Developing and validating a tool for measuring the educational environment in clinical anesthesia

  • Navdeep S. SidhuEmail author
  • Eleri Clissold
Reports of Original Investigations



We aimed to develop a contemporary measure for anesthesia teaching and learning in the operating theatre that was applicable to a variety of training jurisdictions, the Measure for the Anaesthesia Theatre Educational Environment (MATE).


A systematic review of the literature and modified Delphi approach was used to identify items for content validity. Reliability and exploratory factor analyses were conducted after a pilot survey of trainees to show construct validity, with removal of redundant items. Item domains were identified through a global assessment of factor structure accuracy and relation to real-world constructs.


Literature review generated an initial 73-item list. A modified Delphi approach with 24 experts identified 44 relevant items. The pilot survey generated 390 responses. Reliability analysis, exploratory factor analysis, and global assessment refined the measure to 33 items. Four domains were identified according to factor structure: teaching preparation and practice, assessment and feedback, procedures and responsibility, and overall atmosphere. The educational environment was rated by trainees at 74.6 ± 15.6% with excellent internal consistency (Cronbach’s α = 0.975).


The MATE survey tool generated valid and reliable scores when measuring the educational environment in the operating theatre. Further research is required to investigate possible differences between the training countries and age of junior doctors and the associated underlying factors. Other researchers are invited to administer the survey and share results within a central database.

Élaboration et validation d’un outil de mesure de l’environnement éducatif en anesthésie clinique



Nous avons cherché à élaborer une mesure contemporaine pour l’enseignement et l’apprentissage de l’anesthésie en salles d’opération qui pourrait être appliquée dans différents cadres de formation : la mesure pour l’environnement éducatif en salle d’anesthésie ou MATE (Measure for the Anaesthesia Theatre Educational Environment).


Une revue systématique des publications et une approche de Delphes modifiée ont servi à identifier les éléments de validation du contenu. Des analyses de fiabilité et de facteurs exploratoires ont été menées après une enquête pilote auprès de stagiaires pour montrer la fiabilité du montage avec la suppression d’éléments redondants. Les domaines d’items ont été identifiés via une évaluation globale de l’exactitude des structures de facteurs et leurs relations avec des montages en situation réelle.


La recherche bibliographique a permis de créer une liste initiale de 73 éléments. Une approche de Delphes modifiée avec 24 experts a identifié 44 éléments pertinents. L’enquête pilote a généré 390 réponses. L’analyse de fiabilité, l’analyse des facteurs exploratoires et l’évaluation globale ont permis d’affiner la mesure à 33 éléments. Quatre domaines ont été identifiés en fonction de la structure des facteurs : préparation et pratique de l’enseignement, évaluation et rétroaction, procédures et responsabilité, et environnement global. Les stagiaires ont attribué à l’environnement éducatif une cote de 74,6 ± 15,6 % avec une excellente homogénéité interne (coefficient α de Cronbach = 0,975).


L’outil d’enquête MATE a généré des scores valides et fiables pour la mesure de l’environnement éducatif en salle d’opération. Des recherches supplémentaires sont nécessaires pour étudier les différences possibles entre les pays de formations, l’âge des jeunes médecins et les facteurs sous-jacents associés. D’autres chercheurs sont invités à administrer l’enquête et à en partager les résultats dans une base de données centrale.



We thank the following individuals for their input: Tom Burrows, Damien Castanelli, Nina Civil, Marlin De Silva, Kirsty Forrest, Alistair Kan, Laura Kwan, David Law, Emelyn Lee, Helen Lindsay, Neil Macdonald, Nola Ng, Lindy Roberts, Ross Scott-Weekly, Natalie Smith, Ben Snow, Melanie Speer, Timothy Starkie, Ghassan Talab, Michael Tan, Kersi Taraporewalla, Jennifer Weller, Eva Wilson, and Caroline Zhou. We also thank the Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network for facilitating survey distribution to New Zealand and Australian trainees and all educational supervisors and residents internationally who engaged in the study.

Declaration of interests

No external funding and no competing interests declared

Editorial responsibility

This submission was handled by Dr. Gregory L. Bryson, Deputy Editor-in-Chief, Canadian Journal of Anesthesia.

Author contributions

Navdeep Sidhu contributed substantially to all aspects of this manuscript, including the conception and design, acquisition, analysis and interpretation of data, and drafting the article. Eleri Clissold contributed substantially to the conception and design of the manuscript, analysis of data, and drafting the article.

Supplementary material

12630_2018_1185_MOESM1_ESM.pdf (142 kb)
Supplementary material 1 (PDF 141 kb)


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Copyright information

© Canadian Anesthesiologists' Society 2018

Authors and Affiliations

  1. 1.Department of Anaesthesia and Perioperative MedicineNorth Shore HospitalAucklandNew Zealand
  2. 2.Institute for Innovation and ImprovementWaitemata District Health BoardAucklandNew Zealand

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