Kripalani Sunil, Pope Allison C, Rask Kimberly, Hunt Kimberly, Dressler Daniel D, Branch William T, Zhang Rebecca, Williams Mark V
Division of General Medicine, Emory University School of Medicine, Atlanta, GA 30303, USA.
J Gen Intern Med. 2004 Jan;19(1):8-15. doi: 10.1111/j.1525-1497.2004.20907.x.
To compare evaluations of teaching effectiveness among hospitalist, general medicine, and subspecialist attendings on general medicine wards.
Cross-sectional.
A large, inner-city, public teaching hospital.
A total of 423 medical students and house staff evaluating 63 attending physicians.
We measured teaching effectiveness with the McGill Clinical Tutor Evaluation (CTE), a validated 25-item survey, and reviewed additional written comments. The response rate was 81%. On a 150-point composite measure, hospitalists' mean score (134.5 [95% confidence interval (CI), 130.2 to 138.8]) exceeded that of subspecialists (126.3 [95% CI, 120.4 to 132.1]), P =.03. General medicine attendings (135.0 [95% CI, 131.2 to 138.8]) were also rated higher than subspecialists, P =.01. Physicians who graduated from medical school in the 1990s received higher scores (136.0 [95% CI, 133.0 to 139.1]) than did more distant graduates (129.1 [95% CI, 125.1 to 133.1]), P =.006. These trends persisted after adjusting for covariates, but only year of graduation remained statistically significant, P =.05. Qualitative analysis of written remarks revealed that trainees valued faculty who were enthusiastic teachers, practiced evidence-based medicine, were involved in patient care, and developed a good rapport with patients and other team members. These characteristics were most often noted for hospitalist and general medicine attendings.
On general medicine wards, medical students and residents considered hospitalists and general medicine attendings to be more effective teachers than subspecialists. This effect may be related to the preferred faculty members exhibiting specific characteristics and behaviors highly valued by trainees, such as enthusiasm for teaching and use of evidence-based medicine.
比较内科住院医师、普通内科医师和专科医师在普通内科病房的教学效果评估。
横断面研究。
一家大型市中心公立教学医院。
共有423名医学生和住院医师对63名主治医师进行评估。
我们使用经过验证的25项麦吉尔临床教师评估（CTE）调查来衡量教学效果，并查看了其他书面评论。回复率为81%。在150分的综合评分中，内科住院医师的平均得分（134.5[95%置信区间（CI），130.2至138.8]）超过了专科医师（126.3[95%CI，120.4至132.1]），P = 0.03。普通内科主治医师（135.0[95%CI，131.2至138.8]）的评分也高于专科医师，P = 0.01。20世纪90年代毕业于医学院的医师得分（136.0[95%CI，133.0至139.1]）高于更早毕业的医师（129.1[95%CI，125.1至133.1]），P = 0.006。在对协变量进行调整后，这些趋势仍然存在，但只有毕业年份仍具有统计学意义，P = 0.05。对书面评论的定性分析表明，学员重视那些热情教学、践行循证医学、参与患者护理并与患者及其他团队成员建立良好关系的教员。这些特征在内科住院医师和普通内科主治医师中最为常见。
在普通内科病房，医学生和住院医师认为内科住院医师和普通内科主治医师比专科医师教学更有效。这种效应可能与受青睐的教员表现出学员高度重视的特定特征和行为有关，例如对教学的热情和循证医学的应用。
