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Alahmadi AM, Albaz NK, Alharbi NS. Evaluation of learning environment of different family medicine programs, Jeddah-KSA, 2021. J Family Med Prim Care 2023; 12:551-555. [PMID: 37122656 PMCID: PMC10131954 DOI: 10.4103/jfmpc.jfmpc_1378_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/11/2022] [Accepted: 12/22/2022] [Indexed: 05/02/2023] Open
Abstract
Background A supportive educational climate in which learners are educated and monitored is a significant determinant of the medical trainees' performance and progress and eventually contributes to better patient care. Therefore, residents' training programs need to be assessed and incorporated according to the views and expectations of the candidates. The objectives of this research are to compare and evaluate the learning environment of Family Medicine (FM) programs in Jeddah and make practical recommendations for improvement of the learning environment. Methods A descriptive causal-comparative study was designed at FM programs in Jeddah, Saudi Arabia during January, and February 2021, including all residents from R1 to R4. A Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire was used in this study. The overall score and the three domains were calculated. Results Two hundred and eighty-three questionnaires were distributed, and 262 were completed and collected, making a response rate of 92.6%. Females represented were 150 (57.3%), and males were 112 (42.7%). The study shows that 78 (29.8%) of the residents reported that the learning environment was excellent, and 154 (58.8%) described it as a more positive than the negative environment, whereas 29 (11.1%) described it as having a lot of problems. Out of 160 maximum scores, the highest total score (127) was observed among residents at the National Guard program, whereas the lowest score (108) was in the FM joint program, P < 0.001. Conclusion Evaluation of the training programs is an essential component of quality assurance procedures. The satisfaction of the FM residents at different programs in Jeddah, Saudi Arabia, is better than reported previously, but however, further improvement is warranted. Juniors and residents of the National Guard program were more satisfied than their peers. We recommend low score items should have special consideration from high authorities and ongoing evaluation of the FM training program for further improvement of the learning environment.
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Affiliation(s)
- Abeer M. Alahmadi
- Departmemt of Family Medicine, Joint Program of Postgraduate Studies in Family Medicine, Jeddah, Saudi Arabia
- Address for correspondence: Dr. Abeer M. Alahmadi, Consultant, Joint Program of Postgraduate Studies in Family Medicine – Jeddah, Saudi Arabia. E-mail:
| | - Noof K. Albaz
- Departmemt of Family Medicine, Joint Program of Postgraduate Studies in Family Medicine, Jeddah, Saudi Arabia
| | - Nouf S. Alharbi
- Departmemt of Family Medicine, Joint Program of Postgraduate Studies in Family Medicine, Jeddah, Saudi Arabia
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Berrani H, Abouqal R, Izgua AT. Moroccan residents' perception of hospital learning environment measured with French version of the postgraduate hospital educational environment measure. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2020; 17:4. [PMID: 32000301 PMCID: PMC7062605 DOI: 10.3352/jeehp.2020.17.4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 01/31/2020] [Indexed: 06/10/2023]
Abstract
PURPOSE This study aimed to assess the educational environment of resident in Morocco and to compare the residents' perception depending on their specialties. METHODS We applied the French version of the postgraduate hospital educational environment measure (PHEEM) to measure the educational environment in 6 hospitals in Rabat from January to June 2017. Internal reliability of the questionnaire was assessed using Cronbach's alpha coefficient. Principal component analysis was conducted to assess the construct validity of the three subscales of the PHEEM questionnaire. Variance analysis (ANOVA test) was performed to compare means of PHEEM overall, subscale, and each item score among 6 specialties. RESULTS The response of 255 resident was included. The 40 items PHEEM questionnaire showed reliability with a Cronbach's alpha of 0.91. Principal component analysis on all 40 items suggested three factors explaining 48% of the variance with better results for the teaching subscale. Moroccan resident perceived their educational environment as more positive than negative. There was a significant difference in the overall and subscales score among the 6 specialties. CONCLUSION French version of the PHEEM score is a valid and reliable instrument in Morocco. Moroccan resident perceived their educational environment as more positive than negative but room for improvement of many challenges particularly the poor infrastructure, the suboptimal quality of supervision, and teaching and inadequate work regulation remained.
