title: Cause or effect? The relationship between student perception of the medical school learning environment and academic performance on USMLE Step 1.
abstract: BACKGROUND
  A school's learning environment is believed to influence academic performance yet few studies have evaluated this association controlling for prior academic ability, an important factor since students who do well in school tend to rate their school's environment more highly than students who are less academically strong.
  
  
  OBJECTIVE
  To evaluate the effect of student perception of the learning environment on their performance on a standardized licensing test while controlling for prior academic ability.
  
  
  METHODS
  We measured perception of the learning environment after the first year of medical school in 267 students from five consecutive classes and related that measure to performance on United States Medical Licensing Examination (USMLE) Step 1, taken approximately six months later. We controlled for prior academic performance by including Medical College Admission Test score and undergraduate grade point average in linear regression models.
  
  
  RESULTS
  Three of the five learning environment subscales were statistically associated with Step 1 performance (p < 0.05): meaningful learning environment, emotional climate, and student-student interaction. A one-point increase in the rating of the subscales (scale of 1-4) was associated with increases of 6.8, 6.6, and 4.8 points on the Step 1 exam.
  
  
  CONCLUSIONS
  Our findings provide some evidence for the widely held assumption that a positively perceived learning environment contributes to better academic performance.
authors: Office of Program Evaluation, Education and Research, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA. swayne@salud.unm.edu
authors: Sharon J
authors: SJ
authors: Wayne
authors: Sally A
authors: SA
authors: Fortner
authors: Judith A
authors: JA
authors: Kitzes
authors: Craig
authors: C
authors: Timm
authors: Summers
authors: S
authors: Kalishman
mesh_terms: D003099:College Admission Test; D004521:Educational Measurement; D004777:Environment; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D010465:Perception; D012577:Schools, Medical; D012944:Social Support; D013337:Students, Medical / Q000523:psychology*