住院医师作为教师工作坊对实习生教学行为及医学生学习成果的影响
Impact of a Resident-as-Teacher Workshop on Teaching Behavior of Interns and Learning Outcomes of Medical Students.
作者信息
Hill Andrew G, Srinivasa Sanket, Hawken Susan J, Barrow Mark, Farrell Susan E, Hattie John, Yu Tzu-Chieh
出版信息
J Grad Med Educ. 2012 Mar;4(1):34-41. doi: 10.4300/JGME-D-11-00062.1.
BACKGROUND
Residents and interns are recognized as important clinical teachers and mentors. Resident-as-teacher training programs are known to improve resident attitudes and perceptions toward teaching, as well as their theoretical knowledge, skills, and teaching behavior. The effect of resident-as-teacher programs on learning outcomes of medical students, however, remains unknown. An intervention cohort study was conducted to prospectively investigate the effects of a teacher-training workshop on teaching behavior of participating interns and on the clerkship learning outcomes of instructed fourth-year medical students.
METHODS
The House Officer-as-Teacher Training Workshop was implemented in November 2009 over 1.5 days and attended by all 34 interns from one teaching hospital. Subsequently, between February and August 2010, 124 fourth-year medical students rated the observable teaching behavior of interns during 6-week general surgery clerkships at this intervention hospital as well as at 2 comparable hospitals serving as control sites. Ratings were collected using an anonymous 15-item Intern Clinical Teaching Effectiveness Instrument. Student achievement of clerkship learning outcomes during this period was evaluated using a validated and centralized objective structured clinical examination.
RESULTS
Medical students completed 101 intern clinical teaching effectiveness instruments. Intern teaching behavior at the intervention hospital was found to be significantly more positive, compared with observed behavior at the control hospitals. Objective structured clinical examination results, however, did not demonstrate any significant intersite differences in student achievement of general surgery clerkship learning outcomes.
CONCLUSIONS
The House Officer-as-Teacher Training Workshop noticeably improved teaching behavior of surgical interns during general surgery clerkships. This improvement did not, however, translate into improved achievement of clerkship learning outcomes by medical students during the study period.
背景
住院医师和实习医师被视为重要的临床教师和导师。住院医师作为教师的培训项目已知可改善住院医师对教学的态度和认知，以及他们的理论知识、技能和教学行为。然而，住院医师作为教师的项目对医学生学习成果的影响仍不明确。进行了一项干预队列研究，以前瞻性地调查教师培训工作坊对参与实习医师教学行为以及对接受指导的四年级医学生临床实习学习成果的影响。
方法
住院医师作为教师培训工作坊于2009年11月开展，为期1.5天，来自一家教学医院的所有34名实习医师参加。随后，在2010年2月至8月期间，124名四年级医学生对该干预医院以及另外两家作为对照的可比医院的实习医师在为期6周的普通外科临床实习期间的可观察教学行为进行了评分。使用一份包含15个条目的匿名实习医师临床教学有效性量表收集评分。在此期间，使用经过验证的集中式客观结构化临床考试评估学生临床实习学习成果的达成情况。
结果
医学生完成了101份实习医师临床教学有效性量表。与对照医院观察到的行为相比，发现干预医院的实习医师教学行为明显更积极。然而，客观结构化临床考试结果并未显示出各医院在普通外科临床实习学习成果达成方面存在任何显著差异。
结论
住院医师作为教师培训工作坊显著改善了普通外科临床实习期间外科实习医师的教学行为。然而，在研究期间，这种改善并未转化为医学生临床实习学习成果的提高。
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