BACKGROUND: The quality of the learning environment significantly impacts student engagement and professional identity formation in health professions education. Despite global recognition of its importance, research on student perceptions of learning environments across different health education programs is scarce. This study aimed to explore how health professional students perceive their learning environment and its influence on their professional identity development.
METHODS: An explanatory mixed-methods approach was employed. In the quantitative phase, the Dundee Ready Education Environment Measure [Minimum-Maximum possible scores = 0-200] and Macleod Clark Professional Identity Scale [Minimum-Maximum possible scores = 1-45] were administered to Qatar University-Health students (N = 908), with a minimum required sample size of 271 students. Data were analyzed using SPSS, including descriptive statistics and inferential analysis. In the qualitative phase, seven focus groups (FGs) were conducted online via Microsoft Teams. FGs were guided by a topic guide developed from the quantitative results and the framework proposed by Gruppen et al. (Acad Med 94:969-74, 2019), transcribed verbatim, and thematically analyzed using NVIVO®.
RESULTS: The questionnaire response rate was 57.8% (525 responses out of 908), with a usability rate of 74.3% (390 responses out of 525) after excluding students who only completed the demographic section. The study indicated a \"more positive than negative\" perception of the learning environment (Median [IQR] = 132 [116-174], Minimum-Maximum obtained scores = 43-185), and a \"good\" perception of their professional identity (Median [IQR] = 24 [22-27], Minimum-Maximum obtained scores = 3-36). Qualitative data confirmed that the learning environment was supportive in developing competence, interpersonal skills, and professional identity, though opinions on emotional support adequacy were mixed. Key attributes of an ideal learning environment included mentorship programs, a reward system, and measures to address fatigue and boredom.
CONCLUSIONS: The learning environment at QU-Health was effective in developing competence and interpersonal skills. Students\' perceptions of their learning environment positively correlated with their professional identity. Ideal environments should include mentorship programs, a reward system, and strategies to address fatigue and boredom, emphasizing the need for ongoing improvements in learning environments to enhance student satisfaction, professional identity development, and high-quality patient care.

UNASSIGNED: Study engagement is regarded important to medical students\' physical and mental wellbeing. However, the relationship between learning environment of medical schools and the study engagement of medical students was still unclear. This study was aimed to ascertain the positive effect of learning environment in study engagement.
UNASSIGNED: We collected 10,901 valid questionnaires from 12 medical universities in China, and UWES-S was utilized to assess the study engagement levels. Then Pearson Chi-Square test and Welch\'s ANOVA test were conducted to find the relationship between study engagement and learning environment, and subgroup analysis was used to eradicate possible influence of confounding factors. After that, a multivariate analysis was performed to prove learning environment was an independent factor, and we constructed a nomogram as a predictive model.
UNASSIGNED: With Pearson Chi-Square test (p < 0.001) and Welch\'s ANOVA test (p < 0.001), it proved that a good learning environment contributed to a higher mean of UWES scores. Subgroup analysis also showed statistical significance (p < 0.001). In the multivariate analysis, we could find that, taking \"Good\" as reference, \"Excellent\" (OR = 0.329, 95%CI = 0.295-0.366, p < 0.001) learning environment was conducive to one\'s study engagement, while \"Common\" (OR = 2.206, 95%CI = 1.989-2.446, p < 0.001), \"Bad\" (OR = 2.349, 95%CI = 1.597-3.454, p < 0.001), and \"Terrible\" (OR = 1.696, 95%CI = 1.015-2.834, p = 0.044) learning environment only resulted into relatively bad study engagement. Depending on the result, a nomogram was drawn, which had predictive discrimination and accuracy (AUC = 0.680).
UNASSIGNED: We concluded that learning environment of school was an independent factor of medical student\'s study engagement. A higher level of learning environment of medical school came with a higher level of medical students\' study engagement. The nomogram could serve as a predictive reference for the educators and researchers.

