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Allo IJT, Findyartini A, Santoso A, Iqbal M. Cardiology residents' attitudes towards clinical supervision: a multi-centered study. KOREAN JOURNAL OF MEDICAL EDUCATION 2023; 35:407-416. [PMID: 38062686 PMCID: PMC10704050 DOI: 10.3946/kjme.2023.276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/20/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023]
Abstract
PURPOSE Residents' gender, residency level, and hospital types might influence their attitudes towards clinical supervision (CS); however, reports of its impact on cardiology residency are nonexistent. We explore the effect of gender, residency level, and hospital location's effect on Indonesian cardiology trainees' attitudes towards CS. METHODS A multi-centered, cross-sectional study was conducted. We invited 490 Indonesian cardiology residents in September- October 2019 to complete the Cardiology CS Scale. Residents' attitudes, gender, university, and residency year were expressed using descriptive statistics. A Mann-Whitney test analyzed the gender and university location effect on residents' attitudes. Training year and university's impact were subjected to the Kruskal-Wallis test; a p-value of <0.05 reflected a significant result. RESULTS A total of 388 residents agreed to participate (response rate=79.18%). Most of them were male (n=229 [59,02%]), attended universities in Java Island (n=262 [67,52%]), and were in their 2nd-3rd year of training (n=95 [24.48%], each). There were no significant differences in residents' attitudes between genders (U [Nmale=229, Nfemale=159]=17,908.50, z=-0.27, p=0.78). Generally, their attitudes were significantly affected by the university (H(7)=47.38, p<0.01). However, the university location (located in Java Island or outside Java Island) does not affect residents' attitude towards CS (U [NJava=262, Nnon-Java=126]=15,237.00, z=-1.23, p=0.22). In addition, the residents' training year also affected the residents' response (H(2)=14.278, p<0.01). CONCLUSION Cardiology residents' attitudes towards CS are significantly influenced by training year and university but not gender or university location. The results might provide insightful information for further improvement of CS in cardiology training and guide further evaluation.
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Affiliation(s)
- Iswandy Janetputra Turu’ Allo
- Medical Education Centre, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Cardiology and Vascular Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
- Medical Education Unit, Faculty of Medicine, Universitas Pendidikan Indonesia, Bandung, Indonesia
| | - Ardi Findyartini
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Medical Education Cluster, Indonesia Medical Education and Research Institute, Jakarta, Indonesia
| | - Anwar Santoso
- Department of Cardiology- Vascular Medicine, National Cardiovascular Centre-Harapan Kita Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mohammad Iqbal
- Department of Cardiology and Vascular Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
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Vaughan B. Clinical educator self-efficacy, self-evaluation and its relationship with student evaluations of clinical teaching. BMC MEDICAL EDUCATION 2020; 20:347. [PMID: 33032596 PMCID: PMC7542963 DOI: 10.1186/s12909-020-02278-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 10/01/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In a whole-of-system approach to evaluation of teaching across any degree, multiple sources of information can help develop an educators' understanding of their teaching quality. In the health professions, student evaluations of clinical teaching are commonplace. However, self-evaluation of teaching is less common, and exploration of clinical educators' self-efficacy even less so. The aim of the study was to evaluate how a clinical educator's self-evaluation of teaching intersects with their self-efficacy, to ascertain if that matches student evaluation of their teaching. This information may assist in facilitating targeted professional development to improve teaching quality. METHODS Clinical educators in the osteopathy program at Victoria University (VU) were invited to complete: a) self-evaluation version of the Osteopathy Clinical Teaching Questionnaire (OCTQ); and b) the Self-Efficacy in Clinical Teaching (SECT) questionnaire. Students in the VU program completed the OCTQ for each of the clinical educators they worked with during semester 2, 2017. RESULTS Completed OCTQ and SECT were received from 37 clinical educators. These were matched with 308 student evaluations (mean of 6 student ratings per educator). Three possible educator cohorts were identified: a) high clinical eductor self-OCTQ with low student evaluation; b) low clinical educator self-evaluation and high student evaluations; and, c) no difference between self- and student evaulations. Clinical educators in the first cohort demonstrated significantly higher SECT subscale scores (effect size > 0.42) than their colleagues. Age, gender, teaching qualification, and years practicing or years as a clinical educator were not associated with clinical educator OCTQ scores or the SECT subscales. CONCLUSIONS Targeted professional development directed towards fostering self-efficacy may provide an avenue for engaging those clinical educators whose self-efficacy is low and/or those who did not receive high student evaluations. Given there is no gold standard measure of clinical teaching quality, educators should engage with multiple sources of feedback to benchmark their current performance level, and identify opportunities to improve. Student and self-evaluations using the OCTQ and evaluation of self-efficacy using the SECT, are useful tools for inclusion in a whole-of-system approach to evaluation of the clinical learning environment.
