Ramana Feeser V, Zemore Zachary, Appelbaum Nital, Santen Sally A, Moll Joel, Aboff Brian, Hemphill Robin R
Department of Emergency Medicine Richmond VA.
Office of Assessment, Evaluation and Scholarship Richmond VA.
AEM Educ Train. 2019 Jun 20;3(3):286-290. doi: 10.1002/aet2.10356. eCollection 2019 Jul.
Residencies are grappling with ways to identify methods to internally monitor and improve their learning environments. Building on prior work, the objective of this study was to determine emergency medicine (EM) internal evaluations of perceived organizational support and psychological safety and compare to the results from the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey for the purpose of program improvement and to explore factors affecting residents' perception of their learning environment.
In 2017, the Virginia Commonwealth University School of Medicine Office of Graduate Medical Education and Office of Quality and Safety conducted an in-person, anonymous safety survey of the residents across 19 residency programs on the Short Survey of Perceived Organizational Support (SPOS) and Psychological Safety Scale (PSS). These were compared to the ACGME Resident Survey for 19 programs. Resident interviews and open response evaluation data informed content analysis on program experiences.
Institutional response rates were 63% for the internal learning environment survey and 96% for ACGME Resident Safety Survey. EM residents responded positively on the SPOS and PSS compared to other programs (ranked second highest scores on both scales). One-hundred percent of respondents agreed or strongly agreed on SPOS items: "Help is available from my department when I have a problem." "My department really cares about my well-being." "My department values my contribution to its well-being." Furthermore, EM had the highest overall training experience score (mean = 4.83) on the ACGME survey compared to the 18 other training programs. Qualitative responses suggest program strengths included supportive program leadership, positive working relationships with faculty, and emphasis on trainee wellness.
Compared to other programs, EM has created a positive environment of safety and support as perceived by their residents. Internal surveys of the learning environment can help programs understand their culture for purposes of improvement and align with the ACGME survey.
住院医师培训项目正在努力寻找内部监测和改善学习环境的方法。基于先前的工作，本研究的目的是确定急诊医学（EM）对感知到的组织支持和心理安全的内部评估，并与毕业后医学教育认证委员会（ACGME）住院医师调查结果进行比较，以改进项目，并探索影响住院医师对其学习环境感知的因素。
2017年，弗吉尼亚联邦大学医学院研究生医学教育办公室和质量与安全办公室对19个住院医师培训项目的住院医师进行了一项关于感知组织支持简短调查问卷（SPOS）和心理安全量表（PSS）的面对面匿名安全调查。将这些结果与19个项目的ACGME住院医师调查结果进行比较。住院医师访谈和开放式回应评估数据为项目经验的内容分析提供了信息。
内部学习环境调查的机构回应率为63%，ACGME住院医师安全调查的回应率为96%。与其他项目相比，急诊医学住院医师对SPOS和PSS的回应较为积极（在两个量表上的得分均排名第二高）。100%的受访者对SPOS项目表示同意或强烈同意：“当我遇到问题时，我的部门会提供帮助。”“我的部门真的关心我的幸福。”“我的部门重视我对其幸福的贡献。”此外，与其他18个培训项目相比，急诊医学在ACGME调查中的总体培训经验得分最高（平均=4.83）。定性回应表明，项目优势包括支持性的项目领导、与教员的积极工作关系以及对学员健康的重视。
与其他项目相比，急诊医学为住院医师营造了一个积极的安全与支持环境。对学习环境的内部调查有助于项目了解自身文化以进行改进，并与ACGME调查保持一致。
