title: Adoption and correlates of Postgraduate Hospital Educational Environment Measure (PHEEM) in the evaluation of learning environments - A systematic review.
abstract: BACKGROUND
  The Postgraduate Hospital Educational Environment Measure (PHEEM) is a highly reliable and valid instrument to measure the educational environment during post graduate medical training. This review extends earlier reports by evaluating the extant adoption of PHEEM in various international clinical training sites, and its significant correlations in order to expand our understanding on the use of PHEEM and facilitate future applications and research.
  
  
  METHODS
  A systematic literature review was conducted on all articles between 2005 and October 2015 that adopted and reported data using the PHEEM.
  
  
  RESULTS
  Overall 30 studies were included, encompassing data from 14 countries internationally. Notable differences in the PHEEM scores were found between different levels of training, disciplines, and clinical training sites. Common strengths and weaknesses in learning environments were observed and there were significant correlations between PHEEM scores and In-Training Exam (ITE) performance (positive correlation) and level of burnout (negative correlation), respectively.
  
  
  CONCLUSIONS
  PHEEM is widely adopted in different learning settings, and is a useful tool to identify the strengths and weaknesses of an educational environment. Future research can examine other correlates of PHEEM and longitudinal changes in interventional studies.
authors: a Department of General Psychiatry , Institute of Mental Health , Singapore , Singapore.
authors: Christopher Yi Wen
authors: CY
authors: Chan
authors: b Research Division , Institute of Mental Health , Singapore , Singapore.
authors: Min Yi
authors: MY
authors: Sum
authors: c Centre for Geriatric Medicine, Cognition and Memory Disorders Service , Tan Tock Seng Hospital , Singapore , Singapore.
authors: Wee Shiong
authors: WS
authors: Lim
authors: d Education Office, National Healthcare Group , Singapore , Singapore.
authors: Nicholas Wuen Ming
authors: NW
authors: Chew
authors: e Centre for Medical Education , National University of Singapore , Singapore , Singapore.
authors: Dujeepa D
authors: DD
authors: Samarasekera
authors: a Department of General Psychiatry , Institute of Mental Health , Singapore , Singapore.|b Research Division , Institute of Mental Health , Singapore , Singapore.
authors: Kang
authors: K
authors: Sim
mesh_terms: D004777:Environment; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards; D007398:Interpersonal Relations; D008511:Medicine; D011594:Psychometrics; D015203:Reproducibility of Results; D012737:Sex Factors; D011795:Surveys and Questionnaires / Q000592:standards*; D017132:Workplace / Q000458:organization & administration* / Q000523:psychology* / Q000592:standards