Medical Education Symposium

First Author Information

Nital P. Appelbaum, PhD, Assistant Professor, Office of Assessment, Evaluation and Scholarship, Virginia Commonwealth University School of Medicine, Richmond VA.

Additional Author(s) Information

Brian M. Aboff, MD, MMM is senior associate dean for Graduate Medical Education and clinical professor of Medicine, Virginia Commonwealth University School of Medicine, Richmond VA. Sally Santen, MD, PhD is senior associate dean, Office of Assessment, Evaluation and Scholarship, Virginia Commonwealth University School of Medicine, Richmond VA. Robin Hemphill, MD, MPH is chief quality and safety officer and associate dean of safety and quality, Virginia Commonwealth University Health, Virginia Commonwealth University School of Medicine, Richmond VA.

Presentation Format

Oral

Type of Activity

Research

Original Presentation Date

2018

Date of Submission

April 2018

Abstract/Short Description

Purpose. To utilize two validated instruments to assess the cultural facets of the clinical learning environment in medical education and correlate findings with external program evaluation data. Identification of measurement tools could allow early intervention in graduate medical education to better facilitate work and learning processes. Method. During FY17, our institution surveyed residents across nineteen training programs on perceived organizational support and psychological safety to assess the clinical learning environment. These data were aggregated to the departmental level and correlated with nineteen residency program results on the FY17 ACGME Resident Survey. Results. Perceived organizational support correlated positively with domains of the ACGME Resident Survey: overall program evaluation score (r=.75, p<.01), Faculty (r=.72, p<.01), Evaluation (r=.73, p<.01), Educational Content (r=.52, p=.02), and Resources (r=.55, p=.01). Psychological safety had a strong positive correlation with overall program evaluation score (r=.57, p=.01), Faculty (r=.50, p=.03), and Evaluation (r=.62, p<.01). Neither internal assessment scale correlated with the Patient Safety/Teamwork domain of the ACGME Resident Survey. Conclusions. GME and health systems should actively monitor and improve aspects of the clinical learning environment through internal assessment including measurement on perceived organizational support and psychological safety. Based on our data, departments perceived to have greater support of their residents, where residents can speak up freely, are likely to show more positive ratings of programs on the ACGME Resident Survey. Programs should also identify and evaluate interventions to facilitate positive relationships between residents and their training programs, as well as foster environments that allow for speaking up without the fear of negative consequence.

References

Eisenberger, R., Huntington, R., Hutchison, S., & Sowa, D. Perceived organizational support. Journal of Applied Psychology, 1986, 71, 500–507. Eisenberger R, Fasolo P, Davis-LaMastro V. Perceived organizational support and employee diligence, commitment, and innovation. J Appl Psychol. 1990;75:51. Kurtessis JN, Eisenberger R, Ford MT, Buffardi LC, Stewart KA, Adis CS. Perceived organizational support a meta-analytic evaluation of organizational support theory. Journal of management. 2015:0149206315575554. Rhoades L, Eisenberger R. Perceived organizational support: a review of the literature. J Appl Psychol. 2002;87:698. Hafferty FW. Beyond curriculum reform: Confronting medicine's hidden curriculum. Acad Med. 1998;73(4):403-407. Kahn, W. A. 1990. Psychological conditions of personal engagement and disengagement at work. Academy of Management Journal, 33, 692-724. Carmeli A, Gittell JH. 2009. High-quality relationships, psychological safety, and learning from failures in work organizations. J. Organ. Behav. 30(6):709–29 Detert, J.R. & Edmondson, A.C. (2011). Implicit Voice Theories: Taken-for-granted rules of self-censorship at work. Academy of Management Journal, 54(3), 461-488. Edmondson, A. (2002). The local and variegated nature of learning in organizations: A group-level perspective. Organization Science, 13, 128-146. Edmondson, A.C. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350-383. Holt KD, Miller RS, Philibert I, Heard JK, Nasca TJ. Residents' perspectives on the learning environment: Data from the accreditation council for graduate medical education resident survey. Acad Med. 2010;85(3):512-518. Holt KD, Miller RS. The ACGME resident survey aggregate reports: An analysis and assessment of overall program compliance. J Grad Med Educ. 2009;1(2):327-333. Billings ME, Lazarus ME, Wenrich M, Curtis JR, Engelberg RA. The effect of the hidden curriculum on resident burnout and cynicism. J Grad Med Educ. 2011;3(4):503-510.

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