Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement

The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.

Rheumatology Fellows Report Higher Satisfaction with VA-Based Training in Comparison to Other Internal Medicine Subspecialty Fellows

Cannon1,  Grant W., Kashner2,  T. Michael

VAMC and University of Utah. Salt Lake City, UT,
VA Office of Academic Affiliations and University of Texas Southwestern. Dallas


The Learners' Perception Survey (LPS) has been administered to trainees at Veterans Affairs (VA) medical centers since 2001. This validated survey assesses overall trainee satisfaction (OTS) on a 100 point scale with the higher score representing higher satisfaction. Using five point Likert scales, trainees also rated their experience in six domains listed in table 1. Each domain contained between 12 and 15 items (total 81). Domains and items were assessed as 1 = very satisfied, 2 = somewhat satisfied, 3 = neither, 4 = somewhat dissatisfied, 5 = very dissatisfied. Lower scores represent higher levels of satisfaction.


This analysis compared the LPS results for rheumatology (Rheum) fellows to other internal medicine subspecialty (Other) fellows during VA-based training for OTS, domain scores, and items scores. These results were adjusted for year of survey, year of training, and VA facility. Ratings are shown as mean ± standard error.


The OTS for Rheum fellows (n= 109) was 84.1±1.3 in comparison to other fellows 81.3±1.3 (n=2,112) (p<0.03). For each of the domains, rheumatology fellows reported higher levels of satisfaction (Table 1).

 Rheum FellowsOther Fellowsp-value
Clinical Faculty (CF)1.50±0.081.62±0.090.166
Personal Experience (PEx)1.53±0.081.70±0.080.037
Learning Environment (LE)1.69±0.091.86±0.090.053
Working Environment (WE)1.70±0.091.94±0.090.013
Clinical Environment (CE)1.75±0.102.05±0.100.004
Physical Environment (PEn)1.81±0.092.01±0.090.027

Rheum fellows reported higher satisfaction with 78 (96%) of the 81 elements within the 6 domains. The ten elements with highest satisfaction for Rheum fellows during VA training are listed in table 2.

 Rheum FellowsOther Fellowsp-value
CF-Clinical Skills1.31±0.071.52±0.070.005
CF-Quality of faculty1.35±0.091.57±0.090.012
PEx-Relationship with patients1.37±0.071.44±0.070.310
CF-Teaching ability1.39±0.071.61±0.070.011
CE-Hours at work1.41±0.081.61±0.080.013
LE-Degree of autonomy1.41±0.071.44±0.070.690
CF-Interest in teaching1.43±0.091.61±0.090.044
PEx-Appreciation by patients1.43±0.072.14±0.070.339

In an analysis of the impact of changes in domain scores and items scores on OST, all domains and items showed association with satisfaction score. The domains changes associated with the greatest OTS scores were personal experience, working environment and clinical environment.


Rheumatology fellows report higher training satisfaction with VA based training than other subspecialty fellows. Satisfaction with clinical faculty and personal experience was highest for the domains tested. Since working environment, personal experience, and clinical environment are most strongly associated with trainee satisfaction, these domains may have high potential for improving trainee satisfaction.

To cite this abstract, please use the following information:
Cannon, Grant W., Kashner, T. Michael; Rheumatology Fellows Report Higher Satisfaction with VA-Based Training in Comparison to Other Internal Medicine Subspecialty Fellows [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1223
DOI: 10.1002/art.26297

Abstract Supplement

Meeting Menu