Multicenter Study

. 2022 Apr 29:10:825279.

doi: 10.3389/fpubh.2022.825279. eCollection 2022.

Nomograms for Predicting Medical Students' Perceptions of the Learning Environment: Multicenter Evidence From Medical Schools in China

Zhitong Zhou^{1

2

3}, Runzhi Huang^{1

2

3}, Guoyang Zhang⁴, Meiqiong Gong⁵, Shuyuan Xian³, Huabin Yin⁶, Tong Meng⁶, Xiaonan Wang⁷, Yue Wang⁸, Wenfang Chen⁹, Chongyou Zhang¹⁰, Erbin Du¹¹, Min Lin¹², Xin Liu¹³, Qing Lin¹⁴, Shizhao Ji¹⁵, Hongbin Wu¹⁶, Zongqiang Huang¹⁷, Jie Zhang^{1

2

3}

Affiliations

¹ Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
² Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
³ Tongji University School of Medicine, Shanghai, China.
⁴ School of Education, Shanghai Jiao Tong University, Shanghai, China.
⁵ Office of Educational Administration, Shanghai University, Shanghai, China.
⁶ Department of Orthopedics, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁷ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
⁸ Department of Health Statistics, School of Public Health, The Forth Military Medical University of PLA, Xi'an, China.
⁹ Faculty of Medicine, Jinggangshan University, Ji'An, China.
¹⁰ Center of Science and Technology Research and Development and Industrial Management, Harbin Medical University, Heilongjiang, China.
¹¹ Frist Clinical Medical College, Mudanjiang Medical University, Mudanjiang, China.
¹² Mental Health Education and Consultation Center, Chongqing Medical University, Chongqing, China.
¹³ Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
¹⁴ Department of Human Anatomy, Laboratory of Clinical Applied Anatomy, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.
¹⁵ Department of Burns, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
¹⁶ Institute of Medical Education/National Centre for Health Professions Education Development, Peking University, Beijing, China.
¹⁷ Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

PMID: 35570958
PMCID: PMC9099049
DOI: 10.3389/fpubh.2022.825279

Multicenter Study

Nomograms for Predicting Medical Students' Perceptions of the Learning Environment: Multicenter Evidence From Medical Schools in China

Zhitong Zhou et al. Front Public Health. 2022.

. 2022 Apr 29:10:825279.

doi: 10.3389/fpubh.2022.825279. eCollection 2022.

Authors

Affiliations

¹ Department of Gynecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
² Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Orthopaedic Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
³ Tongji University School of Medicine, Shanghai, China.
⁴ School of Education, Shanghai Jiao Tong University, Shanghai, China.
⁵ Office of Educational Administration, Shanghai University, Shanghai, China.
⁶ Department of Orthopedics, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁷ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
⁸ Department of Health Statistics, School of Public Health, The Forth Military Medical University of PLA, Xi'an, China.
⁹ Faculty of Medicine, Jinggangshan University, Ji'An, China.
¹⁰ Center of Science and Technology Research and Development and Industrial Management, Harbin Medical University, Heilongjiang, China.
¹¹ Frist Clinical Medical College, Mudanjiang Medical University, Mudanjiang, China.
¹² Mental Health Education and Consultation Center, Chongqing Medical University, Chongqing, China.
¹³ Department of Rheumatology and Immunology, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
¹⁴ Department of Human Anatomy, Laboratory of Clinical Applied Anatomy, School of Basic Medical Sciences, Fujian Medical University, Fuzhou, China.
¹⁵ Department of Burns, The First Affiliated Hospital of Naval Medical University, Shanghai, China.
¹⁶ Institute of Medical Education/National Centre for Health Professions Education Development, Peking University, Beijing, China.
¹⁷ Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

PMID: 35570958
PMCID: PMC9099049
DOI: 10.3389/fpubh.2022.825279

Abstract

Medical students' perceptions of the medical school learning environment (MSLE) have an important impact on their professional development, and physical and mental health. Few studies reported potential factors that influenced medical students' perceptions of MSLE. Thus, the main goal of this study was to identify influencing factors for medical students' perception levels of MSLE. The perception levels of MSLE were assessed by the Johns Hopkins Learning Environment Scale. The univariate and multivariate logistic regression analyses were performed to identify significant predictors for the perceptions of MSLE. The nomograms were established to predict medical students' perception levels of MSLE. In the multivariate logistic regression model, gender, university category, grade, mother education level, learning environment of schools, interests in medicine, and Kolb learning experience were significantly associated with medical students' perceptions of MSLE. Correspondently, the nomograms were built based on significant variables identified by the univariate logistic regression analysis. The validation of the nomograms showed that the model had promising predictive accuracy, discrimination, and accordance (area under the curve (AUC) = 0.751). This study identified influencing factors of medical students' perceptions of MSLE. It is essential to implement corresponding interventions to improve medical students' perceptions.

Keywords: learning environment; medical students; nomograms; perceptions; prediction.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Heatmap of the baseline characteristics of the participants. GPA, grade point average; JHLES, Johns Hopkins Learning Environment Scale.

**Figure 2**
Nomograms of predicting medical students' perceptions of MSLE. MSLE, medical school learning environment; JHLES, Johns Hopkins Learning Environment Scale.

**Figure 3**
Validation of the nomograms. **(A)** DCA of the nomograms. Medical students had higher net benefit when high JHLES probability was >0.25. **(B)** The ROC curve of the nomograms. The ROC curve showed that the predictive model had potential predictive discrimination and accuracy (Total set AUC = 0.751, Train set AUC = 0.749, Test set AUC = 0.756). **(C)** The calibration curve of the nomograms. DCA, decision curve analysis; JHLES, Johns Hopkins Learning Environment Scale; ROC, receiver operating characteristic; AUC, area under the curve.

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Nomograms for Predicting Medical Students' Perceptions of the Learning Environment: Multicenter Evidence From Medical Schools in China

Affiliations

Nomograms for Predicting Medical Students' Perceptions of the Learning Environment: Multicenter Evidence From Medical Schools in China

Authors

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Abstract

Conflict of interest statement

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