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.