Validation of the Postgraduate Hospital Educational Environment Measure (PHEEM) in a sample of 731 Greek residents.

Dimitris Mavridis,Ioannis D K Dimoliatis,Eleni Jelastopulu,Stefanos Bellos,Vassilis Karathanos,Persa Koutsogiannou

doi:10.1186/s13104-015-1720-9

Abstract

BackgroundThe Greek version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was evaluated to determine its psychometric properties, i.e., validity, internal consistency, sensitivity and responsiveness to be used for measuring the learning environment in Greek hospitals. MethodsThe PHEEM was administered to Greek hospital residents. Internal consistency was measured using Cronbach’s alpha. Root Mean Square Error of Approximation (RMSEA) was used to evaluate the fit of Structural Equation Models. Content validity was addressed by the original study. Construct validity was tested using confirmatory (to test the set of underlying dimensions suggested by the original study) and exploratory (to explore the dimensions needed to explain the variability of the given answers) factor analysis using Varimax rotation. Convergent validity was calculated by Pearson’s correlation coefficient regarding the participant’s PHEEM score and participant’s overall satisfaction score of the added item “Overall, I am very satisfied with my specialization in this post”. Sensitivity was checked by comparing good versus poor aspects of the educational environment and by satisfied versus unsatisfied participants.ResultsA total of 731 residents from 83 hospitals and 41 prefectures responded to the PHEEM. The original three-factor model didn’t fit better compared to one factor model that is accounting for 32 % of the variance. Cronbach’s α was 0.933 when assuming one-factor model. Using a three-factor model (autonomy, teaching, social support), Cronbach’s α were 0.815 (expected 0.830), 0.908 (0.839), 0.734 (0.793), respectively. The three-factor model gave an RMSEA value of 0.074 (90 % confidence interval 0.071, 0.076), suggesting a fair fit. Pearson’s correlation coefficient between total PHEEM and global satisfaction was 0.765. Mean question scores ranged from 19.0 (very poor) to 73.7 (very good), and mean participant scores from 5.5 (very unsatisfied) to 96.5 (very satisfied).ConclusionsThe Greek version of PHEEM is a valid, reliable, and sensitive instrument measuring the educational environment among junior doctors in Greek hospitals and it can be used for evidence-based SWOT analysis and policy.

Highlights

The Greek version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was evaluated to determine its psychometric properties, i.e., validity, internal consistency, sensitivity and responsiveness to be used for measuring the learning environment in Greek hospitals
There exists a generic instrument for the assessment of the educational environment of all junior doctors in hospitals, the Postgraduate Hospital Educational Environment Measure (PHEEM) [26], developed and validated by the Centre of Medical Education of the University of Dundee, UK, and being used worldwide [12,13,14,15,16,17,18,19,20,21,22,23,24]
Several Greek residents interpreted this question as suggesting discrimination between the different specialties and not race discrimination; racism has gradually become a generic term in Greece meaning any discrimination

Summary

Introduction

The Greek version of the Postgraduate Hospital Educational Environment Measure (PHEEM) was evaluated to determine its psychometric properties, i.e., validity, internal consistency, sensitivity and responsiveness to be used for measuring the learning environment in Greek hospitals. Continuing efforts targeting training improvements led to development of many instruments, created and validated in different countries [7]. These instruments include procedures for undergraduate medical students, such as DREEM [8], and instruments for various medical specialties, such as, anesthesiology, ATEEM [9], surgery, STEEM/OREEM [10], and ambulatory service, ACLEEM [11]. There exists a generic instrument for the assessment of the educational environment of all junior doctors in hospitals, the Postgraduate Hospital Educational Environment Measure (PHEEM) [26], developed and validated by the Centre of Medical Education of the University of Dundee, UK, and being used worldwide [12,13,14,15,16,17,18,19,20,21,22,23,24]

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