title: Profiling medical school learning environments in Malaysia: a validation study of the Johns Hopkins Learning Environment Scale.
abstract: OBJECTIVE
  While a strong learning environment is critical to medical student education, the assessment of medical school learning environments has confounded researchers. Our goal was to assess the validity and utility of the Johns Hopkins Learning Environment Scale (JHLES) for preclinical students at three Malaysian medical schools with distinct educational and institutional models. Two schools were new international partnerships, and the third was school leaver program established without international partnership.
  
  
  METHODS
  First- and second-year students responded anonymously to surveys at the end of the academic year. The surveys included the JHLES, a 28-item survey using five-point Likert scale response options, the Dundee Ready Educational Environment Measure (DREEM), the most widely used method to assess learning environments internationally, a personal growth scale, and single-item global learning environment assessment variables.
  
  
  RESULTS
  The overall response rate was 369/429 (86%). After adjusting for the medical school year, gender, and ethnicity of the respondents, the JHLES detected differences across institutions in four out of seven domains (57%), with each school having a unique domain profile. The DREEM detected differences in one out of five categories (20%). The JHLES was more strongly correlated than the DREEM to two thirds of the single-item variables and the personal growth scale. The JHLES showed high internal reliability for the total score (α=0.92) and the seven domains (α, 0.56-0.85).
  
  
  CONCLUSIONS
  The JHLES detected variation between learning environment domains across three educational settings, thereby creating unique learning environment profiles. Interpretation of these profiles may allow schools to understand how they are currently supporting trainees and identify areas needing attention.
authors.affiliation: Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, USA.
authors.forename: Sean
authors.identifier: 0000-0001-5369-7225
authors.initials: S
authors.lastname: Tackett
authors.affiliation: Cyberjaya University College of Medical Sciences, Cyberjaya, Malaysia.
authors.forename: Hamidah Abu
authors.identifier: 0000-0002-2775-0085
authors.initials: HA
authors.lastname: Bakar
authors.affiliation: Division of Pediatrics and Anesthesiology/Critical Care Medicine at Johns Hopkins University School of Medicine, Baltimore, USA.
authors.forename: Nicole A
authors.identifier: 0000-0003-0000-0871
authors.initials: NA
authors.lastname: Shilkofski
authors.affiliation: Perdana University Royal College of Surgeons in Ireland School of Medicine, Serdang, Malaysia.
authors.forename: Niamh
authors.identifier: 0000-0003-2671-1356
authors.initials: N
authors.lastname: Coady
authors.affiliation: Department of Community Medicine, Perdana University Graduate School of Medicine, Serdang, Malaysia.
authors.forename: Krishna
authors.identifier: 0000-0002-4011-0373
authors.initials: K
authors.lastname: Rampal
authors.affiliation: Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, USA.
authors.forename: Scott
authors.identifier: 0000-0002-3178-9193
authors.initials: S
authors.lastname: Wright
keywords: Educational assessment; Learning; Malaysia; Medical students; Validation studies