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The blame culture creates unhealthy environment for learning. And this requires behavior modification and training and need to change the attitude not only students but also all stakeholders, this issue could be embedded to culturally accept the process of feedback that may be considered as blaming, may needs further exploration. Nevertheless it is considered a very important barrier for making conducive environment for learning. Indeed it is a lengthy process to change the behavior but need to start from the identification of the problem and supposed that this study is a start-up point. Majority items of PHEEM in our study counted as an average and scored around 2 but these results are better than other studies [6, 8-10] where most of the items received responses below 2 mean score. Conversely, BLU9931 in vivo a few of the responses have crossed the mean value more than three, which means that the residents were more satisfied with some of areas of the learning environment in all sites of study. These areas include that residents have good collaboration and they were given sufficient time to practice actively in educational events, when compared with other study we found almost similar results. There may be an argument that these results perhaps indicated biased response because these items are directly related to their 17-DMAG (Alvespimycin) HCl participation in learning environment. In contrast, the other study that conducted in Medinah doesn��t show the same results but pediatric residents scored high in only one item that is they have the opportunity to provide continuity of care [5]. The overall comparison of the results among published studies indicated that learning environment in eastern region is more conducive, however, may need to have further comparison from other areas of the kingdom to draw any conclusion. The Saudi Commission for Health Specialties may play an important role taking consideration of students�� thoughts for future planning for enhancing the learning BEZ235 cell line environment. We analyzed the questionnaire based on three domains [9-11]; therefore, we found that there is a significant difference (p