Evaluation of the educational environment of postgraduate surgical teaching.

BACKGROUND Medical Education is becoming increasingly community-oriented, student-centred, self-learning and self & peer-assessing process especially in the undergraduate years. This is happening because of increasing patient awareness of their rights in our new healthcare world of increased consultant responsibility; and implementation in the U.K. health institutions of the 'European Working Time Directive' and 'Modernization of Medical Careers'. The study was conducted to determine the change if any in the education environment of postgraduate surgical teaching in a leading teaching hospital in London when a teacher-centred, old-fashioned postgraduate teaching approach was replaced with a student-centred, self-assessment, portfolio-based approach. METHOD Postgraduate Hospital Educational Environment Measure (PHEEM). Twenty postgraduate trainees filled in the questionnaire before and after the change in their learning/teaching pattern. RESULTS The response rate was 100%. No statistically significant difference in the overall score for the two teaching environments (p = 0.8024, 95% CI = -5.549273 to 4.349273) was found, because the loss of on-call rooms, trainee's mess and catering services statistically significantly deteriorated the social support subscale of the PHEEM scale (p < 0.0001, 95% CI = 6.66752 to 13.03248) to counteract any statistically significant improvement in the teaching role perception subscale of the instrument (p = 0.001, 95% CI= -12.443896 to -4.856104). There was no statistically significant difference in the role autonomy perception subscale in the two methods (p = 0.3663, 95% CI = -5.870437 to 2.270437). CONCLUSIONS A student-centred approach to postgraduate teaching is better than a teacher-centred approach. However, further studies will be needed to evaluate both postgraduate teaching and training environment.