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Assessing the Learning environment of major Specialty PGRs in a tertiary care Hospital by Health Education Learning Environment Survey (HELES)”

Background: 
There are many surveys available to quantify educational climate of postgraduate residents but these are lacking in validity and theoretical background. Health education learning environment survey (HELES) with 35 questions in six subscales is used in undergraduates with good results. 
Objectives: 
To quantify current health education learning environment of our Post graduate residents of FCPS/MS/MD in Surgery, Medicine and Gynae & Obs in a tertiary care hospital by using HELES tool. This quantification will help Supervisors, Hospital administrators to monitor their programs, suggest and bring improvement.   
  
Methods: 
A cross sectional study was done in Services Institute of Medical Sciences Lahore from 10th Sep to 1st Oct 2019. A sum of 90 residents in FCPS/MS/MD program with 30 each from Surgery, Medicine and Gynae & Obstetrics were selected.  A predesigned HELES proforma with 35 questions subdivided in 6 factors and 3 main dimensions was used. In “Personal development “a mean score of 34 and above was taken as positive score. In “Relationship” and in “System maintenance” dimension a mean score of 48 and above was taken as positive. Data was analyzed using SPSS 22 and p value of 0.05 was taken as significant. 
Results: 
Out of 90 residents, 57 (63.3%) were males and 33 (36.7%) were females without any significant difference between gender. The mean age was 27.4 ± 3.6 years. The mean score of all the residents in Surgery, Medicine and Gynae & Obs in all the three dimensions remained below the average reference values, which implies that our postgraduates are not content with the learning environment they live in.  The comparison of means among different specialties was 0.02 which was statistically significant. Resident’s response in all the three dimensions with their year of training was significant with a p value of < 0.05. 2nd year residents of all specialties scored comparatively high in all the three dimensions 
Conclusion:  PGRs in the 3 major specialties were dissatisfied with their health education learning environment. Maximum were discontent in Relationship dimension especially in Faculty relationship factor, then in System maintenance and then in Personal development dimension. Residents of Gynae & Obstetrics exhibited significantly low score in System Maintenance dimension. 
  
Key words: Health, education, learning, environment, residents