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Belongingness is a key factor that influences learner development and wellbeing but no previous research has been performed to evaluate perceived belongingness in medical students whilst on their placements. Method: The Belongingness Scale-Clinical Placement Experience (BES-CPE) for nursing students was adapted for use with medical students. Following a face validity assessment, 490 undergraduate medical students in years three to five at a UK university were invited to participate and 302 completed the adapted questionnaire. The factor structure wasexplored using Exploratory Factor Analysis (EFA) with Principal Component Analysis (PCA) and internal consistency was assessed using Cronbach’s alpha. Results: A three-component structure was identified (Esteem, Connectedness, and Efficacy), which was aligned to the original theoretical model underpinning the scale, and the instrument had high internal consistency. Four items were discarded and the final adapted version had a total of 30. Conclusions: The adapted BES-CPE instrument for medical students in our sample of UK undergraduate medical students had an appropriate factor structure and high internal consistency. This context-specific instrument can be used for future research as a valid instrument to measure the role of belongingness in medical education and to support developing belongingness in medical students during clinical placements.

Belongingness is well recognized within higher education as having an important influence on the performance and wellbeing of learners but there appears to be little awareness of the importance of belongingness in undergraduate health professions education. Aim: To identify how belongingness has been defined, how belongingness has been measured, the impact of belongingness on the performance and well being of learners, and how belongingness can be fostered in educational settings. Methods A scoping review to map the published research in the wider higher education literature (including undergraduate health professions education). PubMed and ERIC were searched. Only peer reviewed articles in the English Language between 1996 and 2016 were included. Results Fifty one relevant articles were identified with 16 related to nurse clinical education. No studies were identified in undergraduate medical education or in primary care educational settings. There are common features in the several definitions of belongingness. A thematic analysis of articles revealed that belongingness has an important role in student motivation and learning, identity formation, and in facilitating positive mental health. Discussion The scoping review highlighted the importance of belongingness in higher education and also undergraduate health professions education, with implications for future practice and policy. Further research is recommended since there are important implications for curriculum development and delivery, including clinical placements; within medical education and primary care education.

Introduction Ethnic minority (EM) medical students in the United Kingdom underperform academically compared to their Caucasian counterparts, but the reasons are unclear and further understanding is required. Aim To explore self-reported factors that might influence academic underperformance of EM medical students. Method An online semi-structured questionnaire was used to identify associations between several dimensions that had been identified in previous research and obtain free-text comments. Results Three-hundred and fifty-one medical students (73.3% Caucasian and 26.5% EM) from the Universities of Sheffield, Keele and London responded. EM medical students were less satisfied with their academic performance and less likely to feel they belonged to the medical school community due to their cultural background, including socio-economic factors. Conclusion Differences exist between EM and Caucasian medical students in their learning experiences in medical school. There is a need to increase awareness, for both medical students and teaching staff, of the impact of cultural diversity on academic performance at medical school.