Table 2.
Factor Analysis of Clinical Learning Environment Questionnaire (CLENQ) across three levels of medical trainees
| I | II | III | IV | V | |
|---|---|---|---|---|---|
| Teaching | Workload | Relationship pressure | Support | Trust | |
| 19. My clinical teachers are enthusiastic about teaching | 0.78 | 0.07 | −0.17 | 0.14 | −0.02 |
| 15. All of my clinical teachers have good teaching skills | 0.74 | 0.14 | −0.18 | 0.03 | 0.03 |
| 21. My clinical teachers effectively utilise clinical cases when teaching me | 0.72 | 0.12 | −0.03 | 0.16 | −0.13 |
| 28. My clinical teachers set up clear learning objectives for me | 0.71 | −0.15 | −0.10 | −0.02 | 0.18 |
| 33. Senior residents take the initiative to care about my clinical work | 0.69 | −0.07 | 0.26 | 0.07 | −0.20 |
| 37. I feel that my clinical teachers are approachable | 0.69 | −0.07 | −0.21 | −0.04 | −0.20 |
| 34. I regularly receive feedback from senior medical staff that helps me review and improve my clinical practices | 0.68 | −0.21 | 0.01 | 0.22 | −0.01 |
| 38. My clinical teachers encourage me to learn independently to improve my clinical skills | 0.67 | −0.14 | −0.05 | −0.01 | −0.16 |
| 18. During my clinical learning hours, I have good supervision and protection | 0.65 | −0.20 | −0.02 | 0.28 | 0.18 |
| 14. Visiting staff take the initiative to care about my clinical work | 0.58 | 0.09 | −0.21 | 0.35 | 0.09 |
| 32. There are appropriate mechanisms in place to assess if my training plans meet my needs | 0.45 | −0.16 | 0.12 | 0.28 | 0.23 |
| 23. I like the current work environment and atmosphere | 0.44 | −0.35 | 0.09 | 0.38 | −0.03 |
| 35. I have enough opportunity to learn the knowledge and skills I need to practice medicine | 0.41 | −0.29 | 0.21 | 0.23 | −0.26 |
| 1. My workload is more than I can handle | −0.15 | 0.79 | −0.06 | 0.06 | 0.15 |
| 2. My job takes a lot of my energy and physical strength | −0.09 | 0.75 | −0.03 | 0.09 | 0.12 |
| 16. I have a heavy workload when I am on call | −0.01 | 0.71 | 0.17 | −0.15 | −0.05 |
| 3. When I am on call I am unable to get enough sleep | −0.18 | 0.61 | 0.21 | 0.16 | −0.18 |
| 4. I do not receive appropriate compensation from my job | −0.19 | 0.54 | 0.24 | −0.18 | 0.01 |
| 27. I am stressed when dealing with patients who present with problems outside my specialty when I am on duty | 0.09 | 0.48 | 0.24 | −0.03 | 0.13 |
| 5. 5. I am not familiar with the equipment in this hospital | 0.12 | 0.46 | 0.13 | −0.37 | 0.32 |
| 11. When patients or their family know that I am a new physician, they do not trust the medical treatment I provide | −0.01 | 0.08 | 0.62 | −0.19 | 0.14 |
| 9. I feel stressed when communicating with patients or their family members | 0.01 | 0.08 | 0.58 | −0.33 | 0.25 |
| 10. I have been asked to treat patients based on cost, not on quality of care | −0.22 | 0.21 | 0.58 | 0.11 | −0.22 |
| 24. I feel stressed when interacting with visiting staff | −0.19 | 0.03 | 0.56 | −0.04 | 0.36 |
| 31. I did not learn enough about medical ethics to help me with my clinical decisions | −0.13 | 0.01 | 0.56 | −0.08 | 0.18 |
| 8. 8. I am afraid of causing a lawsuit | 0.01 | 0.23 | 0.55 | 0.10 | −0.14 |
| 26. Other non-physician medical staff members do not trust my clinical decisions because I am a new physician | −0.16 | 0.05 | 0.54 | −0.34 | 0.17 |
| 20. My colleagues and I are competitive | 0.01 | 0.08 | 0.47 | 0.04 | 0.21 |
| 30. A patient’s or their family’s socioeconomic status affects my clinical decisions about their care | 0.07 | 0.08 | 0.45 | 0.09 | 0.18 |
| 22. The knowledge and skills I have learned help me in dealing with clinical emergencies | 0.24 | −0.04 | 0.06 | 0.68 | −0.01 |
| 17. Nursing staff members help me with my clinical work | 0.33 | −0.06 | −0.05 | 0.59 | 0.19 |
| 25. I get along with non-physician medical staff members | 0.23 | −0.04 | −0.21 | 0.56 | 0.01 |
| 7. The knowledge and skills I have learned help me to finish my work | 0.22 | 0.15 | 0.06 | 0.35 | −0.19 |
| 36. I feel stressed when interacting with senior residents | −0.14 | −0.10 | 0.21 | 0.02 | 0.69 |
| 39. Visiting staff don’t trust my clinical decisions because I am a new physician | −0.04 | −0.04 | −0.29 | 0.10 | 0.60 |
| 13. I feel anxious and helpless when my patient is dying | 0.19 | 0.03 | 0.10 | −0.47 | 0.50 |
| 6. I do not have enough confidence in my clinical skills | 0.04 | 0.32 | 0.22 | −0.31 | 0.42 |
| 29. I am unfamiliar with the medical system that helps me take care of patients | 0.01 | 0.38 | 0.26 | −0.29 | 0.34 |
| 12. I feel lonely and helpless when I am on call | −0.03 | 0.06 | 0.07 | −0.01 | 0.32 |
| Cronbach’s | 0.89 | 0.79 | 0.76 | 0.62 | 0.71 |
| Eigen value | 7.42 | 4.37 | 2.68 | 2.12 | 1.57 |
| Explained variances | 19.04% | 11.20% | 6.86% | 5.42% | 4.01% |
Bold numbers denote the loadings of item in each factor.