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Affiliation(s)
- Brett Vaughan
- College of Health & Biomedicine, Victoria University, Melbourne, Australia.
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Pront L, Gillham D, Schuwirth LWT. Competencies to enable learning-focused clinical supervision: a thematic analysis of the literature. MEDICAL EDUCATION 2016; 50:485-495. [PMID: 26995486 DOI: 10.1111/medu.12854] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 03/17/2015] [Accepted: 07/30/2015] [Indexed: 06/05/2023]
Abstract
CONTEXT Clinical supervision is essential for development of health professional students and widely recognised as a significant factor influencing student learning. Although considered important, delivery is often founded on personal experience or a series of predetermined steps that offer standardised behavioural approaches. Such a view may limit the capacity to promote individualised student learning in complex clinical environments. The objective of this review was to develop a comprehensive understanding of what is considered 'good' clinical supervision, within health student education. The literature provides many perspectives, so collation and interpretation were needed to aid development and understanding for all clinicians required to perform clinical supervision within their daily practice. METHOD A comprehensive thematic literature review was carried out, which included a variety of health disciplines and geographical environments. RESULTS Literature addressing 'good' clinical supervision consists primarily of descriptive qualitative research comprising mostly small studies that repeated descriptions of student and supervisor opinions of 'good' supervision. Synthesis and thematic analysis of the literature resulted in four 'competency' domains perceived to inform delivery of learning-focused or 'good' clinical supervision. Domains understood to promote student learning are co-dependent and include 'to partner', 'to nurture', 'to engage' and 'to facilitate meaning'. CONCLUSIONS Clinical supervision is a complex phenomenon and establishing a comprehensive understanding across health disciplines can influence the future health workforce. The learning-focused clinical supervision domains presented here provide an alternative perspective of clinical supervision of health students. This paper is the first step in establishing a more comprehensive understanding of learning-focused clinical supervision, which may lead to development of competencies for clinical supervision.
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Affiliation(s)
- Leeanne Pront
- School of Nursing & Midwifery, Flinders University, Adelaide, SA, Australia
| | - David Gillham
- School of Nursing & Midwifery, Flinders University, Adelaide, SA, Australia
| | - Lambert W T Schuwirth
- School of Medicine, Flinders University, Adelaide, SA, Australia
- Maastricht University, Maastricht, The Netherlands
- Chang Gung University, Taipei, Taiwan
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Fluit CRMG, Feskens R, Bolhuis S, Grol R, Wensing M, Laan R. Understanding resident ratings of teaching in the workplace: a multi-centre study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2015; 20:691-707. [PMID: 25314933 DOI: 10.1007/s10459-014-9559-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 10/03/2014] [Indexed: 06/04/2023]
Abstract
Providing clinical teachers with feedback about their teaching skills is a powerful tool to improve teaching. Evaluations are mostly based on questionnaires completed by residents. We investigated to what extent characteristics of residents, clinical teachers, and the clinical environment influenced these evaluations, and the relation between residents' scores and their teachers' self-scores. The evaluation and feedback for effective clinical teaching questionnaire (EFFECT) was used to (self)assess clinical teachers from 12 disciplines (15 departments, four hospitals). Items were scored on a five-point Likert scale. Main outcome measures were residents' mean overall scores (MOSs), specific scale scores (MSSs), and clinical teachers' self-evaluation scores. Multilevel regression analysis was used to identify predictors. Residents' scores and self-evaluations were compared. Residents filled in 1,013 questionnaires, evaluating 230 clinical teachers. We received 160 self-evaluations. 'Planning Teaching' and 'Personal Support' (4.52, SD .61 and 4.53, SD .59) were rated highest, 'Feedback Content' (CanMEDS related) (4.12, SD .71) was rated lowest. Teachers in affiliated hospitals showed highest MOS and MSS. Medical specialty did not influence MOS. Female clinical teachers were rated higher for most MSS, achieving statistical significance. Residents in year 1-2 were most positive about their teachers. Residents' gender did not affect the mean scores, except for role modeling. At group level, self-evaluations and residents' ratings correlated highly (Kendall's τ 0.859). Resident evaluations of clinical teachers are influenced by teacher's gender, year of residency training, type of hospital, and to a lesser extent teachers' gender. Clinical teachers and residents agree on strong and weak points of clinical teaching.
