Background: Quality of the educational environment affects trainee performance and well-being in postgraduate healthcare education. In pharmacy practice the quality of the educational environment has not been extensively studied. Self-determination Theory can assist in understanding the underlying mechanisms. Objectives: In this study, the quality of the educational environment and its relationship with satisfaction and frustration of trainees’ basic psychological needs and motivation were investigated in a Dutch community pharmacy postgraduate education programme. Methods: In a cross-sectional study, pharmacists specializing to become community pharmacists completed the Scan of Postgraduate Educational Environment Domains (SPEED), the Basic Psychological Need Satisfaction and Frustration Scale for the Work Domain, and the Academic Motivation Scale. Confirmatory factor analysis followed by path analysis was used to analyse the relationships between the variables. Results: Out of 232 trainees, 205 responded (88%). Most trainees (82%) were positive about the quality of the educational environment. The resulting path model displayed a moderate to good fit. The perceived quality of the educational environment had a moderate positive association with basic psychological needs satisfaction (Factor loading = 0.40) and a similar negative association with basic psychological needs frustration (Factor loading = -0.47). Basic psychological needs frustration had a moderate association with an increased sense of internal and external pressures also known as controlled motivation (Factor loading = 0.31). Intrinsic motivation was not affected by the perceived quality of the educational environment. Conclusions: The educational environment was perceived as positive in most community pharmacies. However, having a less positive or a negative perception was associated with reduced satisfaction and increased frustration of trainees’ basic needs for autonomy, compentence and relatedness. Moreover, basic psychological needs frustration was associated with an increased perception of controlled motivation. We recommend supporting supervisors in creating a positive educational environment in pharmacy practice, thereby reducing the risk of basic psychological needs frustration and increased controlled motivation amongst trainees.

Quality of the educational environment in postgraduate community pharmacy education and the relationship with trainees’ basic psychological needs

Natural semantic networks (NSNs) provide an approach to understanding concepts in terms of their density and strength. The objective of this study was to conceptualize mistreatment and good treatment among health science students in Chile, according to gender and training cycle. Methods: A mixed-methods study with a relational scope was conducted, involving 994 health science students. The present study is exploratory and combines both qualitative and quantitative analysis. We utilized the NSN technique, applying a questionnaire via SurveyMonkey after obtaining informed consent. Results: A total of 4386 defining words for mistreatment were identified, with the most relevant being ‘aggression’, ‘abuse’, and ‘violence’. In the case of good treatment, a total of 4146 defining words were obtained, with ‘respect’, ‘empathy’, and ‘kindness’ standing out. For good treatment, a statistically significant relationship was observed between the defining words and the variables of gender (χ2 = 41.158; p &lt; 0.05) and training cycle (χ2 = 28.698; p &lt; 0.05). For mistreatment, a statistically significant relationship was found only with training cycle (χ2 = 35.858; p &lt; 0.05). Conclusions: Exploring the meanings associated with mistreatment and good treatment has a theoretical implication in the way in which two highly polysemic aspects of the educational environment can be understood. 

Natural Semantic Networks: The Concept of Mistreatment and Good Treatment in Students of Health Careers

Abstract Introduction: The PHEEM (postgraduate hospital educational environment measure) is a validated and reliable instrument to assess the educational environment in medical residency programs. Objective: To map the application of the PHEEM questionnaire in medical residency, evaluate the results found, positive and negative aspects and points for improvement. Method: We performed a scoping review according to the Joanna Briggs institution’s methodology. Studies that followed the PCC structure were included, as follows: P (participants) = resident physicians of any specialty; C (concept) = The PHEEM is an instrument used to assess the educational environment in medical residency, through a 40-item questionnaire divided into 3 subscales that include perception of autonomy, teaching and social support. C (context)= studies on PHEEM in medical residency of any specialty. PubMed, EMBASE and the Virtual Health Library databases were the data sources. Results: We identified 1588 references, and after reading the title and abstract, 50 references were selected for full reading, and 36 studies were included. The studies were carried out in 22 countries, and most revealed a more positive than negative educational environment, albeit with room for improvement. In the subscales, the perception of autonomy was more positive than negative, and the perception of teaching revealed that most programs are moving in the right direction. However, when evaluating social support, the results were divided between an unpleasant environment and an environment with more pros than cons. The main highlighted positive points were low racial and sexual discrimination, possibility of working in a team, adequate level of responsibilities, accessible teachers with good teaching skills, learning opportunities and participation in educational events. The main negative points were lack of adequate food and accommodation during the shifts, excessive workload, lack of feedback from preceptors and lack of protected time for study and the culture of blaming the resident. Conclusion: The application of PHEEM revealed that in most medical residency programs the educational environment was more positive than negative, albeit with room for improvement. Efforts are needed to improve the educational environment, especially social support, in medical residency programs.

