Ijaz Hamza, Stull Matthew, McDonough Erin, Paulsen Robbie, Hill Jeffrey
University of Cincinnati Cincinnati Ohio USA.
University Hospitals Cleveland Medical Center Cleveland Ohio USA.
AEM Educ Train. 2022 Aug 11;6(4):e10789. doi: 10.1002/aet2.10789. eCollection 2022 Aug.
Evaluating a resident's development as a bedside educator in the emergency department (ED) is challenging. Teaching consults, where trainees are observed and assessed in their teaching skills, have been used to improve bedside teaching. Within emergency medicine, there are a few assessment tools to evaluate a clinician's bedside teaching, with the majority focusing on faculty. A user-friendly assessment tool adapted to the ED that emphasizes behaviorally anchored, milestone-based evaluations for residents has yet to be developed. We sought to develop such an assessment tool for evaluating residents' bedside teaching in the ED. Using a nominal-group consensus-building technique, we derived the bedside teaching assessment tool. The consensus-building panel was composed of clinician-educators with extensive experience in resident education. The teaching consult process consisted of the consultant, a faculty member with a focus in medical education, directly observing a resident's bedside teaching throughout their shift while filling out the evaluation form based on observed behaviors. A total of 35 consults were provided to 30 individual residents. The mean (±SD) scores for the 35 consults for the learning climate, content teaching, supervision, feedback and evaluation, and self-assessment were 3.84 (±0.75), 3.56 (±0.58), 3.70 (±0.60), 3.64 (±0.77), and 3.92 (±0.45), respectively. The median scores for the above domains were 4, 3.5, 4, 3.5, and 4, respectively. The tool has acceptable internal consistency with a Cronbach's alpha of 0.723 (95% CI 0.469-0.839). Eleven of 13 (85%) residents who provided feedback agreed or strongly agreed that the quantitative feedback provided by the assessment tool was useful. Twelve of 13 (92%) residents found the consultation process to be unobtrusive to their clinical performance. In conclusion, this novel behaviorally anchored assessment tool for bedside teaching can serve as a useful adjunct to a teaching consult and provide useful feedback for the development of residents' bedside teaching skills.
评估住院医师在急诊科作为床边教育者的发展具有挑战性。教学会诊，即观察并评估实习生的教学技能，已被用于改善床边教学。在急诊医学领域，有一些评估工具用于评估临床医生的床边教学，但大多数工具关注的是教员。尚未开发出一种适用于急诊科的、用户友好型评估工具，该工具强调基于行为锚定、以里程碑为基础的住院医师评估。我们试图开发这样一种评估工具，用于评估住院医师在急诊科的床边教学。我们采用名义群体共识构建技术，得出了床边教学评估工具。共识构建小组由在住院医师教育方面具有丰富经验的临床教育工作者组成。教学会诊过程包括会诊人员，即一位专注于医学教育的教员，在住院医师整个轮班期间直接观察其床边教学，同时根据观察到的行为填写评估表。共为30名住院医师提供了35次会诊。35次会诊在学习氛围、内容教学、监督、反馈与评估以及自我评估方面的平均（±标准差）得分分别为3.84（±0.75）、3.56（±0.58）、3.70（±0.60）、3.64（±0.77）和3.92（±0.45）。上述领域的中位数得分分别为4、3.5、4、3.5和4。该工具具有可接受的内部一致性，Cronbach's α系数为0.723（95%置信区间0.469 - 0.839）。提供反馈的13名住院医师中有11名（85%）同意或强烈同意评估工具提供的定量反馈是有用的。13名住院医师中有12名（92%）发现会诊过程对其临床工作没有干扰。总之，这种用于床边教学的新型行为锚定评估工具可作为教学会诊的有益辅助手段，并为住院医师床边教学技能的发展提供有用反馈。
