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Factors Determining Medical Students and Residents Satisfaction During VA-Based Training: Findings from the VA Learners Perceptions Survey

Cannon, Grant W. MD; Keitz, Sheri A. MD, PhD; Holland, Gloria J. PhD; Chang, Barbara K. MD, MA; Byrne, John M. DO; Tomolo, Anne MD, MPH; Aron, David C. MD, MS; Wicker, Annie B.; Kashner, T Michael PhD, JD, MPH

Academic Medicine:
doi: 10.1097/ACM.0b013e3181722e97
Medical Education
Abstract

Purpose: To compare medical students’ and physician residents’ satisfaction with Veterans Affairs (VA) training to determine the factors that were most strongly associated with trainee satisfaction ratings.

Method: Each year from 2001 to 2006, all medical students and residents in VA teaching facilities were invited to complete the Learners’ Perceptions Survey. Participants rated their overall training satisfaction on a 100-point scale and ranked specific satisfaction in four separate educational domains (learning environment, clinical faculty, working environment, and physical environment) on a five-point Likert scale. Each domain was composed of unique items.

Results: A total of 6,527 medical students and 16,583 physician residents responded to the survey. The overall training satisfaction scores for medical students and physician residents were 84 and 79, respectively (P < .001), with significant differences in satisfaction reported across the training continuum. For both medical students and residents, the rating of each of the four educational domains was statistically significantly associated with the overall training satisfaction score (P < .001). The learning environment domain had the strongest association with overall training satisfaction score, followed by the clinical preceptor, working environment, and physical environment domains; no significant differences were found between medical students and physician residents in the rank order. Satisfaction with quality of care and faculty teaching contributed significantly to training satisfaction.

Conclusions: Factors that influence training satisfaction were similar for residents and medical students. The domain with the highest association was the learning environment; quality of care was a key item within this domain.

Author Information

Dr. Cannon is associate chief of staff for academic affiliations, George E. Wahlen VA Medical Center, Salt Lake City, Utah; and Thomas E. and Rebecca D. Jeremy Presidential and Endowed Chair for Arthritis Research, School of Medicine, University of Utah, Salt Lake City, Utah.

Dr. Keitz is chief, Medical Service, Miami VA Medical Center, Miami, Florida; and associate dean, Miller School of Medicine, University of Miami, Miami, Florida.

Dr. Holland is special assistant for policy and planning, Office of Academic Affiliations, Veterans Health Administration, Washington, DC.

Dr. Chang is director, Medical and Dental Education, Office of Academic Affiliations, Veterans Health Administration and Washington, DC; and professor of medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico.

Dr. Byrne is associate chief of staff for education, Jerry L. Pettis Memorial VA Medical Center, Loma Linda VA Healthcare System, Loma Linda, California; and assistant professor of medicine, School of Medicine, Loma Linda University, Loma Linda, California.

Dr. Tomolo is chief of the emergency department, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio; and assistant professor of medicine, School of Medicine, Case Western Reserve University, Cleveland, Ohio.

Dr. Aron is associate chief of staff for education, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio; and professor of medicine, School of Medicine, Case Western Reserve University, Cleveland, Ohio.

Ms. Wicker is research health science specialist, Department of Veterans Affairs Medical Center, Dallas, Texas.

Dr. Kashner is associate director for program evaluation, Office of Academic Affiliations, Department of Veterans Affairs, Washington, DC; and professor, Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.

Please see the end of this article for information about the authors.

Correspondence should be addressed to Dr. Cannon, Associate Chief of Staff for Academic Affiliations, George E. Wahlen VA Medical Center, 500 Foothill Boulevard (Mail Code 11E), Salt Lake City, UT 84148; telephone: (801) 584-1277; fax: (801) 584-2559; e-mail: (grant.cannnon@va.gov).

© 2008 Association of American Medical Colleges