Dotters-Katz Sarah, Hargett Charles W, Zaas Aimee K, Criscione-Schreiber Lisa G
Division of Maternal Fetal Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Med Educ. 2016 Jul;50(7):768-77. doi: 10.1111/medu.13075.
Graduate medical trainees have a critical role in the teaching of other trainees. Improving their teaching requires an understanding of their attitudes towards teaching and their motivation to teach. Both have been incompletely explored in this population. We aimed to better understand graduate medical trainees' attitudes towards teaching and motivation to teach in the clinical setting in order to inform modifications to resident-as-teacher (RAT) programmes and enhance teaching practices.
We applied Q methodology, an established sorting method, to identify and quantify the factors that have an impact on trainees' engagement in teaching. We invited house officers at our institution to rank-order 47 statements regarding their attitudes to and motivation for teaching. Respondents explained their Q-sort rankings in writing and completed a demographic questionnaire. By-person factor analysis yielded groups of individuals with similar attitudes.
One hundred and seven trainees completed the Q-sort. We found three primary groups of attitudes towards teaching in the clinical setting: enthusiasm, reluctance and rewarded. Enthusiastic teachers are committed and make time to teach. Teaching increases their job satisfaction. Reluctant teachers have enthusiasm but are earlier in training and feel limited by clinical workload and unprepared. Rewarded teachers feel teaching is worthwhile and derive satisfaction from the rewards and recognition they receive for teaching.
This improved understanding of common attitudes shared by groups of residents will help curriculum designers create RAT programmes to further reinforce and encourage attitudes that promote teaching as well as improve trainees' motivation to teach. Designing RAT programmes that acknowledge the attitudes to and motivations for teaching should help develop effective teachers to improve educational outcomes. Directed efforts to enhance motivation for reluctant teachers and encourage more positive attitudes in rewarded teachers may lead to improved teaching behaviours among residents.
医学研究生培训学员在对其他学员的教学中起着关键作用。改善他们的教学需要了解他们对教学的态度以及教学动机。在这一群体中，这两方面都尚未得到充分研究。我们旨在更好地理解医学研究生培训学员在临床环境中对教学的态度和教学动机，以便为改进住院医师担任教师（RAT）项目并加强教学实践提供依据。
我们应用Q方法（一种既定的排序方法）来识别和量化影响学员参与教学的因素。我们邀请本院的住院医师对47条关于他们对教学的态度和动机的陈述进行排序。受访者以书面形式解释他们的Q分类排序，并完成一份人口统计学调查问卷。通过个人因素分析得出了态度相似的个体群体。
107名学员完成了Q分类。我们发现临床环境中对教学的三种主要态度群体：热情型、不情愿型和有收获型。热情型教师全身心投入并抽出时间教学。教学提高了他们的工作满意度。不情愿型教师有热情，但处于培训早期，感觉受到临床工作量的限制且准备不足。有收获型教师认为教学是值得的，并从因教学获得的奖励和认可中获得满足感。
对住院医师群体共同态度的这种更好理解将有助于课程设计者创建RAT项目，以进一步强化和鼓励促进教学的态度，并提高学员的教学动机。设计承认教学态度和动机的RAT项目应有助于培养有效的教师，以改善教育成果。针对不情愿型教师增强动机并鼓励有收获型教师形成更积极态度的定向努力，可能会导致住院医师教学行为的改善。
