Adshead Lesley, White Patrick T, Stephenson Anne
King's College, London School of Medicine at Guy's, King's College and St Thomas' Hospitals, UK.
Med Teach. 2006 Mar;28(2):e68-73. doi: 10.1080/01421590600617533.
In medical education programmes which rely on clinical teachers spread across diverse sites, the application of peer observation of teaching offers the potential of both supporting teachers and maintaining quality. This paper reports on a questionnaire survey carried out with general practitioner (GP) teachers of medical undergraduate students from King's College London School of Medicine at Guy's, King's College and St Thomas' Hospitals. The aim of the study was to determine GP teachers' views on a proposed programme of peer observation of their teaching. The majority of GP teachers identified benefits of the proposed scheme with 69% saying it would help improve the education of future doctors. However, despite seeing the benefits, less than half wished to take part in the programme. Two thirds cited time and paperwork as major disincentives to taking part and 62% said that they felt it would make them feel under scrutiny. No associations were found between measures of workload and willingness to take part. This suggests that a fundamental fear of scrutiny and criticism may be the main hurdle to be overcome in implementing the scheme. Imposing peer observation on GP teachers in the form proposed could create suspicion and distance between the university department and practice-based GP teachers and may even result in a loss of teachers. The introduction of peer observation is more likely to be successful if GPs' apprehensions are addressed. Using peer observation to strengthen the process of quality assurance may undermine its role in the support and development of clinical teachers.
在依赖分布于不同地点的临床教师的医学教育项目中，教学同行观察的应用具有支持教师和维持教学质量的潜力。本文报告了一项针对伦敦国王学院医学院盖伊医院、国王学院医院和圣托马斯医院的医学本科学生全科医生（GP）教师开展的问卷调查。该研究的目的是确定全科医生教师对拟议的教学同行观察项目的看法。大多数全科医生教师认同拟议方案的益处，69%的人表示这将有助于改善未来医生的教育。然而，尽管看到了益处，但不到一半的人希望参与该项目。三分之二的人指出时间和文书工作是参与的主要阻碍，62%的人表示他们觉得这会让他们感到受到审视。在工作量指标与参与意愿之间未发现关联。这表明对审视和批评的根本恐惧可能是实施该方案时需要克服的主要障碍。以提议的形式对全科医生教师强制进行同行观察可能会在大学部门与基于实践的全科医生教师之间引发猜疑和隔阂，甚至可能导致教师流失。如果能解决全科医生的担忧，同行观察的引入更有可能取得成功。利用同行观察来强化质量保证过程可能会削弱其在支持和发展临床教师方面的作用。
