Perceptions of Emergency Medicine Residents on the Quality of Residency Training in the United States and Saudi Arabia

Overview

Journal World J Emerg Med

Specialty Emergency Medicine

Date 2018 Jan 2

PMID 29290889

Citations 2

Authors

Ahmad Aalam

Mark Zocchi

Khalid Alyami

Abdullah Shalabi

Abdullah Bakhsh

Asaad Alsufyani

Abdulrahman Sabbagh

Mohammed Alshahrani

Jesse M Pines

Affiliations

Soon will be listed here.

Abstract

Background: We compare educational environments (i.e. physical, emotional and intellectual experiences) of emergency medicine (EM) residents training in the United States of America (USA) and Saudi Arabia (SA).

Methods: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure (PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales (autonomy, teaching, and social Support), using chi-squared, -tests, and analysis of variance.

Results: A total of 219 surveys were returned for 260 residents across six programs (3 SA, 3 USA), with a response rate of 84%. Program-specific response rates varied from 79%-100%. All six residencies were qualitatively rated as "more positive than negative but room for improvement". Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, =0.001. In subscales, perceptions of social support were not different between the two countries (=0.243); however, role autonomy (<0.001) and teaching (=0.005) were better in USA programs. There were no significant differences by post-graduate training year.

Conclusion: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.

Citing Articles

Knowledge and Attitudes of Saudi Medical Students about Emergency Management of Traumatic Dental Injuries.

Al-Haj Ali S, Farah R, Alhariqi S Int J Environ Res Public Health. 2022; 19(21).

PMID: 36361130 PMC: 9654410. DOI: 10.3390/ijerph192114249.

Emergency medicine in Saudi Arabia: a century of progress and a bright vision for the future.

Khattab E, Sabbagh A, Aljerian N, Binsalleeh H, Almulhim M, Alqahtani A Int J Emerg Med. 2019; 12(1):16.

PMID: 31286863 PMC: 6615245. DOI: 10.1186/s12245-019-0232-0.

References

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):326-31. DOI: 10.1080/01421590500150874. View

Gilbert S, Wen L, Pines J . A comparison of perspectives on costs in emergency care among emergency department patients and residents. World J Emerg Med. 2017; 8(1):39-42. PMC: 5263034. DOI: 10.5847/wjem.j.1920-8642.2017.01.007. View

Koutsogiannou P, Dimoliatis I, Mavridis D, Bellos S, Karathanos V, Jelastopulu E . Validation of the Postgraduate Hospital Educational Environment Measure (PHEEM) in a sample of 731 Greek residents. BMC Res Notes. 2015; 8:734. PMC: 4666073. DOI: 10.1186/s13104-015-1720-9. View

Khoja A . Evaluation of the educational environment of the Saudi family medicine residency training program. J Family Community Med. 2015; 22(1):49-56. PMC: 4317995. DOI: 10.4103/2230-8229.149591. View

Riquelme A, Herrera C, Aranis C, Oporto J, Padilla O . Psychometric analyses and internal consistency of the PHEEM questionnaire to measure the clinical learning environment in the clerkship of a Medical School in Chile. Med Teach. 2009; 31(6):e221-5. DOI: 10.1080/01421590902866226. View

Jalili M, Mortaz Hejri S, Ghalandari M, Moradi-Lakeh M, Mirzazadeh A, Roff S . Validating modified PHEEM questionnaire for measuring educational environment in academic emergency departments. Arch Iran Med. 2014; 17(5):372-7. DOI: 0141705/AIM.0012. View

Clapham M, Wall D, Batchelor A . Educational environment in intensive care medicine--use of Postgraduate Hospital Educational Environment Measure (PHEEM). Med Teach. 2007; 29(6):e184-91. DOI: 10.1080/01421590701288580. View

Edson Vieira J . The postgraduate hospital educational environment measure (PHEEM) questionnaire identifies quality of instruction as a key factor predicting academic achievement. Clinics (Sao Paulo). 2008; 63(6):741-6. PMC: 2664272. DOI: 10.1590/s1807-59322008000600006. View

Auret K, Skinner L, Sinclair C, Evans S . Formal assessment of the educational environment experienced by interns placed in rural hospitals in Western Australia. Rural Remote Health. 2013; 13(4):2549. View

10.

Asch D . Evaluating residency programs by whether they produce good doctors. LDI Issue Brief. 2009; 15(1):1-4. View

11.

Al-Shiekh M, Ismail M, Al-Khater S . Validation of the postgraduate hospital educational environment measure at a Saudi university medical school. Saudi Med J. 2014; 35(7):734-8. View

12.

Wall D, Clapham M, Riquelme A, Vieira J, Cartmill R, Aspegren K . Is PHEEM a multi-dimensional instrument? An international perspective. Med Teach. 2009; 31(11):e521-7. DOI: 10.3109/01421590903095528. View

13.

Alghamdi K, Alburaih A, Wagner M . A Comparison between Emergency Medicine Residency Training Programs in the United States and Saudi Arabia from the Residents' Perception. Emerg Med Int. 2014; 2014:362624. PMC: 3915805. DOI: 10.1155/2014/362624. View

14.

Binsaleh S, Babaeer A, Alkhayal A, Madbouly K . Evaluation of the learning environment of urology residency training using the postgraduate hospital educational environment measure inventory. Adv Med Educ Pract. 2015; 6:271-7. PMC: 4396647. DOI: 10.2147/AMEP.S81133. View