OBJECTIVE: There is currently no widely accepted multidimensional School Satisfaction Scale (SSS) for Chinese medical students. To develop and validate the first SSS specifically for medical students in China. Our research sample is from China. This study was conducted in two parts: the first focused on scale development, validity and reliability verification, while the second focused on the analysis of factors influencing school satisfaction. METHODS: The study was conducted in four stages: (a) item generation (a literature review
a pilot test, n = 35
two rounds of the Delphi method, n = 12)
(b) exploratory factor analysis (EFA) and reliability measure, n = 237
(c) confirmatory factor analysis (CFA), n = 446
(d) test-retest reliability, n = 100
predictive validity, n = 290
measurement invariance, n = 444. The content validity was evaluated with Pearson correlation coefficients. Medical students (n = 897) completed a cross-sectional survey. RESULTS: Fifteen questions and four SSS dimensions, including learning satisfaction, interpersonal relationship satisfaction, teaching satisfaction, and service satisfaction. The entire SSS has good reliability (Cronbach's α = 0.916) and validity (0.673-0.783). Logistic regression predictive effects of learning, interpersonal, teaching and service on school satisfaction. And the model has invariance at different majors (p >
0.05). CONCLUSION: This study demonstrated that the SSS has good validity and reliability and is a reliable tool for assessing medical students' school satisfaction in China.