BACKGROUND: Undergraduates\' workplace learning is an important part of health sciences education. Educational psychology research considers many different aspects of self-regulated learning at the workplace, including cognition, motivation, emotions, and context. Multivariate longitudinal and diary studies in this field require fewer items than alternatives or even a single item per construct and can reveal the sub-processes of workplace learning and contribute to a better understanding of students\' learning. Short instruments are necessary for application in workplace settings, especially stressful ones, to mitigate survey fatigue. The present study aimed to assess the psychometric properties of single items measuring various aspects of workplace learning.
METHODS: Twenty-nine single items selected from the Workplace Learning Inventory in Health Sciences Education were analyzed for reliability, information reproduction, and relationships within the nomological network. The authors additionally analyzed four generally formulated single items\' relationships with the full Workplace Learning Inventory scales and external criteria within the nomological network. Participants were 214 ninth- or tenth-semester veterinary medicine students in Austria and Germany who were learning at varied workplaces during the winter semester of 2021/2022.
RESULTS: Of the 29 single items selected from existing scales, 27 showed sufficient reliability, but mixed results were obtained regarding validity. Although the items\' relationships within the nomological network were similar to those of the full scales, information reproduction was insufficient for most items. The four general single items showed acceptable validity, but the reliability of these measures of states could not be assessed.
CONCLUSIONS: This paper reported findings on the psychometric properties of single items for undergraduates\' workplace learning in health science education. The findings are crucial for deciding whether to use scales versus single-item measures in future studies. By applying the findings, researchers can be more economical in their workplace learning data collection and can include more constructs.

UNASSIGNED: While study approaches have been directly associated with students\' academic performance, learning environment factors may play a more indirect role. The aim of this study was (i) to assess learning environment factors as predictors of students\' average exam grades, and (ii) whether study approaches mediated associations between learning environment factors and exam grades.
UNASSIGNED: Three annual surveys (2017-2019) yielded data from a total of 263 Norwegian occupational therapy students. Learning environment factors were assessed with the Course Experience Questionnaire, and the Approaches and Study Skills Inventory for Students were used to assess study approaches. Linear regression analyses and mediation analyses were performed.
UNASSIGNED: Higher levels of \'student autonomy\' were directly associated with lower averaged grades whereas higher levels of \'appropriate workload\' were associated with higher averaged grades. There were statistically significant total indirect effects of \'clear goals\' and \'appropriate workload\' on grades; these effects occurred through the study approach variables. However, all learning environment variables showed one or more relationships with academic performance that was mediated by study approach variables.
UNASSIGNED: Learning environment variables appear to be complexly associated with academic performance, both directly and indirectly.

Description Research shows that when educational leaders support their learners\' autonomy, it positively impacts both parties. This is particularly important in graduate medical education (GME), given that there is a strong emphasis on resident performance, evaluation, and development. Unfortunately, GME faculty often misunderstand autonomy as the resident\'s desire for independence or \"freedom,\" when in fact it refers to the core psychological need to feel volitional and agentic. The distinction is important because volition is not synonymous with independence, and providing freedom can be at odds with strategies that provide true autonomy support. This, in turn, can contribute to the stress, maladjustment, and resident burnout that are already prevalent in medicine. To help remedy this issue, this paper provides an evidence-based guide for medical educators to distinguish autonomy from independence, with specific examples to help translate theory into practice to better support the well-being of the medical community.

BACKGROUND: In medical education, the learning environment (LE) significantly impacts students\' professionalism and academic performance. Positive LE perceptions are linked to better academic outcomes. Our study, which was conducted 15 years after curriculum reform at King Saud University\'s College of Medicine, aimed to explore students\' perspectives on their LE and identify areas for improvement. By understanding their experiences, we strive to enhance LE and promote academic success.
METHODS: This mixed-method study employed an explanatory sequential approach in which a cross-sectional analytical survey phase was collected first using the Johns Hopkins Learning Environment Scale (JHLES), followed by qualitative focus groups. Findings from quantitative and qualitative methods were integrated using joint display.
RESULTS: A total of 653 medical students completed the JHLES. The total average score was 81 out of 140 (16.8), and the average subscale scores ranged from 2.27 (0.95) for inclusion and safety to 3.37 (0.91) for community of peers. The qualitative approach encompasses both inductive and deductive analyses, identifying overarching themes comprising proudness, high expectations and competition, and views about the curriculum. The integration of results emphasizes the need for continued efforts to create a supportive and inclusive LE that positively influences students\' experiences and academic success.
CONCLUSIONS: This research offers valuable insights for educational institutions seeking to enhance medical education quality and support systems. Recommendations include faculty development, the cultivation of supportive environments, curriculum revision, improved mentorship programs, and initiatives to promote inclusivity and gender equity. Future research should explore longitudinal and comparative studies, innovative mixed methods approaches, and interventions to further optimize medical education experiences. Overall, this study contributes to the ongoing dialog on medical education, offering a nuanced understanding of the complex factors influencing students\' perceptions and suggesting actionable strategies for improvement.

