Lessons learned from the Victorian PHEEM project
A guide to the use of PHEEM in Australia
The Australian version of the PHEEM instrument has been used successfully to provide valuable data about the educational environment in Victorian hospitals. In the course of this project, key elements that enhance the successful use of the instrument have become evident and are outlined below.
Key element 1
Have a thorough understanding of the PHEEM instrument. To do this you will need to:
- Read the original article describing the PHEEM (Roff et al);
- Having an understanding of the psychometric testing of PHEEM is also advised (Boor et al) (Riquelme et al);
- Understand the scoring schema; and
- Review the Australian PHEEM form and become familiar with the 40 items.
Key element 2
Be clear about the Why, Where, Who, and How of using the PHEEM:
- Why you are using the PHEEM instrument – eg. gathering information about various jobs / units / departments; quality improvement etc. Using the PHEEM instruments for external benchmarking is potentially counter-productive in a collaborative project.
- Where to use it – jobs / units / departments;
- Who will be involved – all prevocational levels or limited to one prevocational group;
- Who to report the data to; and
- How to collect the data. Various data collection methods yield vastly different results. The greatest return rates have been achieved by collecting data at group education sessions. A return rate of 85% is our aim.
Key element 3
Ensure organisational support for using the PHEEM. Having a local champion is also very beneficial so designate someone at the hospital to ensure that the following activities occur:
- Administer the distribution and collection of PHEEM questionnaires. If data about specific jobs is being collected it will be necessary to develop a coding system to identify each job;
- Distribute analysed results as appropriate;
- Provide feedback to the participating units / departments and participating doctors; and
- Facilitate review of the results and items for attention.
Key element 4
Clarify the following important details before commencing the PHEEM:
- Extent of involvement – is it a collaborative activity involving several hospitals or just one hospital? There are benefits in working with others including the capacity to expand positive aspects of the clinical learning environment, and also in facilitating ways to address identified areas for improvement. In our experience, many areas of the learning environment that require attention are common among hospitals. See PHEEM Report (Stage 2) 2009;
- How anonymity will be maintained - this requires greater consideration in smaller facilities with small numbers of prevocational doctors in each job / unit; and
- Who is responsible for facilitating the central collection and analysis of the PHEEM forms and the subsequent distribution of collated data to participating hospitals.