一种新型的住院医师带教课程:体验式学习与指导的作用。
A novel resident-as-teacher curriculum: the role of experiential learning and coaching.
作者信息
Tan Amy, Babenko Oksana, England Alyssa, Humphries Paul, Hillier Tracey
机构信息
University of Calgary.
University of Alberta.
出版信息
MedEdPublish (2016). 2017 Sep 22;6:168. doi: 10.15694/mep.2017.000168. eCollection 2017.
This article was migrated. The article was marked as recommended. Canadian family medicine residency programs have the challenge of training in a wide breadth of topics and competencies within a two-year program, including training residents to be effective teachers. There has been a gap in knowledge with regards to the most effective method to train residents to teach. We developed, implemented, and evaluated a novel multi-level resident-as-teacher (RAT) coaching curriculum to provide training and authentic experiences for family medicine residents in teaching medical students. A curriculum centred around multi-level coaching was designed where family medicine faculty members directly observed and provided feedback to family medicine residents teaching small group clinical skills to first and second year medical students. Family medicine residents received didactic training on how to provide effective feedback to students and manage small group dynamics, after reviewing the learning objectives that students were to achieve. This was followed by the authentic small group teaching experiences. A survey was sent out by email to all residents and faculty members who had participated in the RAT curriculum at the end of the 2013-2014 and 2014-2015 academic years. Quantitative survey data were analyzed using descriptive statistics (frequencies, percentages, correlation coefficients (Spearman's rho)). Qualitative analysis was completed through thematic analysis of respondents' written comments to open-ended survey questions. 80% of 127 residents strongly agreed (26%) or agreed (54%) that the RAT program effectively developed their teaching skills. 57% either strongly agreed (17%) or agreed (40%) that the direct observation and feedback from faculty coaches helped to improve their teaching skills. There was a significant positive correlation between residents' perceptions of the usefulness of the feedback from faculty coaches and residents' perceptions of the overall RAT program's effectiveness in developing their teaching skills (r=0.42; p=0.001). Qualitative analysis revealed that residents perceived the RAT program to have solidified their own knowledge base for the content covered in the sessions. Residents also perceived a benefit of near-peer teaching for the medical students and an elevated family physicians' profile as teachers. They found the active learning experience increased their self-awareness of their teaching skills. Time away from clinical rotations and preparation time were derived as a potential drawback of the program. All faculty coaches agreed or strongly agreed that the RAT curriculum improved the teaching skills of family medicine residents. Thematic analysis of the faculty coaches' comments revealed that participating as coaches allowed for their own professional development in that their feedback and coaching skills improved. Our experiences and program evaluation of a novel multi-level resident-as-teacher coaching curriculum show that direct observation with feedback of authentic teaching activities is highly valued, and appears to be effective in developing resident teaching skills while fostering interest in future teaching.
本文已迁移。该文章被标记为推荐文章。加拿大家庭医学住院医师培训项目面临着在两年的培训计划中涵盖广泛主题和能力的挑战,包括培训住院医师成为有效的教师。在培训住院医师教学的最有效方法方面存在知识差距。我们开发、实施并评估了一种新颖的多层次住院医师即教师(RAT)指导课程,为家庭医学住院医师提供教学医学生的培训和真实体验。设计了一个以多层次指导为中心的课程,家庭医学教员直接观察家庭医学住院医师为一、二年级医学生进行小组临床技能教学,并提供反馈。家庭医学住院医师在审查学生要实现的学习目标后,接受了关于如何向学生提供有效反馈和管理小组互动的理论培训。随后是真实的小组教学体验。在2013 - 2014学年和2014 - 2015学年结束时,通过电子邮件向所有参与RAT课程的住院医师和教员发送了一份调查问卷。定量调查数据使用描述性统计(频率、百分比、相关系数(斯皮尔曼等级相关系数))进行分析。定性分析通过对受访者对开放式调查问题的书面评论进行主题分析来完成。127名住院医师中有80%强烈同意(26%)或同意(54%)RAT项目有效地培养了他们的教学技能。57%的人要么强烈同意(17%)要么同意(40%)教员教练的直接观察和反馈有助于提高他们的教学技能。住院医师对教员教练反馈有用性的看法与住院医师对RAT项目在培养他们教学技能方面整体有效性的看法之间存在显著正相关(r = 0.42;p = 0.001)。定性分析表明,住院医师认为RAT项目巩固了他们对课程中所涵盖内容自己的知识基础。住院医师还认为近同伴教学对医学生有益,并且提升了家庭医生作为教师的形象。他们发现这种主动学习体验提高了他们对自身教学技能的自我认知。脱离临床轮转的时间和准备时间被认为是该项目的一个潜在缺点。所有教员教练都同意或强烈同意RAT课程提高了家庭医学住院医师的教学技能。对教员教练评论的主题分析表明,作为教练参与有助于他们自身的专业发展,因为他们的反馈和指导技能得到了提高。我们对一种新颖的多层次住院医师即教师指导课程的经验和项目评估表明,对真实教学活动进行带反馈的直接观察受到高度重视,并且在培养住院医师教学技能同时激发他们对未来教学的兴趣方面似乎是有效的。