The development and validation of a questionnaire to explore medical students' learning in a blended learning environment.

Background: A blended learning environment is multifaceted and widely used in medical education. However, there is no validated instrument for exploring students' learning in a blended learning environment in medical programs. This study aimed to develop and validate an instrument for exploring how medical students learn in an undergraduate medical program that employs a blended learning approach.

Method: Using Artino's seven step approach, we developed a questionnaire to investigate how medical students learn in a blended learning environment. For pilot testing, 120 students completed this 19-item questionnaire. These 19-items were evaluated for construct and convergent validity across an expert medical education panel. Further item testing was analysed with principal component analysis (PCA) with varimax rotation for item reduction and factor estimation. Hence, validity was thoroughly addressed to ensure the questionnaire was representative of the key focus questions. Cronbach's Alpha was used for item reliability testing, and Spearman's Rho was used for the correlation between the questionnaire items and the extensively used MSLQ. Hence, validity and reliability were systematically addressed.

Results: Exploratory Factor analysis identified four factors F1 and F3: Resources: Accessibility & Guidance (14-items), F2: Learning behaviours: Social and Contextual (5-items), and F4: Motivational factors: Intrinsic and Extrinsic Motivation (4-items). Internal consistency and reliability tests were satisfactory (Cronbach's Alpha ranged from 0.764 to 0.770).

Conclusions: The resulting Blended Learning Questionnaire (BLQ) was determined to be a reliable instrument to explore undergraduate medical students' learning in a blended learning environment.