PHEEM

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PHEEM

• Mike Clapham

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Educational environment

• Determines how our trainees actually experience
  curriculum delivery

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Overview

• What is PHEEM?
• Why measure environment?
• How?
• Results?
• Future?

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PHEEM

• Postgraduate Hospital Educational Environment
  Measure
• 40 statements questionnaire (two sides A4)
• Each with a five point scale
• Strongly agree (4) through to strongly disagree
  (0)

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Teaching by humiliation/fear

• It could have been such a wonderful thing to be
  a doctor but its not. Its just a disaster

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Bullying
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PMETBtrainee surveyJuly 2006
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So how does Intensive Care measure up?
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In general

• Trainees value time in ICU
• Deanery QA visits rate ICU highly

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Specifically

• Pilot study for ICS 2004
• ICU is non sexist and non racist
• Excellent environment
• Good teaching
• Good support
• Allowed autonomy

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What did we do?July 2006

• Wider benchmarking
• Self-administered PHEEM
• Voluntary
• Anonymous
• 144 trainees
• 25 ICUs

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Analysis

• Used SPSS version 14
• Questions 7, 8, 11 and 13 were reverse scored
• Cronbachs alpha
• Calculated means and 95 confidence intervals
• Tests of significance Mann Whitney and Kruskal
  Wallis

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Reliability

• Cronbachs alpha 0.931 overall
• No rogue questions using the alpha if item
  deleted function in SPSS
• (a value above 0.7 is considered an acceptable
  reliable score)

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Main findings

• Good scores overall
• No gender differences
• Significant differences between
• Grades of doctor
• Units (identity unknown to us)

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Overall individual
poor
excellent
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Teaching - individual
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Autonomy - individual
poor
excellent
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Social - individual
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Grade of trainee
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Global - hospitals
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Highlights

• No racism
• No sexism
• Enthusiastic teachers
• Feel part of a team
• Teachers good communication skills

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Room for improvement

• Lack of feedback
• Junior Doctors handbook
• Counseling opportunities
• Accommodation
• Catering facilities

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Global scores 2004/2006
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Please try it out

• Forms and scoring instructions on ICS website
• ePHEEM available at
• http//intranet.wmdeanery.org/pheem/
• Mike.clapham_at_uhb.nhs.uk

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PHEEM a useful measure

• Individual trainees know what to expect
• Evaluation of each post
• Evaluation of each post over time to track
  changes
• Standards can be set at local, regional and
  national levels

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ConclusionICU environment

• Excellent
• Trainees 50
• Hospitals 52
• Good or excellent
• Trainees 95
• Hospitals 96