Bajwa Nadia M, De Grasset Jehanne, Audétat Marie-Claude, Jastrow Nicole, Richard-Lepouriel Hélène, Dominicé Dao Melissa, Nendaz Mathieu R, Junod Perron Noëlle
Department of General Pediatrics at the Children's Hospital, Geneva University Hospitals, Geneva, Switzerland.
Faculty of Medicine, Unit of Development and Research in Medical Education (UDREM), University of Geneva, Geneva, Switzerland.
Med Teach. 2020 Jun;42(6):663-672. doi: 10.1080/0142159X.2020.1732316. Epub 2020 Mar 4.
Junior clinical faculty require institutional support in the acquisition of feedback and clinical supervision skills of trainees. We tested the effectiveness of a personalized coaching versus guided self-reflection format of a faculty development program at improving faculty skills and self-efficacy. Participants were evaluated both before and after the program using a four-station Objective Structured Teaching Exercise (OSTE). A gain-score analysis, one-way ANOVA, and paired -tests were used to evaluate both groups. The impact on the learning environment was measured by resident ratings of the Maastricht Clinical Teaching Questionnaire. One hundred and twenty-seven participants completed the study over a three-year period. Both groups had significant improvements in self-efficacy. Participants in the coaching group demonstrated superior performance in encouraging learner self-reflection, teaching effectiveness, verifying learner understanding, exploring feelings/needs, and defining learning objectives. Over a 5-year period, the overall institutional learning climate significantly improved concerning faculty role-modeling, coaching, articulation, and explorations skills. Offering a contextualized faculty-development program using OSTEs that provides multiple opportunities for feedback and is focused on creating a community of practice is an effective method to facilitate the transfer of skills to the clinical environment, supports teacher identity development, and favorably impacts the learning climate.
初级临床教员在获得对学员的反馈和临床监督技能方面需要机构支持。我们测试了教员发展计划中个性化辅导与引导式自我反思形式在提高教员技能和自我效能方面的有效性。使用四站式客观结构化教学练习（OSTE）在项目前后对参与者进行评估。采用增益分数分析、单因素方差分析和配对检验对两组进行评估。通过住院医师对马斯特里赫特临床教学问卷的评分来衡量对学习环境的影响。在三年时间里，127名参与者完成了该研究。两组的自我效能都有显著提高。辅导组的参与者在鼓励学习者自我反思、教学效果、验证学习者理解、探索感受/需求以及确定学习目标方面表现更优。在五年时间里，机构整体学习氛围在教员榜样作用、辅导、表达和探索技能方面有显著改善。提供一个使用OSTE的情境化教员发展计划，该计划提供多次反馈机会并专注于创建实践社区，是促进技能向临床环境转移、支持教师身份发展并对学习氛围产生积极影响的有效方法。
