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Ahmad Aalam1,2, Mark Zocchi3, Khalid Alyami4, Abdullah Shalabi5, Abdullah Bakhsh1, Asaad Alsufyani6, Abdulrahman Sabbaghr7, Mohammed Alshahrani4, Jesse M. Pines2,3


1 Department of Emergency Medicine, King Abdulaziz University, Jeddah, Saudi Arabia


Department of Emergency Medicine, The George Washington University, Washington, DC, USA


3 Center for Healthcare Innovation and Policy Research, The George Washington University, Washington, DC, USA


4 Department of Pediatrics, University of Dammam, Dammam, Saudi Arabia


5 Department of Emergency Medicine, King Abdulaziz Medical City, National Guard Hospital, Jeddah, Saudi Arabia


6 Department of Emergency Medicine, University of Toledo, Toledo, Ohio, USA


7 Department of Emergency Medicine, King Fahad Medical City, Riyadh, Saudi Arabia


Corresponding Author: Muhammad Akhter Hamid, Email: mahamid@rougevalley.ca


© 2017 World Journal of Emergency Medicine


DOI: 10.5847/wjem.j.1920–8642.2018.01.001


BACKGROUND: We compare educational environments (i.e. physical, emotional and intellectual experiences) of emergency medicine (EM) residents training in the United States of America (USA) and Saudi Arabia (SA).

METHODS: A cross-sectional survey study was conducted using an adapted version of the validated Postgraduate Hospital Educational Environment Measure (PHEEM) survey instrument from April 2015 through June 2016 to compare educational environments in all emergency medicine residency programs in SA and three selected programs in the USA with a history of training Saudi physicians. Overall scores were compared across programs, and for subscales (autonomy, teaching, and social Support), using chi-squared, t-tests, and analysis of variance.

RESULTS: A total of 219 surveys were returned for 260 residents across six programs (3 SA, 3 USA), with a response rate of 84%. Program-specifi c response rates varied from 79%–100%. All six residencies were qualitatively rated as “more positive than negative but room for improvement”. Quantitative PHEEM scores for the USA programs were significantly higher: 118.7 compared to 109.9 for SA, P=0.001. In subscales, perceptions of social support were not different between the two countries (P=0.243); however, role autonomy (P<0.001) and teaching (P=0.005) were better in USA programs. There were no signifi cant differences by post-graduate training year.

CONCLUSION: EM residents in all three emergency medicine residency programs in SA and the three USA programs studied perceive their training as high quality in general, but with room for improvements. USA residency programs scored higher in overall quality. This was driven by more favorable perceptions of role autonomy and teaching. Understanding how residents perceive their programs may help drive targeted quality improvement efforts.

(World J Emerg Med 2018;9(1):5–12)


KEY WORDS: Emergency medicine residents; Residency training; United States of America; Saudi Arabia

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