Focus on Quality: Investigating Residents' Learning Climate Perceptions

Milou E W M Silkens, Onyebuchi A Arah, Albert J J A Scherpbier, Maas Jan Heineman, Kiki M J M H Lombarts

Research output: Contribution to JournalArticleAcademicpeer-review


BACKGROUND: A department's learning climate is known to contribute to the quality of postgraduate medical education and, as such, to the quality of patient care provided by residents. However, it is unclear how the learning climate is perceived over time.

OBJECTIVES: This study investigated whether the learning climate perceptions of residents changed over time.

METHODS: The context for this study was residency training in the Netherlands. Between January 2012 and December 2014, residents from 223 training programs in 39 hospitals filled out the web-based Dutch Residency Educational Climate Test (D-RECT) to evaluate their clinical department's learning climate. Residents had to fill out 35 validated questions using a five point Likert-scale. We analyzed data using generalized linear mixed (growth) models.

RESULTS: Overall, 3982 D-RECT evaluations were available to investigate our aim. The overall mean D-RECT score was 3.9 (SD = 0.3). The growth model showed an increase in D-RECT scores over time (b = 0.03; 95% CI: 0.01-0.06; p < 0.05).

CONCLUSIONS: The observed increase in D-RECT scores implied that residents perceived an improvement in the learning climate over time. Future research could focus on factors that facilitate or hinder learning climate improvement, and investigate the roles that hospital governing committees play in safeguarding and improving the learning climate.

Original languageEnglish
Pages (from-to)e0147108
JournalPLoS ONE
Issue number1
Publication statusPublished - 2016


  • Education, Medical, Graduate/standards
  • Humans
  • Internship and Residency/standards
  • Learning
  • Netherlands
  • Quality of Health Care
  • Social Perception
  • Time Factors


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