Internal Medicine Residents’ Perceptions of the Learning Environment of a Residency Training Program in Ethiopia: a Mixed Methods Study

Abstract

Introduction:The learning environment is an important determinant of the quality of medical education. Having a good learning climate leads to improved learning process, satisfaction with education, and helps achieve the goals of the curriculum. Assessment of the quality of learning environment helps with the identification of areas that need improvement. The aim of this study was to assess the learning environment of internal medicine training program in Ethiopia. Methods: A mixed methods study using a cross-sectional survey using Postgraduate Hospital Educational Environment Measure and a qualitative study using a focus group discussion was done on internal medicine residents from December 2020 to May 2021. Comparison of quantitative data was done using Mann-Whitney U-Test and Kruskal-Wallis H-test. P-value <0.05 was considered statistically significant. Results: A total of 100 residents participated in the study. The overall total mean score of the responses of the participants was 70.87 (±19.8) with mean perceptions of role autonomy, perceptions of teaching and perceptions of social support of 25.9 (±7.1), 27.1 (10.2) and 17.9 (±5.1), respectively. These values suggest the presence of plenty of problems in the program. Higher mean scores were reported by males and by earlier years of residency. Ten residents participated in the focus group discussion. Four recurring themes that negatively affect learning environment were identified and included excessive workload, inadequate teaching activity, nonconducive hospital physical environment and lack of diagnostic and therapeutic modalities. Conclusion:The internal medicine residency learning environment has many challenges that need immediate attention and follow-up.

Measuring Clinical Learning Environment across three residency programs using a Postgraduate Hospital Educational Environment Measure (PHEEM) scale at a tertiary care hospital in the United Arab Emirates

“…The overall score is higher, similar to other studies in the developing world probably due to experienced teaching staff, and variation in resident workload (10,11,12,13). In contrast, studies from African continent report a very low score of 80 or lower due to an apparent lack of healthcare facilities, policies, curriculum for residents, and implementation in practice (14,15). Unusually, studies from the region (16, 17,18,19) showed a very low overall score of below 80, indicating plenty of problems in the residency program.…”

Assessment of Psychiatry Trainees Satisfaction towards Postgraduate Psychiatry Clinical MD in Sudan

“…Training atmosphere has evident effect on the overall satisfaction of trainees and the other sub construct of training process consequently it directly impact the quality of healthcare delivered. Our result showed that most of the psychiatry trainees were satisfied with practice of professionalism in relation with supervisors, colleagues, and worker [34]. A similar result were found in 2015 in a report about family medicine in Sudan which revealed that most of the residents were satisfied with practicing professionalism, 81.5% were satisfied about professional relationship with patients, 84.5% in relationship with collage and 78.5% in relationship with PHC teacher.…”

Residents’ Perception of the Educational Program “Family Medicine” in Kazakhstan: A Focus Group Study

“…The results of our study are consistent with those obtained in a study of internal medicine residents' perceptions of the training environment of the residency program in Ethiopia. There, four recurring themes were identified that negatively affect the learning environment, including excessive workload, inadequate teaching, unfavorable physical environment in the hospital, and lack of diagnostic and therapeutic methods [26]. During the focus groups, residents expressed their wishes for the use of best practices.…”