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了解住院医师对工作场所教学的评价:一项多中心研究。

Understanding resident ratings of teaching in the workplace: a multi-centre study.

作者信息

Fluit Cornelia R M G, Feskens Remco, Bolhuis Sanneke, Grol Richard, Wensing Michel, Laan Roland

机构信息

Academic Educational Institute, Radboud University Medical Center Nijmegen, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, The Netherlands,

出版信息

Adv Health Sci Educ Theory Pract. 2015 Aug;20(3):691-707. doi: 10.1007/s10459-014-9559-8. Epub 2014 Oct 15.

Abstract

Providing clinical teachers with feedback about their teaching skills is a powerful tool to improve teaching. Evaluations are mostly based on questionnaires completed by residents. We investigated to what extent characteristics of residents, clinical teachers, and the clinical environment influenced these evaluations, and the relation between residents' scores and their teachers' self-scores. The evaluation and feedback for effective clinical teaching questionnaire (EFFECT) was used to (self)assess clinical teachers from 12 disciplines (15 departments, four hospitals). Items were scored on a five-point Likert scale. Main outcome measures were residents' mean overall scores (MOSs), specific scale scores (MSSs), and clinical teachers' self-evaluation scores. Multilevel regression analysis was used to identify predictors. Residents' scores and self-evaluations were compared. Residents filled in 1,013 questionnaires, evaluating 230 clinical teachers. We received 160 self-evaluations. 'Planning Teaching' and 'Personal Support' (4.52, SD .61 and 4.53, SD .59) were rated highest, 'Feedback Content' (CanMEDS related) (4.12, SD .71) was rated lowest. Teachers in affiliated hospitals showed highest MOS and MSS. Medical specialty did not influence MOS. Female clinical teachers were rated higher for most MSS, achieving statistical significance. Residents in year 1-2 were most positive about their teachers. Residents' gender did not affect the mean scores, except for role modeling. At group level, self-evaluations and residents' ratings correlated highly (Kendall's τ 0.859). Resident evaluations of clinical teachers are influenced by teacher's gender, year of residency training, type of hospital, and to a lesser extent teachers' gender. Clinical teachers and residents agree on strong and weak points of clinical teaching.

摘要

为临床教师提供关于其教学技能的反馈是提高教学质量的有力工具。评估大多基于住院医师填写的问卷。我们调查了住院医师、临床教师的特征以及临床环境在多大程度上影响了这些评估,以及住院医师得分与教师自评得分之间的关系。使用有效临床教学评估与反馈问卷(EFFECT)对来自12个学科(15个科室,4所医院)的临床教师进行(自我)评估。项目采用五点李克特量表评分。主要结局指标为住院医师的平均总体得分(MOSs)、特定量表得分(MSSs)以及临床教师的自我评价得分。采用多水平回归分析来确定预测因素。比较了住院医师的得分与自我评价。住院医师填写了1013份问卷,对230名临床教师进行了评估。我们收到了160份自我评价。“教学规划”和“个人支持”(均值分别为4.52,标准差0.61和4.53,标准差0.59)得分最高,“反馈内容”(与CanMEDS相关)(均值为4.12,标准差0.71)得分最低。附属医院的教师MOS和MSS最高。医学专业不影响MOS。大多数MSS中,女性临床教师得分更高,具有统计学意义。1 - 2年级的住院医师对其教师评价最为积极。住院医师的性别除在角色示范方面外不影响平均分。在组水平上,自我评价与住院医师评分高度相关(肯德尔τ系数为0.859)。住院医师对临床教师的评价受教师性别、住院医师培训年份、医院类型影响,且在较小程度上受教师性别的影响。临床教师和住院医师对临床教学的优缺点看法一致。

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