Table 3 Validation of 50-item DK-RECTa with 11 subscales and evaluation of postgraduate educational climate
Subcales; No. 1-11 | N | Median (IQR)b | Mean(SD) | Floor/ Ceiling (%)c | Range inter-item correlation | Item-total correlationd | Item-restcore correlatione | |
|---|---|---|---|---|---|---|---|---|
Items; No. 1-50 | ||||||||
1. Supervision | ||||||||
1 | I can always get a hold of a supervisor if I need to | 304 | 5.0 (4.0-5.0) | 4.3(0.9) | 1/52.3 | (0.6-0.8) | 0.9 | 0.7 |
2 | A supervisor is easily accessible if I have the need to discuss something | 304 | 5.0 (4.0-5.0) | 4.2(1.0) | 1/50.3 | (0.6-0.8) | 0.9 | 0.8 |
3 | There is a clear understanding of when I should ask for guidance | 303 | 4.0 (4.0-5.0) | 3.6(1.1) | 2.3/27.1 | (0.5-0.6) | 0.8 | 0.6 |
2. Coaching and assessment | ||||||||
4 | I am regularly asked to provide a rationale for my patient care and treatment | 283 | 3.0 (2.0-4.0) | 3.3(1.1) | 5/15.6 | (0.4-0.6) | 0.7 | 0.6 |
5 | I receive guidance on communicating with demanding patients | 274 | 3.0 (2.0-4.0) | 3.1(1.0) | 5.9/5.1 | (0.4-0.5) | 0.7 | 0.6 |
6 | My supervisors take the initiative to explain their patient care and treatment | 281 | 3.0 (2.0-4.0) | 3.3(1.1) | 7.9/12.5 | (0.4-0.6) | 0.7 | 0.6 |
7 | My supervisors, unasked, tell me how I am performing | 302 | 3.0 (2.0-4.0) | 3.1(1.1) | 9.3/11.6 | (0.4-0.7) | 0.7 | 0.7 |
8 | Supervisors take the initiative to discuss difficult situations I have been involved in | 290 | 3.0 (2.0-4.0) | 3.1(1.1) | 7.2/11.7 | (0.4-0.7) | 0.7 | 0.6 |
9 | Supervisors assess whether the patient care I perform corresponds to my level of training | 292 | 4.0 (3.0-4.0) | 3.7(1.0) | 4.5/19.5 | (0.4-0.7) | 0.7 | 0.6 |
10 | Supervisors occasionally observe when patient medical histories are taken | 249 | 2.0 (1.0-3.0) | 2.5(1.2) | 25.7/6.0 | (0.4-0.5) | 0.6 | 0.5 |
11 | Supervisors assess not only my medical expertise but also other skills, such as collaborative, organisational, or professional abilities | 299 | 4.0 (3.0-4.0) | 3.5(1.0) | 5.4/16.1 | (0.4-0.6) | 0.6 | 0.5 |
3. Feedback | ||||||||
12 | Supervisors give me feedback on both what I do right and what I can improve | 302 | 4.0 (3.0-4.0) | 3.6(1.1) | 5.0/15.9 | (0.5-0.5) | 0.7 | 0.4 |
13 | Structured forms are used to provide feedback | 293 | 3.0 (2.0-4.0) | 2.7(1.2) | 18.4/7.9 | (0.5-0.9) | 0.9 | 0.8 |
14 | Structured observation forms are used to clarify my progress | 294 | 3.0 (2.0-4.0) | 2.7(1.1) | 17.7/6.5 | (0.5-0.9) | 0.9 | 0.8 |
4. Teamwork | ||||||||
15 | Specialist doctors, nurses, other health professionals and trainees work together in teams in my department | 297 | 5.0 (4.0-5.0) | 4.3(0.8) | 0.3/51.9 | (0.4-0.5) | 0.8 | 0.6 |
16 | Nurses and other health professionals contribute positively to my training | 303 | 4.0 (4.0-5.0) | 4.1(0.8) | 0.3/34 | (0.4-0.7) | 0.8 | 0.6 |
17 | Nurses and other health professionals are willing to reflect jointly on patient care | 289 | 4.0 (4.0-5.0) | 4.2(0.8) | 0.0/39.5 | (0.4-0.7) | 0.8 | 0.6 |
18 | We explicitly discuss our teamwork in my training | 298 | 3.0 (2.0-4.0) | 3.1(1.0) | 5.0/8.7 | (0.37-0.43) | 0.7 | 0.4 |
5. Peer collaboration | ||||||||
19 | There is high-quality collaboration between the trainees in my department | 301 | 5.0 (4.0-5.0) | 4.5(0.7) | 0.7/56.5 | (0.5-0.7) | 0.8 | 0.5 |
20 | As trainees we jointly ensure that the day’s work is completed | 301 | 4.0 (4.0-5.0) | 4.2(0.9) | 1.0/45.2 | (0.5-0.7) | 0.8 | 0.6 |
21 | Junior doctors seamlessly switch and cover calls among themselves when necessary | 292 | 4.0 (4.0-5.0) | 4.1(0.8) | 1.0/36.3 | (0.48-0.49) | 0.8 | 0.5 |
6. Professional relationship between supervisors | ||||||||
22 | Continuity of care is unaffected by conflicts between supervisors | 255 | 4.0 (4.0-5.0) | 4.0(0.9) | 0.4/34.9 | (0.6-0.7) | 0.7 | 0.5 |
23 | Differences of opinion between supervisors about patient management are discussed instructively in the team | 258 | 4.0 (3.0-4.0) | 3.9(0.9) | 1.6/24.8 | (0.6-0.7) | 0.7 | 0.5 |
