title: Psychometric analysis of the ambulatory care learning education environment measure (ACLEEM) in Iran.
abstract: BACKGROUND
  Examining educational environment (academic and clinical) by means of a valid, reliable and comprehensive questionnaire is a major key in achieving a highly qualified student - oriented curricula. The Persian translation of Ambulatory Care Learning Education Environment Measure-ACLEEM questionnaire has been developed to support this goal, and its psychometrics has been explored in this administration in teaching hospitals affiliated to Tehran University of Medical Sciences.
  
  
  METHODS
  This descriptive - analytical study involved medical residents in four major clinics. In this study, the ACLEEM Questionnaire was conducted after translating and retranslating the questionnaire and examine the face and content validity, construct validity, test retest reliability and internal consistency coefficient.
  
  
  RESULTS
  In this study, 157 out of 192 residents completed the questionnaire (response rate 82%). The mean age of the residents was 31.81 years .The final mean of the questionnaire was calculated as 110.91 out of 200 (with 95% confidence interval). Test - retest stability of the questionnaire was between 0.322 and 0.968. The face validity of the questionnaire was confirmed. The content validity ratio was 0.64; and content validity Index was 0.78. In Exploratory factor analysis, eight factors were confirmatory that changed the orientation of some questions. The Cronbach's alpha coefficient of the whole questionnaire was 0.936.
  
  
  CONCLUSIONS
  According to the data, the Persian version of the ACLEEM questionnaire has sufficient psychometric reliability and validity to be used for conducting research, teaching and practicing the educational learning environment in ambulatory care in Iran.
authors.affiliation: MSc of Medical Education, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. z.naghizadeh@yahoo.com.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Naghizadeh Moogari
authors.affiliation: Associate Professor of Community Medicine, Center for Educational Research in Medical Sciences (CERMS), Saveh University of Medical Sciences, Saveh, Iran. jkuhpayeh@yahoo.com.
authors.forename: Jalil
authors.initials: J
authors.lastname: Koohpayehzadeh
authors.affiliation: Educational Consultant and Part-time Tutor, Medical Education Institute, University of Dundee, Scotland. s.l.roff@dundee.ac.uk.
authors.forename: Susanne
authors.initials: S
authors.lastname: Roff
authors.affiliation: Professor of Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. montazeri@acecr.ac.ir .
authors.forename: Ali
authors.initials: A
authors.lastname: Montazeri
authors.affiliation: Professor of Internal Medicine, Department of Medical Education and Center for Educational Research in Medical Sciences, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. Soltarab.34@gmail.com.
authors.forename: Seyyed Kamran
authors.initials: SK
authors.lastname: Soltani Arabshahi
authors.affiliation: Associate Professor, Department of Medical Education and Center for Educational Research in Medical Sciences, Faculty of Medicine, Iran University of Medical Sciences, Iran. shb555@yahoo.com.
authors.forename: Shoaleh
authors.initials: S
authors.lastname: Bigdeli
authors.affiliation: MSc of Medical Education, Department of Medical Education, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. mm5049@yahoo.com.
authors.forename: Maryam
authors.initials: M
authors.lastname: Moosavi
authors.affiliation: Instructor, Department of English language, ACECR TUMS, Tehran, Iran. faranak_azaminejad@yahoo.com.
authors.forename: Faranak
authors.initials: F
authors.lastname: Azaminejad
authors.affiliation: Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran. m.tavousi@gmail.com.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Tavousi
keywords: Ambulatory Care; Educational Environment; Psychometric; Residents