Authors: Dung Ho¹, Quynh Ninh¹, Phung Tran^1,2, Linh Bui^1,3, Tung Pham^1,4

¹ Friendship and Science for Health Research group, Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam

² Institute of Gastroenterology and Hepatology, Hanoi, Vietnam

³ Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam

⁴ Department of Physiology, Hanoi Medical University, Hanoi, Vietnam

Abstract

Background and aims: Clinical learning environment plays a vital role in medical education and can be improved by regular feedbacks of medical students. This study aimed to estimate the Students’ Perception of Clinical Learning Environment (SPCLE) and identify factors associated with SPCLS in medical students at Hanoi Medical University (HMU).

Method: We conducted a cross-sectional study on medical students with clinical experience (4th, 5th, 6th year) at HMU from November 2015 to January 2016. We used the multistage random sampling technique to select the participants, then asked them to complete a paper-based questionnaire including demographic and socioeconomic characteristics, Academic Motivation Scale, Patient Health Questionnaire 9, and Dundee Ready Education Environment Measure. Poisson regression models with robust estimate of variance were employed to determine factors associated with negative SPCLS.

Result: Among 627 invited participants, 484 (77.2%) completed questionnaires were included in the analysis. The prevalence of negative SPCLE was 12.19% (95% CI: 9.8%-15.1%), and there were significant differences in SPCLE among academic years (p < 0.001) and genders (p = 0.014). After adjusting for potential confounders, we found that notable factors associated with negative SPCLE in male including academic year (5^th year: PR = 3.21, 95% CI: 1.45-7.07; 6^th year: PR = 3.68, 95% CI: 1.75-7.77), proficient English skills (PR=0.13; 95% CI: 0.02-0.93), self-determined motivation (PR=0.31, 95% CI: 0.23-0.44), and depression syndrome (PR=2.90, 95% CI: 1.45-5.82). Among female students, academic year (6^th year: PR = 6.37, 95% CI: 1.80-22.55) was the only significant risk factor.

Conclusion: Academic year is the only common risk factor for negative SPCLE for both genders, and different approaches should be developed for each gender to improve SPCLE. More studies with larger sample size are needed to explore the essential role of other risk factors in SPCLE.