ASSESSMENT OF EDUCATIONAL ENVIRONMENT FOR RESIDENTS AT KING ABDUL AZIZ UNIVERSITY HOSPITAL (KAUH) USING POSTGRADUATE HOSPITAL EDUCATION ENVIRONMENT MEASURE (PHEEM) 2010-2011Nadia Fida1, Basem S. Eldeek2, Nasra N. Ayuob3, Reem A. Alafari4, Mazen A. Ismail5

Professor of Pediatrics ,1 Associate professor of Community Medicine, 2

Assistant professor of Histology3, Lecturer in Medical Education 4, Demonstrator in Medical Education 5

Medical Education Department, Faculty of Medicine , King Abdulaziz University.

Introduction:

The educational environment is an important determinant of students' achievements, satisfaction and success. Thus, understanding these educational environments and sub-environments is fundamental to curriculum reform.

PHEEM is a practical, simple and

reliable tool to assess and compare the educational environment in a country that is culturally different from where it was originally constructed. This study was conducted to assess the quality of the educational environment as perceived by residents in KAUH.

Methods:

This study was approved by the research ethics

committee at the Faculty of Medicine KAU. This comparative cross-sectional study was conducted amongst all residents at KAUH (n=201) using the Postgraduate Hospital Educational Environmental Measure (PHEEM) questionnaire.

PHEEM was designed to measure specific component of the educational environment, it included forty-items categorized under three groups or domains measuring the residents’ perception of the role autonomy, teaching and social support provided in the major four clinical departments of KAUH (Internal Medicine, Surgery, Obstetrics and Gynecology and pediatrics).

Results

Out of 201 residents, 137 (68%) completed the questionnaires. The psychometric properties of PHEEM had a high degree of internal reliability (alpha cronbach =0.78) in assessing the educational environment of residents at KAUH.

It was found that the total cumulative

score of the three domains of the questionnaire was significantly higher in the obstetrics and gynecology department (89±5.2) while, Medicine had significant higher score in the role autonomy domain compared to the both Surgery and Pediatrics.

It was found that the four studied departments showed a more positive perception of one’s role and they are moving in the right direction regarding teaching ,while they were seen “Not a pleasant place” regarding ( social support) they provided and overall they were considered “More positive than negative, but there is a room for improvement” regarding the learning environment.

There was no statistical significant difference in mean score of the items of the role of autonomy domain between the four studied departments see Table (3).

Table (3) Perception of residents in the major departments' about role autonomy in KAU:

Table (3) Perception of residents in the major departments' about role autonomy in KAU:

In the teaching domain, there was significant increase in the mean score of the item 30 “The clinical teachers provide me with good feedback on my strengths and weaknesses´ in both Surgery and Medicine compared to the obstetrics and gynecology see Table (4).

Table (4) Perception of residents of the major departments about teaching in KAUH.

Table (5) Perception of the major departments' residents about social support in KAUH.

Conclusion :

The high reliability index and factor analysis ensure that PHEEM is a valid and a reliable tool to measure the satisfaction of residents toward the educational environment at KAUH.

The mean score of almost all items was low and many items of the three domains were below 2 which indicated a problem area and hence mandate future plans for improvement.

Recommendations:

Some improvement and frequent workshops in how to give effective feedback are needed in Pediatrics and OB/Gyn.

Any social issues should be addressed as early as possible and more social support should be provided . Residents who are not finding a good support will lack motivation and confidence and this will affect them to become competent physicians.

Action plans toward gender discrimination are needed to be implemented

Develop some skills for the senior and junior doctors to understand and apply the concept of mentoring within each department in the hospital.

Improving the educational system will give opportunities for a dialogue between consultants and trainees which would be of an educational benefit in itself(15)

 

References:

1)Mohanna K, Wall D, Chambers R. Educational Concepts: the theory behind the practical aspects of teaching andearning. Teaching made easy: a manual for health professionals 2nd ed. Oxon, United Kingdom: Radcliffe Publishing; 2004. 45.

2)Clapham M, Wall D, Batchelor A. Educational environment in intensive care medicine--use of Postgraduate Hospital Educational Environment Measure (PHEEM). Med Teach 2007. Sep; 29(6):e184-91.

3)Pinnock R, Reed P, Wright M. The learning environment of paediatric trainees in New Zealand. J Paediatr Child Health 2009; 45(9):529-34.

4)Taguchi N, Ogawa T, Sasahara H. Japanese dental trainees' perceptions of educational environment in postgraduate training. Med Teach 2008; 30(7):e189-93.

5) Sami A. Algadi. Assessment of educational environment measure for PHEEM. JTU Med Sc 2010;5

6)Aspegren K, Bastholt L, Bested KM, Bonnesen T, Ejlersen E, Fog I, et al. Validation of the PHEEM instrument in a Danish hospital setting. Med Teach 2007; 29(5):498-500.

7)Algaidi SA. Assessment of Educational Environment for Interns Using Postgraduate Hospital Educational Environment Measure (PHEEM) J T U Med Sc 2010; 5(1): 1-12.

8)Genn JM. AMEE Medical Education Guide No. 23 (Part 1): Curriculum, environment, climate, quality and change in medical education – a unifying perspective. Med Teach 2001;23: 337-44.

Harden RM. The learning environment and the curriculum. Med Teach 2001;23:335-6.

9)Al-Hazimi A, Al-Hyiani A, Roff S. Perceptions of the educational environment of the medical school in King Abdul Aziz University,saudi Arabia. Med Teach. 2004a Sep ;26 (6):570-3 15763838 Cit:3

10)Al-Hazimi A, Zaini R, Al-Hyiani A, Hassan N, Gunaid A, Ponnamperuma G, Karunathilake I, Roff S, McAleer S, Davis M. Educational environment in traditional and innovative medical schools: A study in four undergraduate medical schools. Educ Health (Abingdon) 2004b; 17(2): 192-203.

11)Roff S, McAleer S, Skinner A. Development and validation of an instrument to measure the postgraduate clinical learning and teaching educational environment for hospital based junior doctors in the UK. Med Teach 2005; 27(4):326-331.

12)Clapham M, Wall D, Batchelor A. Educational environment in intensive care medicine--use of Postgraduate Hospital Educational Environment

Measure (PHEEM). Med Teach 2007 Sep; 29(6):e184-91.

13)Cronbach L J. Coefficient alpha and internal structure of tests Pscycometrika 1951; 16:297-334.

14)Levey RE. Sources of stress for residents and recommendations for programs to assist them. Acad Med. 2001;76:142–5.

15)M.Baker and P.B Sprackling. The educational component of senior house officer posts: differences in the perceptions of consultants and junior doctors. Post grad Med J (1994) 70, 198-202

 

Thank you