Cross-cultural adaptation and validation of the Indonesian version of the operating room educational environment measure with Indonesian residents.
9 affiliations
- 1Medical Education Master Program, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia. [email protected].
- 2Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, 60132, Indonesia. [email protected].
- 3Faculty of Health, Medicine, and Life Sciences, Universitas Airlangga, Banyuwangi, 68425, Indonesia. [email protected].
- 4Department of Neurosurgery, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, 60132, Indonesia.
- 5Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia.
- 6Medical Education Master Program, Faculty of Medicine, Universitas Airlangga, Surabaya, 60132, Indonesia.
- 7Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Academic General Hospital, Surabaya, 60132, Indonesia.
- 8Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, 10430, Indonesia.
- 9Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
Abstract
Background
Assessing residents' perceptions of the operating room (OR) educational environment is critical for shaping competencies in surgical training and influencing learning outcomes, professional development, and patient safety. Evaluation of these perceptions provides evidence of the effectiveness of teaching, supervision, and teamwork in supporting learning in the OR and helps educators identify areas for improvement in residency programs. The Operating Room Educational Environment Measure (OREEM) is an instrument developed to evaluate learning conditions in the OR. In this study, we aimed to assess the validity, reliability, and cross-cultural applicability of the Indonesian version of the OREEM questionnaire adapted to Indonesian surgical residents.Methods
The original 40-item OREEM was translated into Bahasa Indonesia using a standardized forward and backward translation procedure. Eight experts in surgical education assessed content relevance and clarity based on a contemporary conceptual framework comprising 5 themes and 26 subthemes. The content validity ratio (CVR) and item-level content validity index (I-CVI) were calculated using ratings from 26 experts. Construct validity was examined using exploratory factor analysis (EFA) with Varimax rotation based on responses from 244 residents. Internal consistency reliability was analyzed using Cronbach's alpha and corrected item-total correlations.Results
Thirty-nine items were retained for the final Indonesian version of the OREEM. A total of 21 items exceeded the CVR threshold (≥ 0.37), and 22 achieved acceptable I-CVI values (≥ 0.79). EFA supported a three-factor structure-Teaching and Atmosphere, Learning Opportunities and Workload, and Training, Skills, and Supervision-accounting for 32.34% of the total variance. The overall Cronbach's alpha was 0.887, with 84.6% of items demonstrating corrected item-total correlations above 0.30.Conclusions
The 39-item Indonesian version of the OREEM demonstrated acceptable validity and high internal consistency, suggesting its potential utility as a valid instrument for assessing residents' perceptions of the OR learning environment in Indonesia.
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BibTeX
@article{susilo2026crosscultural,
title = {{Cross-cultural adaptation and validation of the Indonesian version of the operating room educational environment measure with Indonesian residents.}},
author = {Rahadian Indarto Susilo and Erica Medina Ramadhaningtyas and Budi Utomo and Erry Gumilar Dachlan and Diantha Soemantri and Rob J M Groen},
journal = {BMC medical education},
year = {2026},
month = jul,
doi = {10.1186/s12909-026-09673-y},
url = {https://europepmc.org/article/MED/42894219},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Cross-cultural adaptation and validation of the Indonesian version of the operating room educational environment measure with Indonesian residents.
AU - Rahadian Indarto Susilo
AU - Erica Medina Ramadhaningtyas
AU - Budi Utomo
AU - Erry Gumilar Dachlan
AU - Diantha Soemantri
AU - Rob J M Groen
PY - 2026
DA - 2026/07/01
JO - BMC medical education
DO - 10.1186/s12909-026-09673-y
UR - https://europepmc.org/article/MED/42894219
AB - Background Assessing residents' perceptions of the operating room (OR) educational environment is critical for shaping competencies in surgical training and influencing learning outcomes, professional development, and patient safety. Evaluation of these perceptions provides evidence of the effectiveness of teaching, supervision, and teamwork in supporting learning in the OR and helps educators identify areas for improvement in residency programs. The Operating Room Educational Environment Measure (OREEM) is an instrument developed to evaluate learning conditions in the OR. In this study, we aimed to assess the validity, reliability, and cross-cultural applicability of the Indonesian version of the OREEM questionnaire adapted to Indonesian surgical residents.Methods The original 40-item OREEM was translated into Bahasa Indonesia using a standardized forward and backward translation procedure. Eight experts in surgical education assessed content relevance and clarity based on a contemporary conceptual framework comprising 5 themes and 26 subthemes. The content validity ratio (CVR) and item-level content validity index (I-CVI) were calculated using ratings from 26 experts. Construct validity was examined using exploratory factor analysis (EFA) with Varimax rotation based on responses from 244 residents. Internal consistency reliability was analyzed using Cronbach's alpha and corrected item-total correlations.Results Thirty-nine items were retained for the final Indonesian version of the OREEM. A total of 21 items exceeded the CVR threshold (≥ 0.37), and 22 achieved acceptable I-CVI values (≥ 0.79). EFA supported a three-factor structure-Teaching and Atmosphere, Learning Opportunities and Workload, and Training, Skills, and Supervision-accounting for 32.34% of the total variance. The overall Cronbach's alpha was 0.887, with 84.6% of items demonstrating corrected item-total correlations above 0.30.Conclusions The 39-item Indonesian version of the OREEM demonstrated acceptable validity and high internal consistency, suggesting its potential utility as a valid instrument for assessing residents' perceptions of the OR learning environment in Indonesia.
SN - 1472-6920
ER -