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Affiliation(s)
- Cornelia R M G Fluit
- Academic Educational Institute, Radboud University Medical Center Nijmegen, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, The Netherlands,
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Degen C, Kuntz L. University hospitals as drivers of career success: an empirical study of the duration of promotion and promotion success of hospital physicians. BMC MEDICAL EDUCATION 2014; 14:85. [PMID: 24755299 PMCID: PMC4021192 DOI: 10.1186/1472-6920-14-85] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Accepted: 04/10/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND German hospitals have a well-defined career structure for clinicians. In this hierarchical career system university hospital are stepping stones for career advancement. This longitudinal study investigates the impact of working in university hospitals on the career success of junior physicians and senior physicians. METHODS Consideration of the career trajectories of 324 hospital physicians. Discrete-time event history analysis is used to study the influence of working in university hospitals on the chance of promotion from junior physician to senior physician and senior physician to chief physician. A comparison of medians provides information about the impact of working in university hospitals on the duration of promotion to senior and chief physician positions. RESULTS Working in university hospitals has a negative impact for advancement to a senior physician position in terms of promotion duration (p = 0.005) and also in terms of promotion success, where a short time span of just 1-2 years in university hospitals has a negative effect (OR = 0.38, p < 0.01), while working there for a medium or long term has no significant effect. However, working in universities has a positive effect on the duration of promotion to a chief physician position (p = 0.079), and working in university hospitals for 3-4 years increases the chance of promotion to a chief physician position (OR = 4.02, p < 0.05), while working there > =7 years decreases this chance (OR = 0.27, p < 0.05). In addition, physicians have a higher chance of promotion to a chief physician position through career mobility when they come to the position from a university hospital. CONCLUSION Working at university hospitals has a career-enhancing effect for a senior physician with ambitions to become a chief physician. For junior physicians on the trajectory to a senior physician position, however, university hospitals are not drivers of career success.
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Affiliation(s)
- Christiane Degen
- Department of Business Administration and Health Care Management, University of Cologne, Albertus-Magnus-Platz, Cologne 50931, Germany
| | - Ludwig Kuntz
- Department of Business Administration and Health Care Management, University of Cologne, Albertus-Magnus-Platz, Cologne 50931, Germany
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Effects of clinical supervision on resident learning and patient care during simulated ICU scenarios. Crit Care Med 2014; 41:2705-11. [PMID: 23963128 DOI: 10.1097/ccm.0b013e31829a6f04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Closer supervision of residents' clinical activities has been promoted to improve patient safety, but may additionally affect resident participation in patient care and learning. The objective of this study was to determine the effects of closer supervision on patient care, resident participation, and the development of resident ability to care independently for critically ill patients during simulated scenarios. DESIGN This quantitative study represents a component of a larger mixed-methods study. Residents were randomized to one of three levels of supervision, defined by the physical proximity of the supervisor (distant, immediately available, and direct). Each resident completed a simulation scenario under the supervision of a critical care fellow, immediately followed by a modified scenario of similar content without supervision. SETTING The simulation center of a tertiary, university-affiliated academic center in a large urban city. SUBJECTS Fifty-three residents completing a critical care rotation and 24 critical care fellows were recruited between April 2009 and June 2010. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS During the supervised scenarios, lower team performance checklist scores were obtained for distant supervision compared with immediately available and direct supervision (mean [SD], direct: 72% [12%] vs immediately available: 77% [10%] vs distant: 61% [11%]; p = 0.0013). The percentage of checklist items completed by the residents themselves was significantly lower during direct supervision (median [interquartile range], direct: 40% [21%] vs immediately available: 58% [16%] vs distant: 55% [11%]; p = 0.005). During unsupervised scenarios, no significant differences were found on the outcome measures. CONCLUSIONS Care delivered in the presence of senior supervising physicians was more comprehensive than care delivered without access to a bedside supervisor, but was associated with lower resident participation. However, subsequent resident performance during unsupervised scenarios was not adversely affected. Direct supervision of residents leads to improved care process and does not diminish the subsequent ability of residents to function independently.
