Educational environment of university and non-university hospitals in Japan

Yasuharu Tokuda1, Eiji Goto2, Junji Otaki3, Joshua Jacobs4, Fumio Omata5, Mina Shapiro5, Kumiko Soejima5, Yasushi Ishida5, Sachiko Ohde5, Osamu Takahashi5 and Tsuguya Fukui5

1Institute of Clinical Medicine, University of Tsukuba, Japan

2Department of Medical Education and Behavioral Medicine, Yokohama City University Graduate School of Medical Science, Japan

3Department of Medical Education, Tokyo Medical University, Japan

4University of Hawaii, John A Burns School of Medicine, USA

5Center for Clinical Epidemiology, St. Luke's Life Science Institute, St. Luke's International Hospital, Japan

Submitted: 25/01/2010; Accepted: 17/03/2010; Published: 19/03/2010

Int J Med Educ. 2010; 1:10-14; doi: 10.5116/ijme.4ba1.4034

© 2010 Yasuharu Tokuda et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use of work provided the original work is properly cited. http://creativecommons.org/licenses/by/3.0

Objectives: The greater satisfaction of residents in non-university hospitals in Japan found in a previous survey may reflect a better educational environment in these hospitals compared to university hospitals. We aimed to compare the educational environment of university hospitals and non-university hospitals.

Methods: A cross-sectional survey was sent to 6725 1st year resident physicians. The Postgraduate Hospital Educational Environment Measure (PHEEM) was used as a reliable and validated instrument to evaluate the educational environment of teaching hospitals.

Results: A total of 2429 PGY-1 physicians-in-training (38% women) completed the questionnaire (response rate, 36%). The mean total scores on the PHEEM ranged from 77 to 125 (mean, 99) for 80 university hospitals, and from 46 to 149 (mean, 102) for 255 non-university hospitals. The PHEEM score was significantly higher for non-university hospitals compared to university hospitals (p=0.001). Among the top ten of hospitals with the greatest scores, there were nine non-university hospitals but only one university hospital.

Conclusions: The difference in educational environment may explain the greater satisfaction of non-university residents in Japan and account for the massive shift of residents from university to non-university hospitals after introduction of the new postgraduate medical education program in Japan.