The aim of this research is to find out to what extent the special qualifications of physical education teachers and the physical environment of kindergartens influence the physical development of preschoolers. Forty-four kindergartens across Estonia participated in the study, half of which had a physical education teacher (PEt), whereas the remaining 22 kindergartens were taught by non-qualified kindergarten teachers (NoPEt). Six Eurofit fitness tests were used to assess the physical development of children (n = 704; aged 6-7 years old, with an average age of 6.55 ± 0.5 years). An analysis of variance was used to compare the mean values of the fitness test results of the two groups. Linear regression analysis was applied to clarify the influence of individual and environmental factors on children\'s fitness scores. In kindergartens where the position of a PEt had been created, the results of children\'s physical fitness were statistically significantly better, more specifically in handgrip strength (m = 12.0, 95% CI = 11.8-12.3 vs. m = 11.5, 95% CI = 11.2-11.7) and in speed tests (m = 23.0, 95% CI = 22.8-23.2 vs. m = 23.6, 95% CI = 23.3-23.8). According to the teacher interviews, these kindergartens also had more rooms and areas specially created for physical exercises. The study revealed that the physical development of children is, when controlling for other individual and environmental factors, influenced by the professional qualification of the PE teacher (95% CI = 0.06-0.56) as well as children\'s participation in sports training (95% CI = 0.29-0.83). These findings are important for preschool institutions and municipalities in designing the optimal physical environment for facilitating children\'s physical fitness.

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Student engagement is a key contributor to educational programme quality. It is a complex construct often defined with the focus on student behaviors. However, a broader, more organizational approach takes into account the institutional context and how this can be structured to encourage and support students\' willingness and ability to become engaged. This paper includes suggestions for a student engagement system using key elements recognized in the literature and concrete examples from medical schools that achieved recognition in the ASPIRE-to-Excellence student engagement initiative. The examples from the ASPIRE participants demonstrate that the presence of certain key features creates a mutually beneficial collaborative approach between students and their institutions. This includes opportunities for students to formally engage in four domains touching on the breadth of student life, including institutional governance and policy-making, educational programme development and evaluation, participation in activities in the academic community, and participation in local community and international outreach. Based on an in-depth review of the information from three medical schools that recently received an ASPIRE-to-Excellence award in student engagement, it was possible to identify certain specific practices that individually and taken together allow an institution to demonstrate excellence in this complex construct. As an overarching concept, it was clear that student participation in each of these domain areas benefitted from a supportive institutional culture characterized by specific formal attributes and activities. Examples included codifying student involvement in governance through institutional policies; maximizing communication routes among students and between students and school administrators and faculty; and formalizing a participatory environment through missions statements or strategic plans. For programme planning, a helpful conceptualization is that a successful student engagement programme occurs when change is championed by all stakeholders within an institution and the organization supports a collaborative culture that includes students as active participants and partners.

UNASSIGNED: Burnout is an increasingly prevalent problem among resident physicians. To address this problem, the Accreditation Council on Graduate Medical Education (ACGME) created the Back to Bedside initiative, supporting resident-driven projects focused on increasing direct interactions with patients. In 2017, Baylor College of Medicine (BCM) Internal Medicine Residency received a Back to Bedside grant to develop and implement \"Humanism Rounds,\" a multifaceted program which sought to promote personal connections between residents and patients and foster reflection about patients\' non-clinical stories, with the hopes of reducing burnout and increasing residents\' sense of meaning at work.
UNASSIGNED: Between 2018 and 2020, internal medicine residents were instructed on and encouraged to participate in Humanism Rounds. The program included three components: taking a \"human history,\" bedside rounds focused on non-clinical concerns, and sharing patient stories with colleagues (\"celebrations\"). Residents were surveyed using institutional and ACGME surveys regarding burnout, meaning at work, and the clinical learning environment.
UNASSIGNED: Three hundred eleven institutional (response rate, 74%) and 328 AGCME (response rate, 78%) surveys were completed and analyzed. Residents who actively engaged with Humanism Rounds reported more meaning and fulfillment at work (p < 0.001). During the period of this project, ratings of the learning environment and personal callousness improved among subgroups of residents.
UNASSIGNED: Baylor College of Medicine Internal Medicine residents who engaged with Humanism Rounds reported more meaning and fulfillment in their work. This program describes a low-cost model for other specialties and institutions to strengthen human connections and improve residents\' experience during training.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s40670-024-02017-9.