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Schönrock-Adema J, Boendermaker PM, Remmelts P. Opportunities for the CTEI: disentangling frequency and quality in evaluating teaching behaviours. PERSPECTIVES ON MEDICAL EDUCATION 2012; 1:172-179. [PMID: 23205342 PMCID: PMC3508268 DOI: 10.1007/s40037-012-0023-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Students' perceptions of teaching quality are vital for quality assurance purposes. An increasingly used, department-independent instrument is the (Cleveland) clinical teaching effectiveness instrument (CTEI). Although the CTEI was developed carefully and its validity and reliability confirmed, we noted an opportunity for improvement given an intermingling in its rating scales: the labels of the answering scales refer to both frequency and quality of teaching behaviours. Our aim was to investigate whether frequency and quality scores on the CTEI items differed. A sample of 112 residents anonymously completed the CTEI with separate 5-point rating scales for frequency and quality. Differences between frequency and quality scores were analyzed using paired t tests. Quality was, on average, rated higher than frequency, with significant differences for ten out of 15 items. The mean scores differed significantly in favour of quality. As the effect size was large, the difference in mean scores was substantial. Since quality was generally rated higher than frequency, the authors recommend distinguishing frequency from quality. This distinction helps to obtain unambiguous outcomes, which may be conducive to providing concrete and accurate feedback, improving faculty development and making fair decisions concerning promotion, tenure or salary.
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Affiliation(s)
- Johanna Schönrock-Adema
- Center for Research and Innovation in Medical Education, University of Groningen and University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - Peter M Boendermaker
- Wenckebach Institute, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
| | - Pine Remmelts
- Wenckebach Institute, University of Groningen and University Medical Center Groningen, Groningen, the Netherlands
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van den Boom M, Pinnock R, Weller J, Reed P, Shulruf B. Paediatric trainee supervision: management changes and perceived education value. J Paediatr Child Health 2012; 48:567-71. [PMID: 22758897 DOI: 10.1111/j.1440-1754.2012.02434.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM Supervision in postgraduate training is an under-researched area. We measured the amount, type and effect of supervision on patient care and perceived education value in a general paediatric service. METHOD We designed a structured observation form and questionnaire to document the type, duration and effect of supervision on patient management and perceived education value. RESULTS Most supervision occurred without the paediatrician confirming the trainee's findings. Direct observation of the trainee was rare. Management was changed in 30% of patients seen on the inpatient ward round and in 42% of the patients discussed during the chart reviews but not seen by the paediatrician. Management was changed in 48% of the cases when the paediatrician saw the patient with the trainee in outpatients but in only 21% of patients when the patient was but not seen. Changes made to patient management, understanding and perceived education value, differed between inpatient and out patient settings. There was more impact when the paediatrician saw the patient with the trainee in outpatients; while for inpatients, the opposite was true. Trainees rated the value of the supervision more highly than their supervisors did. Trainees' comments on what they learnt from their supervisor related almost exclusively to clinical knowledge rather than professional behaviours. CONCLUSIONS We observed little evidence of supervisors directly observing trainees and trainees learning professional behaviours. A review of supervisory practices to promote more effective learning is needed. Communicating to paediatricians the value their trainees place on their input could have a positive effect on their engagement in supervision.