24 | Serious conflicts in the department do not negatively affect the working environment | 286 | 4.0 (3.0-5.0) | 3.8(1.1) | 4.9/26.8 | (0.58-0.62) | 0.7 | 0.5 |
7. Work adapted to trainee skill level | ||||||||
25 | The work that I do corresponds to my level of experience | 304 | 4.0 (4.0-5.0) | 4.0(0.9) | 0.3/29.6 | (0.3-0.6) | 0.7 | 0.5 |
26 | The work that I do corresponds to my current learning objectives in my training | 304 | 4.0 (3.0-5.0) | 3.9(0.9) | 0.7/27.6 | (0.4-0.6) | 0.8 | 0.6 |
27 | I get the opportunity to follow-up on patients | 284 | 4.0 (3.0-5.0) | 3.8(1.1) | 3.2/27.1 | (0.3-0.5) | 0.7 | 0.5 |
28 | There is enough time in the schedule for me to learn new skills | 297 | 3.0 (2.0-4.0) | 3.4(1.2) | 5.7/20.9 | (0.4-0.5) | 0.8 | 0.5 |
8. Role of supervisors | ||||||||
29 | My supervisors take the time to explain when asked for advice | 302 | 4.0 (4.0-5.0) | 4.3(0.8) | 1/43.1 | (0.5-0.7) | 0.8 | 0.7 |
30 | My supervisors are willing to discuss patient care and treatment | 292 | 4.0 (4.0-5.0) | 4.3(0.9) | 1.0/45.9 | (0.5-0.7) | 0.8 | 0.7 |
31 | There are no supervisors who have a negative impact on the educational environment | 297 | 4.0 (3.0-5.0) | 3.7(1.1) | 4.0/26.4 | (0.4-0.7) | 0.8 | 0.7 |
32 | My supervisors are interested in me as a person | 302 | 4.0 (3.0-5.0) | 3.8(1.0) | 1.6/27.3 | (0.5-0.7) | 0.8 | 0.7 |
33 | My supervisors treat me with respect | 299 | 4.0 (4.0-5.0) | 4.1(0.9) | 1.7/36.5 | (0.5-0.8) | 0.9 | 0.8 |
34 | My supervisors are all in their own way positive role models | 300 | 4.0 (4.0-5.0) | 4.0(1.0) | 2.0/33.1 | (0.5-0.8) | 0.8 | 0.8 |
35 | The amount of supervision is adapted to my level of experience | 302 | 4.0 (3.0-5.0) | 3.8(1.0) | 0.0/27.3 | (0.5-0.7) | 0.8 | 0.7 |
36 | It is clear to me who supervises my work | 302 | 4.0 (3.0-5.0) | 3.8(1.2) | 3.3/32.9 | (0.4-0.7) | 0.7 | 0.6 |
9. Formal education | ||||||||
37 | Trainees are normally able to attend scheduled educational activities | 300 | 4.0 (4.0-5.0) | 4.0(1.0) | 2.0/33.4 | (0.6-0.7) | 0.8 | 0.7 |
38 | Scheduled educational activities are carried out | 300 | 4.0 (4.0-5.0) | 4.1(0.9) | 1.3/35.1 | (0.68-0.72) | 0.9 | 0.8 |
39 | Supervisors actively contribute to developing and planning high-quality teaching | 301 | 4.0 (3.0-5.0) | 3.8(1.1) | 3.0/26.7 | (0.6-0.8) | 0.9 | 0.8 |
40 | Formal teaching at the department is well-suited to my needs | 300 | 4.0 (4.0-5.0) | 3.9(1.0) | 1.3/27.2 | (0.6-0.8) | 0.9 | 0.8 |
10. Role of programme director | ||||||||
41 | My programme director knows how far I am in my formal training | 298 | 4.0 (4.0-5.0) | 4.3(0.9) | 0.7/46.9 | (0.5-0.8) | 0.7 | 0.6 |
42 | My programme director provides other supervisors with guidance when needed | 273 | 4.0 (3.0-5.0) | 3.6(1.1) | 1.1/25.9 | (0.5-0.7) | 0.8 | 0.7 |
43 | My programme director works actively to achieve high-quality education | 298 | 4.0 (4.0-5.0) | 4.2(1.1) | 1.7/46.2 | (0.6-0.8) | 0.7 | 0.6 |
44 | We constructively discuss my performance during the departmental assessment interview | 276 | 4.0 (3.0-5.0) | 3.9(1.1) | 3.2/30.6 | (0.6-0.8) | 0.8 | 0.7 |
45 | My plans for the future are reviewed during the assessment interview | 282 | 4.0 (3.0-5.0) | 3.9(1.1) | 1.4/29.3 | (0.5-0.8) | 0.8 | 0.7 |
46 | Assessments of my work by various supervisors are considered during the assessment interview | 271 | 4.0 (3.0-4.0) | 3.4(1.2) | 5.8/21.4 | (0.5-0.7) | 0.8 | 0.7 |
11. Patient sign-out | ||||||||
47 | If the treatment plan I developed with my supervisor is criticised after a morning briefing, I am confident that my supervisor will back me up | 250 | 4.0 (4.0-5.0) | 4.0(1.0) | 1.2/27.8 | (0.6-0.7) | 0.8 | 0.7 |
48 | There is a safe climate at morning briefings | 294 | 4.0 (4.0-5.0) | 4.1(1.0) | 1.8/36.8 | (0.66-0.73) | 0.8 | 0.7 |
49 | Morning briefings are also used as a teaching opportunity | 293 | 4.0 (4.0-5.0) | 4.1(1.0) | 1.3/38.9 | (0.6-0.7) | 0.8 | 0.6 |
50 | Supervisors encourage trainees to join in discussions at morning briefings | 291 | 4.0 (3.0-5.0) | 3.7(1.1) | 2.0/27.0 | (0.6-0.7) | 0,8 | 0.6 |