Bruijn M, Busari J O, Wolf B H M
Emma Children's Hospital AMC, Amsterdam, the Netherlands.
Med Educ. 2006 Oct;40(10):1002-8. doi: 10.1111/j.1365-2929.2006.02559.x.
Clinical supervision promotes the professional development of specialist registrars (SpRs). Our objective was to investigate and compare the perceived quality of supervision (PQS) in a university teaching hospital (UTH) and a district teaching hospital (DTH) and to identify aspects of supervision that could be improved.
The Cleveland Clinic's teaching effectiveness instrument (CCTEI) was used to measure the quality of supervision of attending doctors. Fifteen items reflecting good teaching ability were rated on a 5-point Likert-scale (1-5 = poor-excellent).
SpRs rated 47 attending doctors using the CCTEI. A total of 416 ratings were obtained. Overall, the mean PQS was 3.85 (SD = 0.29) in the DTH and 3.56 (SD = 0.44) in the UTH (P = 0.02). A significant difference in PQS was found in 6 items. The supervisors in the DTH scored better on all these items. The best predictor of PQS was the item 'Organises time to allow for both teaching and care giving'.
Overall, PQS was better in the DTH compared to the UTH. In both settings, generating a good learning environment and respecting the autonomy of the SpRs scored favourably. Supervisory roles focusing on improving cost-effective practice and communicative skills need more emphasis.
临床督导促进专科住院医师（SpRs）的专业发展。我们的目的是调查和比较大学教学医院（UTH）和地区教学医院（DTH）中感知到的督导质量（PQS），并确定可以改进的督导方面。
使用克利夫兰诊所的教学效果工具（CCTEI）来衡量主治医生的督导质量。15项反映良好教学能力的项目采用5点李克特量表评分（1 - 5 = 差 - 优秀）。
SpRs使用CCTEI对47名主治医生进行了评分。共获得416个评分。总体而言，DTH的平均PQS为3.85（标准差 = 0.29），UTH为3.56（标准差 = 0.44）（P = 0.02）。在6个项目中发现PQS存在显著差异。DTH的督导在所有这些项目上得分更高。PQS的最佳预测指标是“安排时间以便同时进行教学和护理”这一项目。
总体而言，与UTH相比，DTH的PQS更好。在这两种环境中，营造良好的学习环境和尊重SpRs的自主权得分较高。需要更加强调侧重于提高成本效益实践和沟通技巧的督导角色。
