Examining the Psychometric Properties of Post-graduate Hospital Educational Environment Measure for Saudi Pediatric Trainees: Principal Component Analysis

Abstract

Background: The quality and congeniality of the hospital educational environment (HEE) is a major determinant for the success of the ‎training of future health professionals. Satisfactory and effective engagement of fellow physicians in the clinical learning program ultimately affects their clinical performance. Objectives: To evaluate and assess the HEE of residents and fellow trainees at a university hospital in Jeddah using a psychometric tool, Post-graduate Hospital Educational Environment Measure (PHEEM). Methods: The PHEEM questionnaire developed by Roff et al. (2005) was used to survey 71 pediatric post-graduate trainees in the second half of 2021. The HEE perception was correlated with the trainee’s demographic and academic data. Principal component ‎analysis was performed to examine the validity of the PHEEM 3-dimensional construct. Results: Most of the participants were from the first (23.9%) and second post-graduate year (33.8%) and ‎had majorly general pediatrics as a specialty (83.1%). The mean PHEEM score was 99.35 ± 22.46 out of 160 with a distribution pattern of poor (2.8%), suboptimal (9.9%), more ‎positive with the need for improvement (73.2%), and optimal (14.1%). The PHEEM score was significantly lower among trainees of < 27 years (94.33 ± 23.48; P = 0.037) compared to the ones aged > 27 years (105.47 ± 19.83). Medical residents and trainees from the first post-graduate year scored remarkably low (87.86 ± 21.21; P = 0.008) compared to the other senior fellow peers. The correlation observed in overall PHEEM scores showed a similar trend in 3 individual components. For the principal component analysis (PCA), 10 components met the ‎initial criteria of eigenvalue > 1 and loading factor > 0.5, encompassing 75.9% of the scale ‎variance. The thematic analysis highlighted several areas for improvement, such as trainee rights and psychological support. Conclusions: The HEE of the pediatric department was broadly ‎suitable for post-graduate training programs. There are still several areas for improvement, including organizational and logistical aspects that include adequate learning time. ‎In addition, the psychological safety of trainees should also be considered.