Why Residents’ Perceptions of the Clinical Learning Environment Matter: Correlations between the ACGME Resident Survey, Perceived Organizational Support, and Psychological Safety
Purpose. To utilize two validated instruments to assess the cultural facets of the clinical learning environment in medical education and correlate findings with external program evaluation data. Identification of measurement tools could allow early intervention in graduate medical education to better facilitate work and learning processes. Method. During FY17, our institution surveyed residents across nineteen training programs on perceived organizational support and psychological safety to assess the clinical learning environment. These data were aggregated to the departmental level and correlated with nineteen residency program results on the FY17 ACGME Resident Survey. Results. Perceived organizational support correlated positively with domains of the ACGME Resident Survey: overall program evaluation score (r=.75, p\u3c.01), Faculty (r=.72, p\u3c.01), Evaluation (r=.73, p\u3c.01), Educational Content (r=.52, p=.02), and Resources (r=.55, p=.01). Psychological safety had a strong positive correlation with overall program evaluation score (r=.57, p=.01), Faculty (r=.50, p=.03), and Evaluation (r=.62, p\u3c.01). Neither internal assessment scale correlated with the Patient Safety/Teamwork domain of the ACGME Resident Survey. Conclusions. GME and health systems should actively monitor and improve aspects of the clinical learning environment through internal assessment including measurement on perceived organizational support and psychological safety. Based on our data, departments perceived to have greater support of their residents, where residents can speak up freely, are likely to show more positive ratings of programs on the ACGME Resident Survey. Programs should also identify and evaluate interventions to facilitate positive relationships between residents and their training programs, as well as foster environments that allow for speaking up without the fear of negative consequence