Scoping review of the application of the Postgraduate Hospital Educational Environment Measure (PHEEM) in medical residency

Resumo Introdução: O Postgraduate Hospital Educational Environment Measure (PHEEM) é um instrumento validado e confiável para avaliar o ambiente educacional nos programas de residência médica. Objetivo: Este estudo teve como objetivos mapear a aplicação do questionário PHEEM na residência médica e avaliar os resultados, os aspectos positivos e negativos e os pontos passíveis de melhoria. Método: Trata-se de uma revisão de escopo de acordo com a metodologia do Instituto Joanna Briggs de revisões de escopo. Foram incluídos estudos seguindo a estrutura PCC: P (participantes) = médicos residentes de qualquer especialidade; C (conceito) = o PHEEM é um instrumento utilizado para avaliar o ambiente educacional na residência médica, por meio de um questionário de 40 itens divididos em três subescalas que incluem percepção de autonomia, ensino e suporte social; C (cenário) = pesquisas sobre o PHEEM na residência médica de qualquer especialidade. As bases eletrônicas pesquisadas foram: PubMed, Embase e Biblioteca Virtual em Saúde (BVS). Resultado: As estratégias de busca rodadas resultaram em 1.588 estudos, 50 foram lidos na íntegra, e incluíram-se 36. Os estudos foram realizados em 22 países, e a maioria revelou um ambiente educacional mais positivo que negativo, entretanto com espaço para melhorias. Nas subescalas, a percepção de autonomia se mostrou mais positiva que negativa, e a percepção de ensino revelou que a maioria dos programas está caminhando na direção certa. Entretanto, na avaliação do suporte social, os resultados foram divididos entre um ambiente não agradável e um ambiente com mais prós do que contras. Os principais pontos positivos destacados foram baixa discriminação racial e sexual, possibilidade de trabalhar em equipe, nível adequado de responsabilidades, professores acessíveis e com boas habilidades de ensino, oportunidades de aprendizado e participação em eventos educacionais. Os principais pontos negativos foram falta de alimentação e acomodação adequadas durante o plantão, carga horária excessiva, falta de feedback por parte dos preceptores, falta de tempo protegido para estudo e cultura de culpar o residente. Conclusão: A aplicação do PHEEM revelou que, na maioria dos programas de residência médica, o ambiente educacional se mostrou mais positivo que negativo, entretanto com espaço para melhorias. São necessários esforços para a melhoria do ambiente educacional, especialmente do suporte social, nos programas de residência médica.

Revisão de escopo da aplicação do Postgraduate Hospital Educational Environment Measure (PHEEM) na residência médica

Educational environment and mental wellbeing of medical and surgical postgraduate residents in Medellin, Colombia.

Introduction: Chronic use of psychoactive substances has been associated with various cognitive impairments. Also, it has been described that an associated cognitive impairment is one of the long-term consequences of having a mental illness. The coexistence of an addiction with at least one other mental illness is quite frequent. Little has been published about cognitive impairments in dual diagnosis patients in Colombia. Methods: A cross-sectional descriptive study with primary data was carried out in 31 patients with a dual diagnosis who were admitted to the Centro de Atención de Patología Dual (Dual Diagnosis Care Center) of the Clínica del Oriente between June and December 2017. The psychiatric diagnostic criteria of DSM-IV-TR and neuropsychological tests were used. Results: It was found that 90.9% of the patients had alterations in the medial orbital cortex; 54.5% in the anterior prefrontal cortex; and 45.5% in the dorsolateral cortex; 72.7% had alterations in sustained attention; 59.1% in alternating attention; and 81.8% in executive functions. Conclusions: 100% of patients with dual pathology suffer from cognitive impairments, which pose significant challenges in their rehabilitation process. For this reason, the inclusion of neuropsychological therapies should be considered in addition to comprehensive management.

Cognitive Impairment in Patients With Dual Pathology

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Educational environment and mental wellbeing of medical and surgical postgraduate residents in Medellin, Colombia.

Cognitive Impairment in Patients With Dual Pathology