Evaluation Of The Clinical Learning Environment Of Tikur Anbessa Specialized Teaching Hospital Of Addis Ababa University Using The Post Graduate Hospital Health Educations Environment Measure

Backgroundrn: The public health system in Ethiopia is the main deliverer of health services and the largestrnemployer of physicians. The public universities are the only available training institutions for postrngraduate medical education and also have full authority over residents’ training. In their training years,rnresidents have dual responsibility as students and responsible physicians. A conflict arises betweenrnthese two roles as students and workers leading to dissatisfaction among the residents that could affectrnthe quality of the services they deliver during the training or then after and the training outcomes; thusrnnegatively affecting resident learning. Determining the work place conditions that can exacerbaterntensions in navigating student and worker roles, can inform reform to improve the resident experience.rnAssessing the post graduate hospital education environment using the Post Graduate Hospital EducationrnEnvironment survey tool identifies the weaknesses and strengths of the hospital education environment rnfor rectifying the weaknesses and maintaining the strengthsrn. rnObjective: To assess the post graduate clinical education/work environment of Tikur AnbessarnSpecialized Teaching Hospital of Addis Ababa university using the PHEEM survey tool as seen by rnresidents from the 4 major clinical departments (Internal medicine, Pediatrics, Surgery, Obstetrics andrnGynecology) in the three domains of the Post graduate Hospital Educational Environment Measuresrn(PHEEM); perception of role Autonomy, perception of teaching and perception of social support.rnMethods: This is a cross sectional study that was conducted from April 1-30, 2016. In this study we usedrnthe English version of the PHEEM tool to assess the perception of residents on the health educationsrnlearning environment. rnResults: Out of 363 residents 218 residents (60.06%) completed the questionnaire. There were 152rnmales (71.7%), and 60 females (28.3%) . Their age ranges between 20-38 years with a mean age of 26.1.rnThere were 89 residents in year one (42%), 64 residents in year 2 (30.2%), 38 year 3 (17.9%) and 20 werernin year 4 (20%) one resident didn’t mention year of residency. Twenty-two items were rated as poorrnwith a score of less than 2. The overall score on the three domains of PHEEM was 76.8/160. Thisrnindicates plenty of problems of the clinical learning environment. There is statistically significantrndifference among genders, year of residency and department of residency in the perception of thernlearning environment (p < 0.05, p =0.002, p < 0.001) respectively. Male residents and junior residentsrnrated the environment as more positive than females and senior residents respectively. The load ofrnwork is heavy in the order Obstetrics and Gynecology, Pediatrics, Internal Medicine and Surgery.rnConclusion and recommendations: For our training program to succeed the program should berndesigned according to the best standards to ensure satisfaction of residents as well as clients. Improvingrnthe quality of duty rooms, more supervision during working hours, reducing the work load, providingrnjunior doctors’ handbook etc. will improve the learning environment and facilitate learning. Afterrnremedial measures are taken we recommend a regular assessment of the clinical learning environmentrnto determine whether the measures taken are effective.

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