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The Work Place Educational Climate in Gynecological Oncology Fellowships Across Europe: The Impact of Accreditation
  1. Jurgen Piek, PhD*,
  2. Michaela Bossart, PhD,
  3. Klarke Boor, PhD*,
  4. Michael Halaska, MD,
  5. Dimitrios Haidopoulos, MD§,
  6. Ignacio Zapardiel, MD,
  7. Jacek Grabowski, PhD,
  8. Vesna Kesic, MD#,
  9. David Cibula, PhD**,
  10. Nicoletta Colombo, PhD,,
  11. Rene Verheijen, PhD, and
  12. Ranjit Manchanda, PhD§§∥∥
  1. *Comprehensive Cancer Center South Location TweeSteden Hospital, Tilburg, the Netherlands;
  2. Department of Obstetrics and Gynecology, University of Freiburg, Freiburg, Germany;
  3. Second Medical Faculty of the Charles University, Prague, Czech Republic;
  4. §First Department of Obstetrics and Gynecology, Gynecologic Oncology Unit, Alexandra Hospital, Athens, Greece;
  5. Gynecological Oncology Unit, La Paz University Hospital, Madrid, Spain;
  6. Department of Gynecology and Gynecological Oncology, Kliniken-Essen-Mitte, Essen, Germany;
  7. #Institute of Obstetrics and Gynecology, Clinical Center of Serbia, Belgrade, Serbia;
  8. **Oncogynecological Centre, Charles University Hospital, Prague, Czech Republic;
  9. ††European Institute of Oncology and Gynecology, Milan, Italy;
  10. ‡‡Division of Surgical and Oncological Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands;
  11. §§Department of Gynaecological Oncology, St Bartholomew’s Hospital, West Smithfield, London, UK; and
  12. ∥∥Department of Women’s Cancer, EGA Institute for Women’s Health, University College London, London, United Kingdom.
  1. Address correspondence and reprint requests to Ranjit Manchanda, PhD, Department of Gynaecological Oncology, St Bartholomew’s Hospital, 7th Floor, Gloucester House, West Smithfield, London EC1A 7BE, United Kingdom. E-mail: r.manchanda{at}


Background A good educational climate/environment in the workplace is essential for developing high-quality medical (sub)specialists. These data are lacking for gynecological oncology training.

Objective This study aims to evaluate the educational climate in gynecological oncology training throughout Europe and the factors affecting it.

Methods A Web-based anonymous survey sent to ENYGO (European Network of Young Gynecological Oncologists) members/trainees to assess gynecological oncology training. This included sociodemographic information, details regarding training posts, and a 50-item validated Dutch Residency Educational Climate Test (D-RECT) questionnaire with 11 subscales (1–5 Likert scale) to assess the educational climate. The χ2 test was used for evaluating categorical variables, and the Mann-Whitney U (nonparametric) test was used for continuous variables between 2 independent groups. Cronbach α assessed the questionnaire reliability. Multivariable linear regression assessed the effect of variables on D-RECT outcome subscales.

Results One hundred nineteen gynecological oncological fellows responded. The D-RECT questionnaire was extremely reliable for assessing the educational environment in gynecological oncology (subscales’ Cronbach α, 0.82–0.96). Overall, trainees do not seem to receive adequate/effective constructive feedback during training. The overall educational climate (supervision, coaching/assessment, feedback, teamwork, interconsultant relationships, formal education, role of the tutor, patient handover, and overall consultant’s attitude) was significantly better (P = 0.001) in centers providing accredited training in comparison with centers without such accreditation. Multivariable regression indicated the main factors independently associated with a better educational climate were presence of an accredited training post and total years of training.

Conclusions This study emphasizes the need for better feedback mechanisms and the importance of accreditation of centers for training in gynecological oncology to ensure training within higher quality clinical learning climates.

  • Educational climate
  • D-RECT
  • Gynecological oncology training
  • Accreditation

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  • Drs Jurgen Piek and Ranjit Manchanda equally contributed to this study.

  • The study was funded through the European Network of Young Gynecological Oncologists budget grant (grant number E/01042012), which was provided by the European Society of Gynecological Oncology.

  • The authors declare no conflicts of interest.