Kilian Paddy, Alshehabi Nagam, Othman Malek, Mahmoud Anan, du Preez Leon, Zary Nabil, Ho Samuel B
Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates.
Mediclinic Middle East, Dubai, United Arab Emirates.
Front Med (Lausanne). 2024 Aug 21;11:1377903. doi: 10.3389/fmed.2024.1377903. eCollection 2024.
Teaching medical students in the clinical setting is frequently perceived as a demanding commitment by attending physicians. There is a paucity of data measuring the duration and efficacy of teaching during clinical rounds.
The aim of this study was to assess both the quantity and quality of clinical teaching time dedicated to medical students on hospital ward rounds.
A cross-sectional direct structured observational study was conducted during the morning rounds of attending physicians involved in teaching undergraduate medical students at three different clinical facilities in three different specialties. A validated observational tool was used by four observers to record teaching time and quality indicators.
In terms of teaching duration, it was observed that 25% of the total morning round time was allocated to teaching. However, this measure varied widely between different physicians and specialties. As for teaching quality, actions categorized as active teaching by the teachers were observed in 19% of the interactions observed per round, while active learning by the students was observed in 17% of the interactions per round. Teacher high-cognition interactions were similarly observed in 23% of actions per round, while student high-cognition interactions occurred in 16% of actions per round. Internal Medicine tended to score higher than both Pediatrics and Surgery in terms of percentage teaching time as well as percentage of active teaching observed per round. Using liberal criteria, rounds characterized overall as predominantly active or high-cognition by both teachers and students were observed in only 21% of the total number of rounds observed.
These results indicate that the percentage of teaching time during ward rounds is highly variable, and that round teaching generally consists of passive and low-cognition interactions. Future work is needed to train clinical faculty to achieve a desired level of teaching quality, and to determine if there are any changes in teaching time commitments and student outcomes.
在临床环境中教授医学生常常被主治医生视为一项艰巨的任务。目前缺乏衡量临床查房期间教学时长和效果的数据。
本研究旨在评估医院查房中专门用于医学生临床教学的时间数量和质量。
在三个不同专业的三个不同临床机构，对参与教授本科医学生的主治医生晨查房进行了一项横断面直接结构化观察研究。四名观察者使用经过验证的观察工具记录教学时间和质量指标。
在教学时长方面，观察到晨查房总时间的25%用于教学。然而，这一指标在不同医生和专业之间差异很大。至于教学质量，在每轮观察到的互动中，教师归类为主动教学的行为占19%，而学生主动学习的行为在每轮互动中占17%。教师的高认知互动在每轮行为中同样占23%，而学生的高认知互动在每轮行为中占16%。在内科方面，无论是教学时间百分比还是每轮观察到的主动教学百分比，得分往往都高于儿科和外科。按照宽松的标准，在观察到的总查房次数中，只有21%的查房总体上被教师和学生都视为主要是主动或高认知的。
这些结果表明，查房期间教学时间的百分比差异很大，而且查房教学通常由被动和低认知互动组成。未来需要开展工作，培训临床教员以达到期望的教学质量水平，并确定教学时间投入和学生成绩是否有任何变化。
