Open Access Research article

Training satisfaction for subspecialty fellows in internal medicine: Findings from the Veterans Affairs (VA) Learners' Perceptions Survey

Catherine P Kaminetzky12*, Sheri A Keitz34, T Michael Kashner56, David C Aron78, John M Byrne69, Barbara K Chang5, Christopher Clarke5, Stuart C Gilman5, Gloria J Holland5, Annie Wicker105 and Grant W Cannon1112

Author Affiliations

1 Department of Medicine, Duke University, Durham NC, USA

2 Department of Education, Durham VA Medical Center, Durham NC, USA

3 Department of Medicine, Miami VA Health Care System, Miami FL, USA

4 Department of Medicine, University of Miami Miller School of Medicine, Miami FL, USA

5 Office of Academic Affiliations, Veterans Health Administration, Washington DC, USA

6 Department of Medicine, Loma Linda University School of Medicine, Loma Linda CA, USA

7 Education Office, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland OH, USA

8 Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA

9 Department of Education, Loma Linda VA Medical Center, Loma Linda CA, USA

10 Center for Advanced Statistics in Education, Loma Linda VA Health Care System, Loma Linda CA, USA

11 Department of Education, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA

12 Division of Rheumatology, University of Utah School of Medicine, Salt Lake City UT, USA

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BMC Medical Education 2011, 11:21  doi:10.1186/1472-6920-11-21

Published: 17 May 2011



Learner satisfaction assessment is critical in the design and improvement of training programs. However, little is known about what influences satisfaction and whether trainee specialty is correlated. A national comparison of satisfaction among internal medicine subspecialty fellows in the Department of Veterans Affairs (VA) provides a unique opportunity to examine educational factors associated with learner satisfaction. We compared satisfaction across internal medicine fellows by subspecialty and compared factors associated with satisfaction between procedural versus non-procedural subspecialty fellows, using data from the Learners' Perceptions Survey (LPS), a validated survey tool.


We surveyed 2,221 internal medicine subspecialty fellows rotating through VA between 2001 and 2008. Learners rated their overall training satisfaction on a 100-point scale, and on a five-point Likert scale ranked satisfaction with items within six educational domains: learning, clinical, working and physical environments; personal experience; and clinical faculty/preceptor.


Procedural and non-procedural fellows reported similar overall satisfaction scores (81.2 and 81.6). Non-procedural fellows reported higher satisfaction with 79 of 81 items within the 6 domains and with the domain of physical environment (4.06 vs. 3.85, p <0.001). Satisfaction with clinical faculty/preceptor and personal experience had the strongest impact on overall satisfaction for both. Procedural fellows reported lower satisfaction with physical environment.


Internal medicine fellows are highly satisfied with their VA training. Nonprocedural fellows reported higher satisfaction with most items. For both procedural and non-procedural fellows, clinical faculty/preceptor and personal experience have the strongest impact on overall satisfaction.