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Affiliation(s)
- Mirjam van den Boom
- University of Auckland Centre for Medical and Health Science Education, Auckland, New Zealand
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Bowie P, McKay J, Kelly M. Maximising harm reduction in early specialty training for general practice: validation of a safety checklist. BMC FAMILY PRACTICE 2012; 13:62. [PMID: 22721273 PMCID: PMC3418214 DOI: 10.1186/1471-2296-13-62] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 06/21/2012] [Indexed: 01/16/2023]
Abstract
Background Making health care safer is a key policy priority worldwide. In specialty training, medical educators may unintentionally impact on patient safety e.g. through failures of supervision; providing limited feedback on performance; and letting poorly developed behaviours continue unchecked. Doctors-in-training are also known to be susceptible to medical error. Ensuring that all essential educational issues are addressed during training is problematic given the scale of the tasks to be undertaken. Human error and the reliability of local systems may increase the risk of safety-critical topics being inadequately covered. However adherence to a checklist reminder may improve the reliability of task delivery and maximise harm reduction. We aimed to prioritise the most safety-critical issues to be addressed in the first 12-weeks of specialty training in the general practice environment and validate a related checklist reminder. Methods We used mixed methods with different groups of GP educators (n = 127) and specialty trainees (n = 9) in two Scottish regions to prioritise, develop and validate checklist content. Generation and refinement of checklist themes and items were undertaken on an iterative basis using a range of methods including small group work in dedicated workshops; a modified-Delphi process; and telephone interviews. The relevance of potential checklist items was rated using a 4-point scale content validity index to inform final inclusion. Results 14 themes (e.g. prescribing safely; dealing with medical emergency; implications of poor record keeping; and effective & safe communication) and 47 related items (e.g. how to safety-net face-to-face or over the telephone; knowledge of practice systems for results handling; recognition of harm in children) were judged to be essential safety-critical educational issues to be covered. The mean content validity index ratio was 0.98. Conclusion A checklist was developed and validated for educational supervisors to assist in the reliable delivery of safety-critical educational issues in the opening 12-week period of training, and aligned with national curriculum competencies. The tool can also be adapted for use as a self-assessment instrument by trainees to guide patient safety-related learning needs. Dissemination and implementation of the checklist and self-rating scale are proceeding on a national, voluntary basis with plans to evaluate its feasibility and educational impact.
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Affiliation(s)
- Paul Bowie
- Department of Postgraduate General Practice Education, NHS Education for Scotland, 2 Central Quay, Glasgow, UK, G3 8BW.
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Fluit CRMG, Bolhuis S, Grol R, Laan R, Wensing M. Assessing the quality of clinical teachers: a systematic review of content and quality of questionnaires for assessing clinical teachers. J Gen Intern Med 2010; 25:1337-45. [PMID: 20703952 PMCID: PMC2988147 DOI: 10.1007/s11606-010-1458-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2009] [Revised: 02/22/2010] [Accepted: 07/02/2010] [Indexed: 11/25/2022]
Abstract
BACKGROUND Learning in a clinical environment differs from formal educational settings and provides specific challenges for clinicians who are teachers. Instruments that reflect these challenges are needed to identify the strengths and weaknesses of clinical teachers. OBJECTIVE To systematically review the content, validity, and aims of questionnaires used to assess clinical teachers. DATA SOURCES MEDLINE, EMBASE, PsycINFO and ERIC from 1976 up to March 2010. REVIEW METHODS The searches revealed 54 papers on 32 instruments. Data from these papers were documented by independent researchers, using a structured format that included content of the instrument, validation methods, aims of the instrument, and its setting. RESULTS Aspects covered by the instruments predominantly concerned the use of teaching strategies (included in 30 instruments), supporter role (29), role modeling (27), and feedback (26). Providing opportunities for clinical learning activities was included in 13 instruments. Most studies referred to literature on good clinical teaching, although they failed to provide a clear description of what constitutes a good clinical teacher. Instrument length varied from 1 to 58 items. Except for two instruments, all had to be completed by clerks/residents. Instruments served to provide formative feedback ( instruments) but were also used for resource allocation, promotion, and annual performance review (14 instruments). All but two studies reported on internal consistency and/or reliability; other aspects of validity were examined less frequently. CONCLUSIONS No instrument covered all relevant aspects of clinical teaching comprehensively. Validation of the instruments was often limited to assessment of internal consistency and reliability. Available instruments for assessing clinical teachers should be used carefully, especially for consequential decisions. There is a need for more valid comprehensive instruments.
