Evaluation of the Clinical learning Environment of Tikur Anbessa Specialized Teaching Hospital of Addis Ababa University using the Post Graduate Hospital Health Education’s Environment Measure
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Date
2020-02
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Addis Ababa University
Abstract
Background
The public health system in Ethiopia is the main deliverer of health services and the largest employer of physicians. The public universities are the only available training institutions for post graduate medical education and also have full authority over residents’ training. In their training years, residents have dual responsibility as students and responsible physicians. A conflict arises between these two roles as students and workers leading to dissatisfaction among the residents that could affect the quality of the services they deliver during the training or then after and the training outcomes; thus negatively affecting resident learning. Determining the work place conditions that can exacerbate tensions in navigating student and worker roles, can inform reform to improve the resident experience.
Assessing the post graduate hospital education environment using the Post Graduate Hospital Education Environment survey tool identifies the weaknesses and strengths of the hospital education environment
for rectifying the weaknesses and maintaining the strengths
Objective: To assess the post graduate clinical education/work environment of Tikur Anbessa Specialized Teaching Hospital of Addis Ababa university using the PHEEM survey tool as seen by residents from the 4 major clinical departments (Internal medicine, Pediatrics, Surgery, Obstetrics and
Gynecology) in the three domains of the Post graduate Hospital Educational Environment Measures (PHEEM); perception of role Autonomy, perception of teaching and perception of social support.
Methods: This is a cross sectional study that was conducted from April 1-30, 2016. In this study we used the English version of the PHEEM tool to assess the perception of residents on the health educations learning environment.
Results: Out of 363 residents 218 residents (60.06%) completed the questionnaire. There were 152 males (71.7%), and 60 females (28.3%) . Their age ranges between 20-38 years with a mean age of 26.1.There were 89 residents in year one (42%), 64 residents in year 2 (30.2%), 38 year 3 (17.9%) and 20 were in year 4 (20%) one resident didn’t mention year of residency. Twenty-two items were rated as poor with a score of less than 2. The overall score on the three domains of PHEEM was 76.8/160. This indicates plenty of problems of the clinical learning environment. There is statistically significant
difference among genders, year of residency and department of residency in the perception of the learning environment (p < 0.05, p =0.002, p < 0.001) respectively. Male residents and junior residents rated the environment as more positive than females and senior residents respectively. The load of
work is heavy in the order Obstetrics and Gynecology, Pediatrics, Internal Medicine and Surgery.
Conclusion and recommendations: For our training program to succeed the program should be designed according to the best standards to ensure satisfaction of residents as well as clients. Improving the quality of duty rooms, more supervision during working hours, reducing the work load, providing junior doctors’ handbook etc. will improve the learning environment and facilitate learning. After remedial measures are taken we recommend a regular assessment of the clinical learning environment to determine whether the measures taken are effective.
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Keywords
Hospital, PHEEM, post graduate, resident