Development and validation of instruments to measure residents and faculty perceptions of learning environment in the operating room at Aga Khan University, Pakistan

Date of Award


Document Type


Degree Name

Master of Health Professions Education (MPHE)


Educational Development


The operating room learning environment is an essential component of any surgical residency programme and provides a basis for the developing surgeon's competence in surgical skills. Faculty's and residents' perceptions regarding learning environment in the OR serve as quality indicator of the teaching and learning within this important venue. The objective of this study was to develop a valid instrument that could be used to measure perceptions of both the faculty and the residents regarding*OR learning environment. Methodology: Two instruments were developed for the study. Initial item generation for the instruments was done using Nominal Group Technique. Some items were added from OREEM with modifications to suit local context. The two draft instruments, each. with 26 items, reworded according to faculty and residents, were subjected to translational and construct validity, and internal consistency calculated. Result: The scale content validity indices for clarity and relevance for both the instruments were found to be 0.91 for clarity and 0.92 for relevance for both the instruments. Ninety residents and 78 faculty members completed the questionnaires. Multiple criteria used for the factorability suggested suitability of all the items for factor analysis. The principle factor analysis with varimax rotation resulted in three-factor solution for the instruments explaining 42% and 48% of the total variance for the faculty and resident version of the instruments. The final 22-item instrument had Cronbach's alpha of 0.67 and 0.7 for the faculty & resident versions respectively. Conclusion: The 'Operating room educational environment scale' (OREES) with faculty (OREES-F) and resident (OREES-R) versions was developed to measure faculty's and residents' perceptions respectively regarding the operating room learning environment. Both the instruments with 22 items have good translational and construct validity and reliability and could be used to identify areas requiring improvement thus ensuring optimal learning experience in OR.

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