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Affiliation(s)
- Cornelia R M G Fluit
- Department for Evaluation, Quality and Development of Medical Education, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Forsyth KD. Critical importance of effective supervision in postgraduate medical education. Med J Aust 2009; 191:196-7. [DOI: 10.5694/j.1326-5377.2009.tb02750.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2009] [Accepted: 07/14/2009] [Indexed: 11/17/2022]
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Busari JO, Verhagen EAA, Muskiet FD. The influence of the cultural climate of the training environment on physicians' self-perception of competence and preparedness for practice. BMC MEDICAL EDUCATION 2008; 8:51. [PMID: 19025586 PMCID: PMC2596784 DOI: 10.1186/1472-6920-8-51] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 11/21/2008] [Indexed: 05/27/2023]
Abstract
BACKGROUND In current supervisory practice, the learning environment in which the training of specialist registrars (SpRs) takes place is important. Examples of such learning environments are the hospital settings and/or geographical locations where training occurs. Our objective was to investigate whether the cultural climate of different learning environments influences physicians' perceived level of competence and preparedness for practice. METHODS An electronic questionnaire was sent to an equal group of paediatricians who had trained in clinical settings located in Europe and the Caribbean. 30 items (Likert scale 1-4 = totally disagree-totally agree) were used to measure the level of preparedness of the respondents in 7 physician competencies. RESULTS 42 participants were included for analysis. The distribution of participants in both groups was comparable. The overall perception of preparedness in the Caribbean group was 2.93 (SD = 0.47) and 2.86 (SD = 0.72) in the European group. The European group felt less prepared in the competency as manager 1.81 (SD = 1.06) compared to their Caribbean counterparts 2.72 (SD = 0.66). The difference was significant (p = 0.006). CONCLUSION The training in the different environments was perceived as adequate and comparable in effect. The learning environment's cultural climate appeared to influence the physician's perception of their competencies and preparedness for clinical practice.
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Affiliation(s)
- Jamiu O Busari
- Department of Paediatrics, Atrium Medical Center, Heerlen, Netherlands
| | - Eduard AA Verhagen
- Department of Paediatrics, University Medical Center, Groningen, Netherlands
| | - Fred D Muskiet
- Department of Paediatrics, St. Elisabeth Hospitaal, Breedestraat 193, Curaçao, Netherlands Antilles
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Busari JO, Koot BG. Quality of clinical supervision as perceived by attending doctors in university and district teaching hospitals. MEDICAL EDUCATION 2007; 41:957-64. [PMID: 17764522 DOI: 10.1111/j.1365-2923.2007.02837.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
CONTEXT Attending doctors (ADs) play important roles in the supervision of specialist registrars. Little is known, however, about how they perceive the quality of their supervision in different teaching settings. We decided to investigate whether there is any difference in how ADs perceive the quality of their supervision in university teaching hospital (UTH) and district teaching hospital (DTH) settings. METHODS We used a standardised questionnaire to investigate the quality of supervision as perceived by ADs. Fifteen items reflecting good teaching ability were measured on a 5-point Likert scale (1-5: never-always). We investigated for factors that influenced the perceived quality of supervision using Likert scale items (1-5: totally disagree-totally agree) and open-ended questionnaires. RESULTS A total of 83 ADs (UTH: 51; DTH: 32) were eligible to participate in the survey. Of these, 43 (52%) returned the questionnaire (UTH: 25; DTH: 18). There was no difference in the overall mean of the 15 items between the UTH (3.67, standard deviation [SD] 0.35) and DTH (3.73, SD 0.31) ADs. Attending doctors in the DTH group rated themselves better at 'teaching technical skills' (mean 3.50, SD 0.70), compared with their UTH counterparts (mean 3.0, SD 0.76) (P = 0.03). Analysis of variance of the overall means revealed no significant difference between the different hospital settings. CONCLUSIONS The results suggest that teaching hospital environments do not influence how ADs perceive the quality of their supervision. Lack of time for teaching was perceived as responsible for poor supervision. Other factors found to influence AD perceptions of good supervision included effective teaching skills, communication skills and provision of feedback.
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Affiliation(s)
- Jamiu O Busari
- Department of Paediatrics, Atrium Medical Centre, Heerlen, The Netherlands.
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