title: Psychometric properties of the Persian version of the Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, Shiraz, Iran.
abstract: OBJECTIVE
  Evaluation is the main component in design and implementation of educational activities and rapid growth of educational institution programs. Outpatient medical education and clinical training environment is one of the most important parts of training of medical residents. This study aimed to determine the validity and reliability of the Persian version of Ambulatory Care Learning Educational Environment Measure (ACLEEM) questionnaire, as an instrument for assessment of educational environments in residency medical clinics.
  
  
  METHODS
  This study was performed on 180 residents in Shiraz University of Medical Sciences, Shiraz, Iran, in 2014-2015. The questionnaire designers' electronic permission (by email) and the residents' verbal consent were obtained before distributing the questionnaires. The study data were gathered using ACLEEM questionnaire developed by Arnoldo Riquelme in 2013. The data were analyzed using the SPSS statistical software, version 14, and MedCalc®software. Then, the construct validity, including convergent and discriminant validities, of the Persian version of ACLEEM questionnaire was assessed. Its internal consistency was also checked by Cronbach's alpha coefficient.
  
  
  RESULTS
  Five team members who were experts in medical education were consulted to test the cultural adaptation, linguistic equivalency, and content validity of the Persian version of the questionnaire. Content validity indexes were >0.9 in all items. In factor analysis of the instrument, the Kaiser-Meyer-Olkin index was 0.928 and Barlett's sphericity test yielded the following results:X2=6,717.551,df=1,225, andP≤0.001. Besides, Cronbach's alpha coefficient of ACLEEM questionnaire was 0.964. Cronbach's alpha coefficients were also >0.80 in all the three domains of the questionnaire. Overall, the Persian version of ACLEEM showed excellent convergent validity and acceptable discriminant validity, except for the clinical training domain.
  
  
  CONCLUSIONS
  According to the results, the Persian version of ACLEEM questionnaire was a valid and reliable instrument for Iranian residents to assess specialized clinics and residency ambulatory settings.
authors.affiliation: Health Policy Research Center; Quality Improvement in Clinical Education Research Center.
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Parvizi
authors.affiliation: Quality Improvement in Clinical Education Research Center.
authors.forename: Mitra
authors.initials: M
authors.lastname: Amini
authors.affiliation: Quality Improvement in Clinical Education Research Center.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Dehghani
authors.affiliation: Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Jafari
authors.affiliation: Health Policy Research Center.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Parvizi
keywords: ACLEEM; Iran; ambulatory medicine; educational environment; postgraduate medical education; psychometric studies; validation