authors.lastname: Kashner
authors.forename: David C
authors.initials: DC
authors.lastname: Aron
authors.forename: John M
authors.initials: JM
authors.lastname: Byrne
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Chang
authors.forename: Christopher
authors.initials: C
authors.lastname: Clarke
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Gilman
authors.forename: Gloria J
authors.initials: GJ
authors.lastname: Holland
authors.forename: Annie
authors.initials: A
authors.lastname: Wicker
authors.forename: Grant W
authors.initials: GW
authors.lastname: Cannon
mesh_terms: D003258:Consumer Behavior / Q000706:statistics & numerical data; D003625:Data Collection; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D013038:Specialization; D014481:United States; D014493:United States Department of Veterans Affairs