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Aim: To look at the characteristics of Postgraduate Hospital Educational Environment Measure (PHEEM) using data from the UK, Brazil, Chile and the Netherlands, and to examine the reliability and characteristics of PHEEM, especially how the three PHEEM subscales fitted with factors derived statistically from the data sets. Methods: Statistical analysis of PHEEM scores from 1563 sets of data, using reliability analysis, exploratory factor analysis and correlations of factors derived with the three defined PHEEM subscales. Results: PHEEM was very reliable with an overall Cronbach's alpha of 0.928. Three factors were derived by exploratory factor analysis. Factor One correlated most strongly with the teaching subscale ( R = 0.802), Factor Two correlated most strongly with the role autonomy subscale ( R = 0.623) and Factor Three correlated most strongly with the social support subscale ( R = 0.538). Conclusions: PHEEM is a multi-dimensional instrument. Overall, it is very reliable. There is a good fit of the three defined subscales, derived by qualitative methods, with the three principal factors derived from the data by exploratory factor analysis. [ABSTRACT FROM AUTHOR]

SUMMARY A literature search for articles concerning communication skills teaching and learning in medicine was done. The search yielded 180 pertinent articles, which were quality graded into the three categories of high, medium and low quality, using established criteria. Only those of high and medium quality were used for the review, which thus is based on 31 randomized studies, 38 open effect studies and 14 descriptive studies. Communication skills can be taught in courses, are learnt, but are easily forgotten if not maintained by practice. The most effective point in time to learn these at medical school is probably during the clinical clerkships, but there is no study that has specifically addressed this question. After a short period of training, doctors can be effective as teachers. The teaching method should be experiential as it has been shown conclusively that instructional methods do not give the desired results. The contents of communication skills courses should primarily be problem defining. All students should have communication skills training since those with the lowest pre-course scores gain the most from such courses. Men are slower learners of communication skills than women, which should be taken into account by course organizers. As there is only one really long-term follow up into the residency phase of communication skills training at medical school, those who have done randomized studies in the field should if possible carry out further follow-up studies. [ABSTRACT FROM AUTHOR]