Cross-validation of a learning climate instrument in a non-western postgraduate clinical environment

Jaime L. Pacifico, Cees P.M. Van Der Vleuten, Arno M.M. Muijtjens, Erlyn A. Sana, Sylvia Heeneman

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: In postgraduate training, there is a need to continuously assess the learning and working conditions to optimize learning. Students or trainees respond to the learning climate as they perceive it. The Dutch Residency Educational Climate Test (D-RECT) is a learning climate measurement tool with well-substantiated validity. However, it was originally designed for Dutch postgraduate trainees and it remains to be shown whether extrapolation to non-Western settings is viable. The dual objective of this study was to revalidate D-RECT outside of a Western setting and to evaluate the factor structure of a recently revised version of the D-RECT containing 35 items.

Methods: We invited Filipino internal medicine residents from 96 hospitals to complete the revised 35-item D-RECT. Subsequently, we performed a confirmatory factor analysis to check the fit of the 9 scale model of the revised 35-item D-RECT. Inter-rater reliability was assessed using generalizability theory.

Results: Confirmatory factor analysis unveiled that the factor structure of the revised 35-item D-RECT provided a reasonable fit to the Filipino data, after removal of 7 items. Five to seven evaluations of individual residents were needed per scale to obtain a reliable result.

Conclusion: Even in a non-Western setting, the D-RECT exhibited psychometric validity. This study validated the factor structure of the revised 35-item D-RECT after some modifications. We recommend that its application be extended to other Asian countries and specialties.

Original languageEnglish
Article number22
Number of pages7
JournalBMC Medical Education
Publication statusPublished - 25 Jan 2018
Externally publishedYes

Bibliographical note

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


  • Cross-cultural validation
  • Educational climate
  • Learning climate
  • Learning climate measurement tool
  • Postgraduate medical education


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