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教学者,行之能也:剖析住院医师培训项目中教学与临床技能之间的关系

Those Who Teach, Can Do: Characterizing the Relationship Between Teaching and Clinical Skills in a Residency Program.

作者信息

Smith C Christopher, Newman Lori R, Huang Grace C

出版信息

J Grad Med Educ. 2018 Aug;10(4):459-463. doi: 10.4300/JGME-D-18-00039.1.

Abstract

BACKGROUND

Teaching practice is presumed to have significant overlap with clinical skills, yet few studies to date have assessed how residents' teaching skills influence their clinical performance.

OBJECTIVE

We examined the relationship between the professional roles of residents as teachers and as practicing clinicians as well as how learning about teaching contributes to enhanced skills in the clinical realm.

METHODS

Using the framework method, the authors performed a 2-phased (exploratory and confirmatory) qualitative analysis on the data sets to characterize the relationship between resident teaching and clinical skills. To investigate the relationship between teaching and clinical work, we extracted qualitative data from 300 evaluations of clinical performance for residents in a large, urban, academic internal medicine residency program submitted over a 3-year period. Informed by the preliminary framework that evolved from this analysis, we conducted a focus group of 6 residents in a dedicated clinician-educator track to examine how teaching was related to clinical work.

RESULTS

We identified attributes and skills of good resident teachers that enhance clinical skills, categorized as 18 subdomains within 4 domains: relationships, communication, relation to self, and relationship with knowledge.

CONCLUSIONS

Themes that link clinical and teaching skills are similar for both patient-physician and learner-teacher relationships. Improving residents' teaching skills may not only benefit the education of learners but also improve the care of patients.

摘要

背景

教学实践被认为与临床技能有显著重叠,但迄今为止很少有研究评估住院医师的教学技能如何影响其临床绩效。

目的

我们研究了住院医师作为教师和执业临床医生的专业角色之间的关系,以及学习教学如何有助于提高临床领域的技能。

方法

作者使用框架法对数据集进行了两阶段(探索性和验证性)定性分析,以描述住院医师教学与临床技能之间的关系。为了研究教学与临床工作之间的关系,我们从一个大型城市学术内科住院医师项目在3年期间提交的300份住院医师临床绩效评估中提取了定性数据。根据该分析得出的初步框架,我们对6名专门从事临床医生教育的住院医师进行了焦点小组讨论,以研究教学与临床工作的关系。

结果

我们确定了优秀住院医师教师的属性和技能,这些属性和技能可提高临床技能,分为4个领域内的18个子领域:关系、沟通、与自我的关系以及与知识的关系。

结论

患者与医生以及学习者与教师关系中,将临床技能与教学技能联系起来的主题是相似的。提高住院医师的教学技能不仅可能有益于学习者的教育,还可能改善患者的护理。

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