Busari Jamiu O, Koot Bart G
Department of Paediatrics, Atrium Medical Centre, Heerlen, The Netherlands.
Med Educ. 2007 Oct;41(10):957-64. doi: 10.1111/j.1365-2923.2007.02837.x. Epub 2007 Aug 31.
Attending doctors (ADs) play important roles in the supervision of specialist registrars. Little is known, however, about how they perceive the quality of their supervision in different teaching settings. We decided to investigate whether there is any difference in how ADs perceive the quality of their supervision in university teaching hospital (UTH) and district teaching hospital (DTH) settings.
We used a standardised questionnaire to investigate the quality of supervision as perceived by ADs. Fifteen items reflecting good teaching ability were measured on a 5-point Likert scale (1-5: never-always). We investigated for factors that influenced the perceived quality of supervision using Likert scale items (1-5: totally disagree-totally agree) and open-ended questionnaires.
A total of 83 ADs (UTH: 51; DTH: 32) were eligible to participate in the survey. Of these, 43 (52%) returned the questionnaire (UTH: 25; DTH: 18). There was no difference in the overall mean of the 15 items between the UTH (3.67, standard deviation [SD] 0.35) and DTH (3.73, SD 0.31) ADs. Attending doctors in the DTH group rated themselves better at 'teaching technical skills' (mean 3.50, SD 0.70), compared with their UTH counterparts (mean 3.0, SD 0.76) (P = 0.03). Analysis of variance of the overall means revealed no significant difference between the different hospital settings.
The results suggest that teaching hospital environments do not influence how ADs perceive the quality of their supervision. Lack of time for teaching was perceived as responsible for poor supervision. Other factors found to influence AD perceptions of good supervision included effective teaching skills, communication skills and provision of feedback.
主治医生在专科住院医生的监督中发挥着重要作用。然而，对于他们如何看待不同教学环境下的监督质量，我们知之甚少。我们决定调查主治医生对大学教学医院（UTH）和地区教学医院（DTH）环境下监督质量的看法是否存在差异。
我们使用标准化问卷来调查主治医生所感知的监督质量。在5点李克特量表（1 - 5：从不 - 总是）上测量反映良好教学能力的15个项目。我们使用李克特量表项目（1 - 5：完全不同意 - 完全同意）和开放式问卷来调查影响监督质量感知的因素。
共有83名主治医生（UTH：51名；DTH：32名）符合参与调查的条件。其中，43名（52%）返回了问卷（UTH：25名；DTH：18名）。UTH（3.67，标准差[SD] 0.35）和DTH（3.73，SD 0.31）的主治医生在15个项目的总体平均值上没有差异。与UTH的同行（平均值3.0，SD 0.76）相比，DTH组的主治医生在“教授技术技能”方面给自己的评分更高（平均值3.50，SD 0.70）（P = 0.03）。总体平均值的方差分析显示不同医院环境之间没有显著差异。
结果表明教学医院环境不会影响主治医生对其监督质量的看法。教学时间不足被认为是监督不力的原因。其他被发现影响主治医生对良好监督看法的因素包括有效的教学技能、沟通技能和反馈的提供。
