An analysis of the Educational Environment at the Malta Foundation Programme using the Postgraduate Hospital Educational Environment Measure (PHEEM).

Background: Learning from managing patients in a real-world context is by far superior to simulation learning. A substandard educational environment is associated with poor patient care and suboptimal learning outcomes. The measurement of the educational environment provides an insight on what is needed to improve the level of training. Methods: This study used the Postgraduate Hospital Educational Environment Measure (PHEEM) to measure the educational environment at the Malta Foundation Programme. Descriptive statistics were used to describe the demographics of the study population. Non-parametric comparative statistics were used to identify statistically significant differences between groups. Results: 98 trainees out of 370 (26.5%) completed the online questionnaire. These consisted of 39 FY1s (31.5% of 124), 33 FY2s (24.8% of 133) and 26 Extended FYs (23.0% of 113). The 40-item PHEEM showed good reliability with a Cronbach’s α value of 0.912. These doctors have perceived their educational environment as more positive than negative. There seems to be a dip midway through training with an improvement towards the end of the two-year training period. The three worst scoring items seem to be related to when the trainees are on call. Conclusion: Perceptions of role autonomy and of social support are areas where most work is needed. Teaching seems to be moving in the right direction but there is always room for improvement.