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

  • damte shimelis awoke Addis Ababa University



Background: Public universities in Ethiopia are the only available training institutions for post graduate medical education. Have inadequate resources to satisfy patients and post-graduate students; circumstances which impact educational outcomes. As a first step to informed reform, we applied the Post Graduate Hospital Education Environment (PHEEM) survey tool to identify the weaknesses and strengths of the clinical learning environment.

Objectives: To assess the post graduate clinical education environment of Internal medicine, Pediatrics, Surgery, Obstetrics and Gynecology in Tikur Anbessa Specialized Teaching Hospital.

Methods: This cross sectional study was conducted from April 1-30, 2016 using the English version of the PHEEM tool.

Results: Out of 363 residents 218 residents (60.06%) completed the questionnaire; 152 males (71.7%), and 60 females (28.3%), with 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%)). 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, indicating significant perceived problems with the clinical learning environment, including a statistically significant difference among genders, year of residency and department of residency in the perception of the learning environment within each department with p < 0.05, p =0.002, p < 0.001 respectively.

Conclusion and recommendations: Improving the quality of duty rooms, more supervision during working hours, reducing the work load, providing better orientation of junior doctors among other reforms may improve residency.  

Key words: environment, PHEEM, Hospital, resident,

Author Biography

damte shimelis awoke, Addis Ababa University
Department of Pediatrics and Child Health


L. Biedma-Velazqeuez, R. Serrano-Del-Rosal, J.M.Garcia-De-Diego, J. A. Cerrillo-Vidal (2012). Dissatisfaction with residency: A discrepancy between preferences and expectations? Medical teacher; e1-e7

.Abeba T..Giorgis, Damte Shimelis, Etsegenet Gedlu, Muluwork Tefera (2014). Why post graduate students are not participatory in discussion forums as expected? Thesis for higher diploma program, College of Health Sciences, Addis Ababa University.

WWW. Indexmundi.com .Ethiopian Demographics Profile 2014

Yifru Berhan (2008 Jan). Medical doctors profile in Ethiopia: production, attrition, and retention: in memory of 100-years Ethiopian Modern Medicine and the new Ethiopian Millennium. Ethiop Med J. 46 suppl:1-77

Eraut M (2007). Learning from other people in the workplace. Oxford Review of Education. 33(4):403-22.

Myers KK, Sadaghiani K (2010 Jun). Millennials in the Workplace: A Communication Perspective on Millennia’s Organizational Relationships and Performance. J Bus Psychol. 25(2):225-38.

Sinai J, Tiberius R, de Groot J, Brunet A, Voore P (2001). Developing a training program to improve supervisor-resident relationships, step 1: defining the types of issues. Teaching and Learning in Medicine 13(2):80-5.

Kilminster S, Cottrell D, Grant J, Jolly B (2007 Feb). AMEE Guide No. 27: Effective educational and clinical supervision. Med Teach 29(1):2-19.

Soemantri D, Herrera C, Rquelme A (2010) Measuring the educational environment in health professions studies; Systematic review. Med Teach 321(2):947-52

Isba R, Boor K (2011): Creating a learning environment. Medical education: theory and practice. Edited by Tim D, Karen M, Alber S. Great Britain: Churchill Livingstone;

Tsai J-C, Chen C-S, Sun I-F, Liu K-M, Lai C-S (2014). Clinical learning environment measurement for medical trainees at transitions: relations with socio-cultural factors and mental distress.BMC Medical Education 14: 226

C.Dominic (2002). Journal of Nursing Education 41(2):69-75

Al-Sheikh M.H., Ismail M. H., Al-Khater S.A (2014). Validation of the postgraduate hospital educational environment measure at a Saudi university medical school. Saudi Med J 35 (7):734-38.

Al-Marshad S., Alotaibi G (2011). Evaluation of clinical educational environment at King Fahad Hospital of Dammam University using the postgraduate Hospital Education Environment Measure (PHEEM) inventory. Education in Medicine Journal 3(2):e6-e14.

Roff S, McAleer S, Skinner A (2005). Development and validation of an instrument to measure the postgraduate clinical learning and teaching educational environment for hospital-based junior doctors in the UK. Medical Teacher 27 (4): 326-31.

Clapham M, Wall D, Batchelor A (2007). Educational environment in intensive care medicine—use of Postrgaduate Hospital Educational Environment Measure (PHEEM). Med Teach 29:e184-e191.

Aspegren K, Bastholt L, Bested KM, Bonnesen T, Ejlersen E, Fog I, et al (2007). Validation of the PHEEM instrument in a Danish hospital setting. Med Teach 29:498-500.

Biggs JSG (2008);. Postgraduate medical training in Pakistan: observations and recommendations. J Coll Physicians Surg Pak 18(1):58-63.

Al-Sheikh M H.,Ismail M H.,Al-Khater S A (2014). Validation of the postgraduate hospital educational environment measure at a Saudi university medical school. Saudi Med J Vol. 35 (7): 734-38

Msaouel P, Keramaris NC, Tasoulis A, Kolokythas D, Syrmos N, Pararas N, Thireos E, Lionis C (2010).

Burnout and training satisfaction of medical residents in Greece: will the European Work Time Directive make a difference?Human Resources for Health 8:16; 1-11

T Swanwick. See one, do one, then what? Faculty development in postgraduate medical education.http://journals.bmj.com/cgi/reprintform.

Original Article