Perception of the Educational Environment of Post-graduate Residents in Teaching Hospitals across Pakistan

Abstract

Aim: To evaluate the perception of educational environment of post-graduate residents in teaching hospitals of Pakistan. Methodology: This cross-sectional descriptive study was conducted in four tertiary care hospitals in Pakistan from January 2020 to November 2020.The Post-graduate Hospital Education Environment Measure (PHEEM) inventory (40 items on a 0-4 Likert scale) was distributed among 195 post-graduate residents of multiple specialties by convenience non-probability sampling technique. Response was recorded into three subscales which included perception of teaching, role of autonomy and social support. The total score of these three domains had a combined maximum and minimum of 160 and 0, respectively. Results: Cumulative mean score obtained in our study showed a total score of 23.69 ± 16.247 / 56 for the theme: Perception of Role of autonomy, 24.17 ± 16.928 / 60 for Perception of Teaching and 19.35 ± 13.224 / 44 for Perception of Social Support. Conclusion: There are no drastic flaws in the post-graduate medical education residency-training program currently running in Pakistan. However, there is need for further improvement in teaching attitude of instructors and the need to eradicate discriminatory behavior felt by the post-graduate residents in certain circumstances. Keywords: Perception, Educational environment, Postgraduate Residents, Pakistan

Post-graduate educational environment of two parallel programs in Pediatric Medicine

“…The Pediatric trainees' overall perception of the educational environment was positive, as observed in the previous studies as well from Pakistan. [12][13][14][15] However, the mean overall and subscale scores were higher in this study compared to the previous local Pediatric studies. [12][13][14] The reason, perhaps, is that the previous studies included trainees from other specialities in addition to Pediatric Medicine trainees.…”

“…Most local studies have reported the perception of FCPS trainees. 12 , 13 , 17 , 18 , 21 One of the reasons is that the MD program is a relatively newer phenomenon and that too only in Punjab. The previous MD programs were too few, with very few trainees.…”

“…Each of the 40 items was coded on the five-point Likert scale ranging from 0 (strongly disagree) to 4 (strongly agree). Four items (7,8,11,13) were reverse coded as these were negative statements. Mean (SD) was calculated for each item, the three subscales, and the overall score.…”

Scoping review of the application of the Postgraduate Hospital Educational Environment Measure (PHEEM) in medical residency

“…In 22 studies 6,8,23,[27][28][29][31][32][33]35,[37][38][39]42,[45][46][47][49][50][51][52][53] the mean PHEEM total score was between 81-120, indicating a more positive than negative educational environment, but with room for improvement. In eight studies, carried out in Saudi Arabia 30,43 , Pakistan 24,55 , Ethiopia 34 , Japan 54 , Turkey 25 and Greece 48 , the mean total score was 41-80, indicating an educational environment with many problems. None of the studies showed that the educational environment was considered very bad (score below 40) or excellent (score above 120).…”

“…Most of the problems highlighted in the studies were related to social support, with the lack of adequate food during shifts being the main problem in most studies, regardless of the country or region, followed by inadequate accommodation and a culture of blaming the resident. In a study carried out in Morocco 28 , sexual discrimination was considered a problem by half of the residents, associated with racial discrimination, problems also observed in Saudi Arabia 31 , Pakistan 24 and Greece 41 , demonstrating that regional and cultural factors influence the educational environment, especially regarding social support of medical residency programs. In the perception of autonomy subscale, the main negative points were lack of an information manual and clinical protocols for residents, excessive workload, and being called at inappropriate times, while in the teaching subscale, the main problems highlighted were lack of protected time for study and lack of feedback from preceptors.…”