What’s in a learning environment? Recognizing teachers’ roles in shaping a learning environment to support competency

ing environment [6, 7] and ongoing efforts to develop new measures [8]. This rising interest made me wonder where teachers and teaching practice fit in the concept of a learning environment. Schronrock-Adema and colleagues [7], through their review of existing instruments, concluded that the domains of learning environment relate to goal orientation, relationships and organization/regulation. Dijkstra and colleagues [1] wrote statements assessing the learning environment from this framing. While teaching is not explicitly mentioned, the majority of statements used to evaluate the learning environment certainly related to teaching and to learner motivation. This is true for most learning environment instruments. In my opinion, many items in learning environment instruments reflect self-determination theory (SDT). In brief, SDT, as put forth by Ryan and Deci [9] and summarized in medical education by Ten Cate [10], proposes that motivation is based on three needs: mastery, relatedness and autonomy. Mastery inspires learners to drive toward more challenging opportunities. Relatedness allows learners to feel connected and safe in an environment. Autonomy is expressed by an ability to initiate actions of one’s own volition. The Dijkstra items asked about examining performance and reflection (mastery), relationships and interactions with supervisors and peers (relatedness), and independence (autonomy). Teachers, in their role in the learning environment, must teach to support and actively incorporate elements of motivation. Interestingly, Lemley et al. [11] examined the learning environment for the 21st century student using the same lens of SDT. Lemley found that millennial students valued relevance of content, autonomy, having choices, and having connection with their teachers as emphasized by two-way conversations, respect, care, and knowledge of the student. When educators in graduate medical education first focused on competency-based education, I remember a rush to find assessment instruments. I struggled to have those same educators pause long enough to think about how they would teach the competencies they planned to assess. Dijkstra and colleagues [1] in this issue have identified the importance of learning environment in preparing individuals who reported being ready to practice once they left residency. These results will encourage medical educators to include a focus on the learning environment when crafting educational programmes. While that is valuable, I want to raise awareness about how, through teaching, faculty can have a major effect on the learning environment. The finding that learning environment affects achievement has appeared previously in higher education [2] and medical education [3]. In fact, the learning environment has risen to such significance that accrediting bodies have taken note. The Liaison Committee for Medical Education (LCME) [4] requires that schools conduct ‘periodic evaluation of the learning environment.’ The Accreditation Council for Graduate Medical Education uses site visits to assess the learning environment related to the institution’s efforts to engage residents in ‘patient safety; health care quality, including reduction in health care disparities; transitions in care; supervision; duty hours and fatigue management and mitigation; and professionalism’ [5]. This emphasis on learning environment has led to reviews of assessments that capture student and resident perceptions of the learn-