Miloslavsky Eli M, Degnan Kathleen, McNeill Jenna, McSparron Jakob I
J Grad Med Educ. 2017 Jun;9(3):345-350. doi: 10.4300/JGME-D-16-00464.1.
Subspecialty consultation in inpatient care is increasing. Teaching by subspecialty fellows in a consultation setting may be an important source of work-based learning for students and residents. However, teaching and evaluation of learners in this context may be challenging due to personal and systems-based barriers.
We developed and evaluated a framework designed to overcome barriers to teaching and to improve fellow teaching skills during inpatient consultation.
The PARTNER (artner with resident, ssess the learner, einforce positives, eaching objectives, ew knowledge, xecute recommendations, eview) framework was delivered to rheumatology and pulmonary and critical care medicine fellows at 3 academic medical centers as part of a 2-session Fellow as Clinical Teacher (FACT) curriculum. Fellows' teaching skills were evaluated using an objective structured teaching exercise (OSTE) pre- and postcurriculum, and at the end of the academic year. Self-assessment surveys were used to evaluate fellows' self-perception of teaching skills.
Twelve of 16 eligible fellows (75%) participated in the program and completed 73 OSTE cases. Teaching skills measured by OSTEs and self-assessment surveys improved after administration of the FACT curriculum. There was no significant skill decay at the end-of-year evaluation. The curriculum was rated highly, and 73% (8 of 11) of fellows stated they would teach more frequently as a result of the intervention.
The FACT curriculum was practical and feasible, and significantly improved fellows' teaching skills teaching during inpatient consultation.
住院护理中的专科会诊正在增加。专科住院医师在会诊环境中的教学可能是学生和住院医师基于工作学习的重要来源。然而，由于个人和系统层面的障碍，在此背景下对学习者的教学和评估可能具有挑战性。
我们开发并评估了一个框架，旨在克服教学障碍并提高住院会诊期间住院医师的教学技能。
作为为期两期的“住院医师临床教师”（FACT）课程的一部分，向3个学术医疗中心的风湿病学、肺病与重症医学住院医师传授了PARTNER（与住院医师合作、评估学习者、强化积极方面、教学目标、新知识、执行建议、回顾）框架。在课程前后以及学年结束时，使用客观结构化教学练习（OSTE）对住院医师的教学技能进行评估。自我评估调查用于评估住院医师对教学技能的自我认知。
16名符合条件的住院医师中有12名（75%）参加了该项目并完成了73个OSTE案例。在实施FACT课程后，通过OSTE和自我评估调查衡量的教学技能有所提高。在年终评估时，技能没有明显下降。该课程获得了高度评价，73%（11名中的8名）的住院医师表示，由于此次干预，他们会更频繁地进行教学。
FACT课程切实可行，显著提高了住院医师在住院会诊期间的教学技能。
