Ullian J A, Bland C J, Simpson D E
Department of Family Medicine, Baylor College of Medicine, Houston, TX 77005.
Acad Med. 1994 Oct;69(10):832-8. doi: 10.1097/00001888-199410000-00013.
A number of studies have attempted to identify the components of the clinical teacher role by examining learners' numerical ratings of items on researcher-generated lists. Some of these studies have also compared different groups' perceptions of clinical teaching, but have not directly compared the perceptions of first- and third-year residents. This study addressed two questions: (1) What do residents consider important components of the clinical teacher role? (2) Do first- and third-year residents perceive this role similarly?
A content analysis was performed on the comments written on evaluation forms by 268 residents about 490 clinical teachers over a five-year period (1980-81 through 1984-85) at a large family practice residency. Of 5,664 forms completed by the residents, 2,388 (42%) contained written comments; comments were on 1,024 (46%) of the first-year resident's forms, 701 (41%) of the second-year residents' forms, and 663 (39%) of the third-year residents' forms. Themes in these comments were coded into a coding dictionary of 157 categories, within 37 clusters, within four roles.
The ten highest-ranked categories (Global; Teaching: General; Knowledgeable; Gives Resident Responsibility; Supportive; Miscellaneous; Interested in Teaching; Clinical Competence; Makes Effort to Teach; and Gives Resident Opportunity to Do Procedures) accounted for 41% of the themes coded. The first- and third-year residents differed in the clusters they used to describe their clinical teachers on evaluation forms (chi 2 = 149.86, df = 36, p < .0001).
The results suggest that content analysis can be used to validly and reliably study residents' written evaluative comments about their teachers. This study contributes to the definition of the clinical teacher role, showing the relative importances of its components, and also supports Stritter's Learning Vector theory, finding the anticipated differences between the comments made by first- and third-year residents.
多项研究试图通过检查学习者对研究人员生成列表中各项的数字评分来确定临床教师角色的组成部分。其中一些研究还比较了不同群体对临床教学的看法,但没有直接比较一年级和三年级住院医师的看法。本研究解决了两个问题:(1)住院医师认为临床教师角色的重要组成部分有哪些?(2)一年级和三年级住院医师对该角色的认知是否相似?
对一家大型家庭医学住院医师培训项目在五年期间(1980 - 81年至1984 - 85年)268名住院医师对490名临床教师的评价表上所写的评论进行了内容分析。在住院医师填写的5664份表格中,2388份(42%)包含书面评论;一年级住院医师表格中有1024份(46%)有评论,二年级住院医师表格中有701份(41%)有评论,三年级住院医师表格中有663份(39%)有评论。这些评论中的主题被编码到一个包含157个类别、37个聚类、四个角色的编码词典中。
排名前十的类别(整体评价;教学:总体;知识渊博;赋予住院医师责任;支持;其他;对教学感兴趣;临床能力;努力教学;给予住院医师操作机会)占编码主题的41%。一年级和三年级住院医师在评价表上用于描述临床教师的聚类方面存在差异(卡方 = 149.86,自由度 = 36,p <.0001)。
结果表明,内容分析可用于有效且可靠地研究住院医师对其教师的书面评价意见。本研究有助于明确临床教师角色的定义,展示其组成部分的相对重要性,同时也支持斯特里特的学习向量理论,发现了一年级和三年级住院医师评论之间预期的差异。