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Affiliation(s)
- Hajar Berrani
- Pediatrics Department, Faculty of Medicine and Pharmacy, Mohammed V University-Rabat, Rabat, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy, Mohammed V University-Rabat, Rabat, Morocco
| | - Amal Thimou Izgua
- Pediatrics Department, Faculty of Medicine and Pharmacy, Mohammed V University-Rabat, Rabat, Morocco
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Lydon S, Byrne D, Vellinga A, Walsh C, Madden C, Connolly F, O'Connor P. A Mixed-Methods Exploration of the Educational Climate and Safety Climate During the First Year of Clinical Practice in Ireland. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:1800-1805. [PMID: 31169543 DOI: 10.1097/acm.0000000000002818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Educational climate (EC) and safety climate (SC) are key determinants of residents' professional development. The goal of this study was to gather longitudinal EC data and data on perceptions of SC in residency, and provide data on practices related to perceptions of EC and SC, by identifying factors associated with and changes in perceptions of EC and SC across the first year of practice, and elucidating good and poor practice relating to key elements of EC and SC. METHOD A mixed-methods design was adopted. First, 131 first-year residents in Ireland were surveyed at the end of each of their first 3 rotations (August 2016-March 2017). The survey measured EC and SC using established measures. Next, 69 semistructured interviews were conducted with a representative sample of residents (March-May 2017). An interview schedule was developed to aid in-depth probing of EC and SC perceptions. A deductive content analysis approach was adopted. RESULTS Perceptions of EC worsened over time. The EC and SC of surgical rotations were significantly poorer than those of medical rotations. Residents were more likely to describe team practices, rather than organizational practices, that contributed positively to their perceptions of EC and SC. CONCLUSIONS Further research is necessary to facilitate improvement of EC and SC for residents, particularly within surgical training. Future research exploring the contribution of organizational practices to EC and SC, the impact of targeted improvement activities, and best practices for involving residents in quality and safety initiatives is recommended.
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Affiliation(s)
- Sinéad Lydon
- S. Lydon is behavioral psychologist and lecturer in quality and patient safety, School of Medicine, National University of Ireland Galway, Galway, Ireland. D. Byrne is professor of health care simulation, School of Medicine, National University of Ireland Galway, and director of simulation, Saolta University Health Care Group, Galway, Ireland. A. Vellinga is epidemiologist and lecturer in primary care and in bacteriology, School of Medicine, National University of Ireland Galway, Galway, Ireland. C. Walsh is a PhD candidate, Discipline of General Practice, National University of Ireland Galway, Galway, Ireland. C. Madden is a PhD candidate, Discipline of General Practice, National University of Ireland Galway, Galway, Ireland. F. Connolly is research assistant, Department of Health Systems, University College Dublin, Dublin, Ireland. P. O'Connor is human factors psychologist and lecturer in primary care, Discipline of General Practice, National University of Ireland Galway, Galway, Ireland
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Ong AML, Fong WWS, Chan AKW, Phua GC, Tham CK. Evaluating the educational environment in a residency programme in Singapore: can we help reduce burnout rates? Singapore Med J 2019; 61:476-482. [PMID: 31388684 DOI: 10.11622/smedj.2019094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The educational environment (EE) reflects the quality of a residency programme and has an association with burnout. Studying the EE allows for interventions to target specific weaknesses. We aimed to measure the EE of an internal medicine residency programme in Singapore, compare the perceptions between genders, residency grades and levels of work experience, and identify specific areas of weaknesses for intervention in hopes of reducing residency burnout rates in Singapore. METHODS This study took place between October and December 2017. We adopted a mixed methods approach, quantitatively using the Postgraduate Hospital Educational Environment Measure (PHEEM), and qualitative exploration using semi-structured focus group discussion. RESULTS A total of 136 (88.9%) out of 153 residents responded. Our total PHEEM scores (112.23 ± 16.71), along with the scores for all three subscales, were higher than those of institutions in previous studies. There were no differences in overall PHEEM and subscale scores between genders, residency grades or levels of work experience. However, there were differences for individual questions, which were explored in the focus group discussion. Senior residents juggling heavier workloads, responsibilities and examinations appeared to be most prone to burnout. We identified three recurring themes that contributed to a poor EE in our programme: excessive workload, poor faculty relationships and differing unmet needs. CONCLUSION Although our programme had a good EE, there were also areas of weaknesses revealed by specific questions, possibly contributing to burnout. We hope to implement interventions to these areas and subsequently assess for longitudinal changes in EE and burnout rates.
