S. Al-Sinani

Perception of Learning Environment among
residents at Oman Medical Specialty Board
residency programs
Siham Al Sinani, MD, FRCPC
Oman Medical Specialty Board
ICRE 2016
16-10-01
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I do not have an affiliation (financial or otherwise) with a
pharmaceutical, medical device or communications
organization.
Je n’ai aucune affiliation (financière ou autre) avec
une entreprise pharmaceutique, un fabricant
d’appareils médicaux ou un cabinet de
communication.
2
This research project is the thesis project for the Masters in
Health Professions Education done by Ms. Raghdah Al Bualy,
Oman Medical Specialty Board (OMSB), Muscat, Oman.
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Overview
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•
•
•
•
•
Introduction
Methods
Analysis
Results
Conclusion
Study advantages and limitations
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Introduction-1
• Quality is a relative and a multi-factorial concept.
• Educational institutions implement various quality tools to
ensure delivery of high quality education.
• Stakeholder involvement is a key element in higher
education quality improvement (QI).
• Learners are main stakeholders.
Harvey, Burrows, & Green, 1992
Gibbs, 2010
O'Mahony & Garavan, 2012
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Introduction-2
• Learning environment (LE) encompasses the educational,
physical, social, and psychological context in which trainees
are immersed.
• Plays a significant role in their professional & moral
development
• Supportive LE is essential for effective medical education.
• Accurate assessment of LE is challenging
Cooke M, Irby DM, O’Brien BC, 2010.
Branch WT Jr., 2000
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Aim
• Explanatory survey based descriptive study to determine
residents’ perceptions of LE in 2 training programs at OMSB
• Is internationally constructed LE tool utilized at local
settings reliable?
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Methods-1
• Setting:
– Postgraduate residency at the Oman Medical Specialty
Board (OMSB)
– Internal Medicine (IM) and Pediatrics (Peds)
– February - March 2016 (Academic Year 2015-2016)
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Methods-2
• Design:
– Convergent parallel design (Quan & Qual data).
– Quantitative component: Dutch Residency Education
Climate Test (D-RECT) tool (Modified with
permission).
– Qualitative component: open-ended questions.
Silkens et al., 2015
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Methods-3
• Participants:
– All Residents of IM & Peds programs (PGY 1 – PGY4).
– Omani nationals.
– Graduates of local medical schools.
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Analysis
• Baseline characteristics were described using descriptive
statistics.
• Mean score > 4.00 = good, 4.00- 3.50 = sufficient and
<=3.50 = require further improvement.
• Reliability was measured using Cronbach’s alpha.
• Open-ended questions’ answers were coded and analyzed
for themes.
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Results-1
Demographic details of residents
Internal Medicine
Pediatrics
Total number of
Residents
105
60
Number of Respondents
77
45
Response Rate
73%
75%
Gender
Male 32 (46.4%) **
Female 37 (53.6%)
Male 18 (40.9%) ***
Female 26 (59.1%)
Residency Level*
R1
R2
R3
R4
R1
R2
R3
R4
22 #
20
22
12
16
11
9
9
*R1 – 4 refers to residency years 1 – 4; ** 8 no responses for Gender; # 1 no response
for Residency Level; *** 1 no response for Gender.
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Results-2
Perceptions of LE among IM Residents
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Results-3
Perceptions of LE among Peds Residents
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Results-4
Qualitative Analysis
• Program’s strengths:
– Dedicated faculty members
– Support for various activities.
• Themes requiring improvement in IM and Peds :
– Educational atmosphere
– Coaching & Assessment
– Role of rotation supervisor
– Work load (peds)
– Formal Education (IM)
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Conclusion
•
Perception of residents’ LE in both programs was very similar.
•
Domains requiring further improvement (M score < 3.5) in both
programs:
– Educational Atmosphere
– Coaching and Assessment
– Role of Rotation Supervisor
– Patient Sign-out
•
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D-RECT is a highly reliable tool for evaluating the LE quality within
Oman and perhaps in similar regional training settings (cronbach’s
alpha 0.92)
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Study Advantages and Limitations
• First study evaluating residents’ LE in Oman.
• Study was limited to 2 training programs.
• Risk of oversimplifying/exaggerating the situation on
ground.
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Suggestions
• Incorporate residents’ suggestions to LE when possible.
• Possible need for training on reflection and reflective
practices.
• Study the influence of cultural & specialty specific
differences (medical vs surgical) on the overall evaluation
of the LE.
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Help us improve.
Your input matters.
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Votre opinion compte!
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Results
Perceptions of LE among IM
Residents at OMSB
Residents
(N=77)
N
76
75
76
70
70
70
70
Residents
(N=77)
M (SD)*
3.21 (0.70)
3.66 (0.72)
3.44 (0.69)
3.30 (0.70)
3.61 (0.61)
3.69 (0.67)
3.68 (0.57)
75
72
3.60 (0.80)
3.48 (0.67)
D-RECT Factors
1. Educational Atmosphere
2. Teamwork
3. Role of Rotation Supervisor
4. Coaching & Assessment
5. Formal Education
6. Resident Peer Collaboration
7. Work is Adapted to Resident
competence
8. Accessibility of Supervisor
9. Patient Sign-out
*Mean scores (M) are given on a scale 1-5, =>4.00: good, =<3.50: improvements
are needed, 3.50- 4.00: sufficient. SD = Standard Deviation, N= number
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Results
Perceptions of LE among Peds
Residents at OMSB
Residents
(N=45)
N
45
45
45
44
44
44
44
Residents
(N=45)
M (SD)*
3.15 (0.52)
3.64 (0.54)
3.50 (0.57)
3.30 (0.60)
3.76 (0.29)
3.77 (0.45)
3.79 (0.41)
45
43
3.60 (0.73)
3.50 (0.70)
D-RECT Factors
1. Educational Atmosphere
2. Teamwork
3. Role of Rotation Supervisor
4. Coaching & Assessment
5. Formal Education
6. Resident Peer Collaboration
7. Work is Adapted to Resident
competence
8. Accessibility of Supervisor
9. Patient Sign-out
*Mean scores (M) are given on a scale 1-5, =>4.00: good, =<3.50: improvements
are needed, 3.50- 4.00: sufficient. SD = Standard Deviation, N= number
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