Initial Development of Items
We identified The Surgical Learning Educational Environment Measure (9) and used this as a starting point in the development of our instrument. This questionnaire developed by Cassar was principally aimed at basic surgical trainees, we therefore removed the items that are less relevant to higher surgical trainees. Further changes were made after reviewing the Anaesthetic Theatre Educational Environment Measure (8), the Postgraduate Hospital Education Environment Measure (7) and the Dundee Ready Education Environment Measure (10). The initial items for inclusion in our own questionnaire were then put through a validation process initially with a focus group.