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Acad Med. 2016 Sep;91(9):1263-9. doi: 10.1097/ACM.0000000000001214.

Medical Student Perceptions of the Learning Environment: Learning Communities Are Associated With a More Positive Learning Environment in a Multi-Institutional Medical School Study.

Author information

S.D. Smith is associate clinical professor, Department of Family Medicine and Public Health, University of California, San Diego, School of Medicine, San Diego, California. L. Dunham is data analyst II, Medical Education Outcomes, American Medical Association, Chicago, Illinois. M. Dekhtyar is research associate, Medical Education Outcomes, American Medical Association, Chicago, Illinois. A. Dinh is institutional research analyst, Office of Institutional Research, Evaluation, and Assessment, University of Massachusetts Medical School, Worcester, Massachusetts. P.N. Lanken is professor of medicine and medical ethics and health policy and associate dean for professionalism and humanism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania. K.F. Moynahan is professor and deputy dean for education, Department of Medicine, University of Arizona College of Medicine, Tucson, Arizona. M.L. Stuber is professor and assistant dean for well-being and career advising, Department of Psychiatry, David Geffen Medical School, University of California, Los Angeles, California. S.E. Skochelak is group vice president, Medical Education, American Medical Association, Chicago, Illinois.



Many medical schools have implemented learning communities (LCs) to improve the learning environment (LE) for students. The authors conducted this study to determine whether a relationship exists between medical student perceptions of the LE and presence of LCs during the preclerkship years.


Students from 24 schools participating in the American Medical Association Learning Environment Study completed the 17-item Medical Student Learning Environment Survey (MSLES) at the end of their first and second years of medical school between 2011 and 2013. Mean total MSLES scores and individual item scores at the end of the first and second years in schools with and without LCs were compared with t tests, and effect sizes were calculated. Mixed-effects longitudinal models were used to control for student demographics and random school and student effects on the relationship between LC status and MSLES score.


A total of 4,980 students (81% of 6,148 matriculants) from 18 schools with LCs and 6 without LCs participated. Mean [SD] MSLES scores were significantly higher in LC schools compared with non-LC schools at the end of year one (3.72 [0.44] versus 3.57 [0.43], P < .001) and year two (3.69 [0.49] versus 3.42 [0.54], P < .001). The effect size increased from 0.35 (small) at the end of year one to 0.53 (medium) at the end of year two.


This large multi-institutional cohort study found that LCs at medical schools were associated with more positive perceptions of the LE by preclerkship students.

[Indexed for MEDLINE]

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