title: Measurement of perceptions of educational environment in evidence-based medicine.
abstract: In recent years, there has been a renewed interest in measuring perceptions regarding different aspects of the medical educational environment. A reliable tool was developed for measuring perceptions of the educational environment as it relates to evidence-based medicine as part of a multicountry randomised controlled trial to evaluate the effectiveness of a clinically integrated evidence-based medicine course. Participants from 10 specialties completed the questionnaire. A working dataset of 518 observations was available. Two independent subsets of data were created for conducting an exploratory factor analysis (n=244) and a confirmatory factor analysis (n=274), respectively. The exploratory factor analysis yielded five 67-item definitive instruments, with five to nine dimensions; all resulted in acceptable explanations of the total variance (range 56.6-65.9%). In the confirmatory factor analysis phase, all goodness of-fit measures were acceptable for all models (root mean square error of approximation ≤ 0.047; comparative fit index ≥ 0.980; normed χ(2) ≤ 1.647; Bentler-Bonett normed fit index ≥ 0.951). The authors selected the factorisation with seven dimensions (factor-7 instrument) as the most useful on pragmatic grounds and named it Evidence-Based Medicine Educational Environment Measure 67 (EBMEEM-67). Cronbach's α for subscales ranged between 0.81 and 0.93. The subscales are: 'Knowledge and learning materials'; 'Learner support'; 'General relationships and support'; 'Institutional focus on EBM'; 'Education, training and supervision'; 'EBM application opportunities'; and 'Affirmation of EBM environment'. The EBMEEM-67 can be a useful diagnostic and benchmarking tool for evaluating the perceptions of residents of the environment in which evidence-based medicine education takes place.
authors.affiliation: Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bergh
authors.affiliation: Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa.
authors.forename: Jackie
authors.initials: J
authors.lastname: Grimbeek
authors.affiliation: Department of Medical Education, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
authors.forename: Win
authors.initials: W
authors.lastname: May
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: A Metin
authors.initials: AM
authors.lastname: Gülmezoglu
authors.affiliation: Women's Health Research Unit, The Blizard Institute, Barts and The London School of Medicine, Queen Mary, University of London, London, UK.
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Khan
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Regina
authors.initials: R
authors.lastname: Kulier
authors.affiliation: Medical Research Council Unit for Maternal and Infant Health Care Strategies, University of Pretoria, Pretoria, South Africa.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Pattinson
mesh_terms: D019317:Evidence-Based Medicine; D005163:Factor Analysis, Statistical; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D010465:Perception; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Gynaecology; Medical Education & Training; Obstetrics