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Affiliation(s)
- Andrew Ming-Liang Ong
- SingHealth Internal Medicine Residency Programme, Singapore.,Duke-NUS Medical School, Singapore
| | - Warren Weng-Seng Fong
- SingHealth Internal Medicine Residency Programme, Singapore.,Duke-NUS Medical School, Singapore
| | - Adrian Kwok-Wai Chan
- SingHealth Internal Medicine Residency Programme, Singapore.,Duke-NUS Medical School, Singapore
| | - Ghee-Chee Phua
- SingHealth Internal Medicine Residency Programme, Singapore.,Duke-NUS Medical School, Singapore
| | - Chee-Kian Tham
- SingHealth Internal Medicine Residency Programme, Singapore.,Duke-NUS Medical School, Singapore
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Ong AML. Using the Postgraduate Hospital Educational Environment Measure to Identify Areas for Improvement in a Singaporean Residency Program. J Grad Med Educ 2019; 11:73-78. [PMID: 31428261 PMCID: PMC6697311 DOI: 10.4300/jgme-d-19-00234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/01/2019] [Accepted: 06/04/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Attributes of the clinical learning environment (CLE) are a measure of quality in postgraduate medical education, and assessing the CLE is a component of the New Accreditation System being introduced in Singapore by the Accreditation Council for Graduate Medical Education International. There is a dearth of published studies of CLE quality in Singapore. OBJECTIVE Our study had 3 aims: (1) to measure the CLE in 1 Singaporean residency program; (2) to compare trainee perceptions by sex, training level, and experience; and (3) to identify areas for improvement. METHODS Between October and December 2017, we conducted a mixed assessment of the CLE in an internal medicine program in Singapore, using the Postgraduate Hospital Educational Environment Measure (PHEEM) and qualitative exploration using a focus group. RESULTS Of 153 IM residents, 136 (89%) provided PHEEM responses and 8 participated in the focus group. Total PHEEM scores and scores for the 3 subscales were higher than published data on the use of the PHEEM in international settings. Exploration of selected PHEEM responses via a focus group identified attributes associated with negative perceptions of the CLE: excessive workload, inadequate faculty presence in the CLE, and unmet trainee needs. It also suggested senior residents' clinical workloads, greater responsibilities, and pending examinations may contribute to their less positive perceptions of the CLE. CONCLUSIONS Our analysis using the PHEEM showed overall positive perceptions of the CLE, along with areas for improvement amenable to interventions. Our approach has relevance to an accreditation model with ongoing evaluation of the CLE.
