Psychometric analyses and internal consistency of the PHEEM questionnaire to measure the clinical learning environment in the clerkship of a Medical School in Chile

Med Teach. 2009 Jun;31(6):e221-5. doi: 10.1080/01421590902866226.


Background and aims: The Spanish version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was evaluated in this study to determine its psychometric properties, validity and internal consistency to measure the clinical learning environment in the hospital setting of Pontificia Universidad Católica de Chile Medical School's Internship.

Methods: The 40-item PHEEM questionnaire was translated from English to Spanish and retranslated to English. Content validity was tested by a focus group and minor differences in meaning were adjusted. The PHEEM was administered to clerks in years 6 and 7. Construct validity was carried out using exploratory factor analysis followed by a Varimax rotation. Internal consistency was measured using Cronbach's alpha.

Results: A total of 125 out of 220 students responded to the PHEEM. The overall response rate was 56.8% and compliances with each item ranged from 99.2% to 100%. Analyses indicate that five factors instrument accounting for 58% of the variance and internal consistency of the 40-item questionnaire is 0.955 (Cronbach's alpha). The 40-item questionnaire had a mean score of 98.21 +/- 21.2 (maximum score of 160).

Conclusions: The Spanish version of PHEEM is a multidimensional, valid and highly reliable instrument measuring the educational environment among undergraduate medical students working in hospital-based clerkships.

Publication types

  • Validation Study

MeSH terms

  • Chile
  • Clinical Clerkship*
  • Clinical Competence*
  • Focus Groups
  • Humans
  • Internship and Residency
  • Learning
  • Psychometrics
  • Reproducibility of Results
  • Schools, Medical*
  • Surveys and Questionnaires*
  • Teaching