The Impact of Organisational Interventions on Student Perceptions of the Learning Environment: A Repeated Cross-Sectional Study.

Background: The learning environment (LE) refers to the social interactions, organisational culture and physical spaces that shape learners' perceptions and learning. With numerous efforts to measure and improve it, there is still a lack of clearly identified, evidence-based interventions that impact the LE. Our aims were to design LE interventions and measure their effectiveness using a comparison of student responses on the Association of American Medical Colleges Graduation Questionnaire (AAMC GQ).

Approach: Root causes of problems in the LE were identified, and comprehensive interventions were then put in place. Interventions addressed three main categories where problems were identified as follows: faculty development, physician wellness, and the learning climate committee. To evaluate changes postintervention, we utilised a repeated cross-sectional design.

Evaluation: Deidentified item-level response data were analysed and organised as a pre-intervention period (2016-2018) and postintervention period (2021-2023). None of the mistreatment events were statistically significant between the periods, except for "required to perform personal services". However, perceptions of faculty professionalism improved significantly in the postintervention period for all questions except the hidden curriculum (HC).

Implications: Taken together, our results show that large-scale interventions may be effective at improving perceptions of faculty professionalism but have limited effect on frequency of mistreatment events. The hidden curriculum failed to show improvement with our interventions and has been identified as an area of further research and ongoing interventions.