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Naidoo KL, Van Wyk JM, Adhikari M. The learning environment of paediatric interns in South Africa. BMC MEDICAL EDUCATION 2017; 17:235. [PMID: 29187179 PMCID: PMC5707910 DOI: 10.1186/s12909-017-1080-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 11/20/2017] [Indexed: 05/28/2023]
Abstract
BACKGROUND South African (SA) paediatric interns (recently qualified medical graduates) work in a high disease burdened and resource deficient environment for two years, prior to independent practice. Perceptions of this learning environment (LE) influences their approaches to training as well as the outcomes of this period of development. Obstacles to creating a supportive LE and supervisor interaction affects the quality of this training. Measuring perceptions of the LE with validated instruments can help inform improvements in learning during this crucial period of medical education. METHODS The aims of this study was to determine the psychometric qualities of the Postgraduate Hospital Educational Environment Measure (PHEEM) amongst paediatric interns across four hospital complexes in South Africa and to measure the LE as perceived by both interns and their supervisors. Construct validity was tested using factor analysis and internal consistency was measured with Cronbach's alpha. RESULTS A total of 209 interns and 60 supervisors (69% intern response rate) responded to the questionnaire. The PHEEM was found to be very reliable with an overall Cronbach's alpha of 0.943 and 0.874 for intern and supervisors respectively. Factor analysis using a 3-factor solution accounted for 42% of the variance with the teaching subscale having the best fit compared with the other sub-scales of the original tool. Most interns perceived the learning environment as being more positive than negative however, their perceptions differed significantly from that of their supervisors. Poor infrastructural support from institutions, excessive workloads and inadequate supervision were factors preventing optimal training of paediatric interns. CONCLUSIONS The SA version of the PHEEM tool used was found to be a reliable and valid instrument for use in interns amongst high disease burdened contexts. Various obstacles to creating an ideal learning environment for paediatric interns were identified to be in need of urgent review. Key differences in perceptions of an ideal learning environment between interns and their supervisors need to be fully explored as these may result in sub-optimal supervision and mentoring.
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Affiliation(s)
- Kimesh L. Naidoo
- KwaZulu-Natal Department of Health, Department of Paediatrics and Child Health, King Edward VIII Hospital, Nelson R Mandela School of Medicine University of KwaZulu-Natal, Durban, South Africa
| | - Jacqueline M. Van Wyk
- Department of Clinical and Professional Practice, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Miriam Adhikari
- Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 719 Umbilo Road, Durban, South Africa
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Chan CYW, Sum MY, Lim WS, Chew NWM, Samarasekera DD, Sim K. Adoption and correlates of Postgraduate Hospital Educational Environment Measure (PHEEM) in the evaluation of learning environments - A systematic review . MEDICAL TEACHER 2016; 38:1248-1255. [PMID: 27564848 DOI: 10.1080/0142159x.2016.1210108] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The Postgraduate Hospital Educational Environment Measure (PHEEM) is a highly reliable and valid instrument to measure the educational environment during post graduate medical training. This review extends earlier reports by evaluating the extant adoption of PHEEM in various international clinical training sites, and its significant correlations in order to expand our understanding on the use of PHEEM and facilitate future applications and research. METHOD A systematic literature review was conducted on all articles between 2005 and October 2015 that adopted and reported data using the PHEEM. RESULTS Overall 30 studies were included, encompassing data from 14 countries internationally. Notable differences in the PHEEM scores were found between different levels of training, disciplines, and clinical training sites. Common strengths and weaknesses in learning environments were observed and there were significant correlations between PHEEM scores and In-Training Exam (ITE) performance (positive correlation) and level of burnout (negative correlation), respectively. CONCLUSIONS PHEEM is widely adopted in different learning settings, and is a useful tool to identify the strengths and weaknesses of an educational environment. Future research can examine other correlates of PHEEM and longitudinal changes in interventional studies.
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Affiliation(s)
| | - Min Yi Sum
- b Research Division , Institute of Mental Health , Singapore , Singapore
| | - Wee Shiong Lim
- c Centre for Geriatric Medicine, Cognition and Memory Disorders Service , Tan Tock Seng Hospital , Singapore , Singapore
| | | | - Dujeepa D Samarasekera
- e Centre for Medical Education , National University of Singapore , Singapore , Singapore
| | - Kang Sim
- a Department of General Psychiatry , Institute of Mental Health , Singapore , Singapore
- b Research Division , Institute of Mental Health , Singapore , Singapore
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O'Connor P, Lydon S, Offiah G, Ahern S, Moloney B, Byrne D. Impact of working 48 h per week on opportunities for training and patient contact: the experience of Irish interns. Int J Qual Health Care 2015; 27:492-8. [DOI: 10.1093/intqhc/mzv076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2015] [Indexed: 11/13/2022] Open
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