title: Evaluation of urology residents' perception of surgical theater educational environment.
abstract: OBJECTIVE
  To evaluate surgical theater learning environment perception in urology residents in Saudi Arabia and to investigate association of learning environment perception and stages of residency program, sectors of health care system, and regions of Saudi Arabia.
  
  
  METHODS
  A cross-sectional survey using the surgical theater educational environment measure (STEEM) inventory.
  
  
  METHODS
  The STEEM inventory was used to measure theater learning environment perception of urology residents in Saudi Arabia. Respondents' perception was compared regarding different residency stages, sectors of the health care system, and regions of Saudi Arabia. Internal reliability of the inventory was assessed using the Cronbach α coefficient. Correlation analysis was done using the Spearman ρ coefficient.
  
  
  RESULTS
  Of 72 registered residents, 33 (45.8%) completed the questionnaire. The residents perceived their environment less than acceptable (135.9 ± 16.7, 67.95%). No significant differences in perception were found among residents of different program stages, different sectors of health care system, or different regions in Saudi Arabia. Residents from the eastern region perceived the training and teaching domain better (p = 0.025). The inventory showed a high internal consistency with a Cronbach α of 0.862.
  
  
  CONCLUSIONS
  STEEM survey is an applicable and reliable instrument for assessing the learning environment and training skills of urology residency program in Saudi Arabia. Urology residents in Saudi Arabia perceived the theater learning environment as less than ideal. The perceptions of theater learning environment did not change significantly among different stages of the program, different sectors of health care system, or different training regions of Saudi Arabia assuring the uniformity of urology training all over Saudi Arabia. The training programs should address significant concerns and pay close attention to areas in surgical theater educational environment, which need development and enhancement, mainly planned fashion of training, supportive supervision and hospital environment, and proper coverage and management of workloads.
authors.affiliation: Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: binsaleh@ksu.edu.sa.
authors.forename: Saleh
authors.initials: S
authors.lastname: Binsaleh
authors.affiliation: Department of Urology, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Babaeer
authors.affiliation: Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Danny
authors.initials: D
authors.lastname: Rabah
authors.affiliation: Department of Urology, Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia.
authors.forename: Khaled
authors.initials: K
authors.lastname: Madbouly
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D009873:Operating Rooms; D012529:Saudi Arabia; D011795:Surveys and Questionnaires; D014572:Urology / Q000193:education*
keywords: Medical Knowledge; Practice-Based Learning and Improvement; Saudi Arabia; Systems-Based Practice; educational environment; residency program; surgical theatre educational environment measure (STEEM); urology residents