title: A multicenter study: how do medical students perceive clinical learning climate?
abstract: BACKGROUND
  The relationship between students and instructors is of crucial importance for the development of a positive learning climate. Learning climate is a multifaceted concept, and its measurement is a complicated process. The aim of this cross-sectional study was to determine medical students' perceptions about the clinical learning climate and to investigate differences in their perceptions in terms of various variables.
  
  
  METHODS
  Medical students studying at six medical schools in Turkey were recruited for the study. All students who completed clinical rotations, which lasted for 3 or more weeks, were included in the study (n=3,097). Data were collected using the Clinical Learning Climate Scale (CLCS). The CLCS (36 items) includes three subscales: clinical environment, emotion, and motivation. Each item is scored using a 5-point Likert scale (1: strongly disagree to 5: strongly agree).
  
  
  RESULTS
  The response rate for the trainees was 69.67% (n=1,519), and for the interns it was 51.47% (n=917). The mean total CLCS score was 117.20±17.19. The rotation during which the clinical learning climate was perceived most favorably was the Physical Therapy and Rehabilitation rotation (mean score: 137.77). The most negatively perceived rotation was the General Internal Medicine rotation (mean score: 104.31). There were significant differences between mean total scores in terms of trainee/intern characteristics, internal medicine/surgical medicine rotations, and perception of success.
  
  
  CONCLUSIONS
  The results of this study drew attention to certain aspects of the clinical learning climate in medical schools. Clinical teacher/instructor/supervisor, clinical training programs, students' interactions in clinical settings, self-realization, mood, students' intrinsic motivation, and institutional commitment are important components of the clinical learning climate. For this reason, the aforementioned components should be taken into consideration in studies aiming to improve clinical learning climate.
authors.affiliation: Department of Medical Education, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Nilufer Demiral
authors.initials: ND
authors.lastname: Yilmaz
authors.affiliation: Department of Medical Education, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Velipasaoglu
authors.affiliation: Department of Medical Education, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey.
authors.forename: Sema
authors.initials: S
authors.lastname: Ozan
authors.affiliation: Department of Medical Education, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Bilge Uzun
authors.initials: BU
authors.lastname: Basusta
authors.affiliation: Department of Medical Education, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Midik
authors.affiliation: Department of Medical Education, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Sumer
authors.initials: S
authors.lastname: Mamakli
authors.affiliation: Department of Medical Education, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.
authors.forename: Nazan
authors.initials: N
authors.lastname: Karaoglu
authors.affiliation: Izmir University of Economics School of Vocational, Izmir, Turkey.
authors.forename: Funda
authors.initials: F
authors.lastname: Tengiz
authors.affiliation: Department of Medical Education, Faculty of Medicine, Ege University, Izmir, Turkey.
authors.forename: Halil İbrahim
authors.initials: Hİ
authors.lastname: Durak
authors.affiliation: Department of Medical Education, Faculty of Medicine, Ege University, Izmir, Turkey; hatice.sahin@ege.edu.tr.
authors.forename: Hatice
authors.initials: H
authors.lastname: Sahin
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D004644:Emotions; D004777:Environment; D006801:Humans; D007858:Learning; D009042:Motivation; D010465:Perception; D012737:Sex Factors; D013337:Students, Medical / Q000523:psychology*; D014421:Turkey; D055815:Young Adult
keywords: clinical learning climate; learning climate; medical students; multi-center study