The teacher, the physician and the person: exploring causal connections between teaching performance and role model types using directed acyclic graphs

Role modelling in professional identity formation: a systematic scoping review

BACKGROUND

Role modelling's pivotal part in the nurturing of a physician's professional identity remains poorly understood. To overcome these gaps, this review posits that as part of the mentoring spectrum, role modelling should be considered in tandem with mentoring, supervision, coaching, tutoring and advising. This provides a clinically relevant notion of role modelling whilst its effects upon a physician's thinking, practice and conduct may be visualised using the Ring Theory of Personhood (RToP).

METHODS

A Systematic Evidence Based Approach guided systematic scoping review was conducted on articles published between 1 January 2000 to 31 December 2021 in the PubMed, Scopus, Cochrane, and ERIC databases. This review focused on the experiences of medical students and physicians in training (learners) given their similar exposure to training environments and practices.

RESULTS

12,201 articles were identified, 271 articles were evaluated, and 145 articles were included. Concurrent independent thematic and content analysis revealed five domains: existing theories, definitions, indications, characteristics, and the impact of role modelling upon the four rings of the RToP. This highlights dissonance between the introduced and regnant beliefs and spotlights the influence of the learner's narratives, cognitive base, clinical insight, contextual considerations and belief system on their ability to detect, address and adapt to role modelling experiences.

CONCLUSION

Role modelling's ability to introduce and integrate beliefs, values and principles into a physician's belief system underscores its effects upon professional identity formation. Yet, these effects depend on contextual, structural, cultural and organisational influences as well as tutor and learner characteristics and the nature of their learner-tutor relationship. The RToP allows appreciation of these variations on the efficacy of role modelling and may help direct personalised and longitudinal support for learners.

Redesign of the System for Evaluation of Teaching Qualities in Anesthesiology Residency Training (SETQ Smart)

BACKGROUND

Given the increasing international recognition of clinical teaching as a competency and regulation of residency training, evaluation of anesthesiology faculty teaching is needed. The System for Evaluating Teaching Qualities (SETQ) Smart questionnaires were developed for assessing teaching performance of faculty in residency training programs in different countries. This study investigated (1) the structure, (2) the psychometric qualities of the new tools, and (3) the number of residents' evaluations needed per anesthesiology faculty to use the instruments reliably.

METHODS

Two SETQ Smart questionnaires-for faculty self-evaluation and for resident evaluation of faculty-were developed. A multicenter survey was conducted among 399 anesthesiology faculty and 430 residents in six countries. Statistical analyses included exploratory factor analysis, reliability analysis using Cronbach α, item-total scale correlations, interscale correlations, comparison of composite scales to global ratings, and generalizability analysis to assess residents' evaluations needed per faculty.

RESULTS

In total, 240 residents completed 1,622 evaluations of 247 faculty. The SETQ Smart questionnaires revealed six teaching qualities consisting of 25 items. Cronbach α's were very high (greater than 0.95) for the overall SETQ Smart questionnaires and high (greater than 0.80) for the separate teaching qualities. Interscale correlations were all within the acceptable range of moderate correlation. Overall, questionnaire and scale scores correlated moderately to highly with the global ratings. For reliable feedback to individual faculty, three to five resident evaluations are needed.

CONCLUSIONS

The first internationally piloted questionnaires for evaluating individual anesthesiology faculty teaching performance can be reliably, validly, and feasibly used for formative purposes in residency training.

Evaluating clinicians' teaching performance

Evaluations of clinicians' teaching performance are usually a preliminary, although essential, activity in quality management and improvement activities. This PhD project focused on testing the validity, reliability and impact of a performance evaluation system named the System of Evaluation of Teaching Qualities (SETQ) across specialities and centres in the Netherlands. The results of this project show that the SETQ questionnaires can provide clinicians with valid and reliable performance feedback that can enhance their teaching performance. Also, we tried to investigate the predictive validity of the SETQ. In conclusion, the SETQ appears to be a helpful tool for improving clinicians' teaching performance.

Residents' engagement and empathy associated with their perception of faculty's teaching performance

BACKGROUND

Faculty members rely on residents' feedback about their teaching performance. The influence of residents' characteristics on evaluations of faculty is relatively unexplored. We aimed to evaluate the levels of work engagement and empathy among residents and the association of both characteristics with their evaluation of the faculty's teaching performance.

METHODS

A multicenter questionnaire study among 271 surgery and gynecology residents was performed from September 2012 to February 2013. Residents' ratings of the faculty's teaching performance were collected using the system for evaluation of teaching quality (SETQ). Residents were also invited to fill out standardized measures of work engagement and empathy using the short Utrecht Work Engagement Scale and the Jefferson Scale of Physician Empathy, respectively. Linear regression analysis using generalized estimating equations to evaluate the association of residents' engagement and empathy with residents' evaluations of teaching performance.

RESULTS

Overall, 204 (75.3 %) residents completed 1814 SETQ evaluations of 302 faculty, and 143 (52.8 %) and 140 (51.7 %) residents, respectively, completed the engagement and empathy measurements. The median scores of residents' engagement and empathy were 4.56 (scale 0-6) and 5.55 (scale 1-7), respectively. Higher levels of residents' engagement (regression coefficient b = 0.128; 95 % confidence interval (CI) 0.072-0.184; p < 0.001) and empathy (b = 0.113; 95 % CI 0.063-0.164; p < 0.001) were associated with higher faculty teaching performance scores.

CONCLUSIONS

Residents' engagement and empathy appear to be positively associated with their evaluation of the faculty's performance. A possible explanation is that residents who are more engaged and can understand and share others' perspectives stimulate and experience faculty's teaching better than others.

Determinants of academics' job satisfaction: empirical evidence from private universities in Bangladesh

The job satisfaction of academics is related to a number of variables of complex function such as demographic characters, the work itself, pay, work responsibilities, variety of tasks, promotional opportunities, relationship with co-workers and others. Academics may be simultaneously satisfied with some facets of the job and dissatisfied with others. This paper aims at determining the influential factors that contribute to the enhancement or reduction of academics' job satisfaction among private universities in Bangladesh with special reference to Dhaka, the capital city of Bangladesh. A total of 346 respondents are considered from ten private universities using non-probability sampling. A pre-tested and closed-ended questionnaire using a seven-point Likert scale is used for data collection. In this study, descriptive statistics, Pearson product moment correlation, multiple regression, and factor analysis are exercised as statistical tools. A conceptual model of job satisfaction is developed and applied for academics' job satisfaction. The results reveal that compensation package, supervisory support, job security, training and development opportunities, team cohesion, career growth, working conditions, and organizational culture and policies are positively associated with the academics' job satisfaction. Amongst them, three factors stood out as significant contributors for job satisfaction of academics i.e. compensation package, job security, and working conditions. Therefore, the management of private universities should focus their effort on these areas of human resource management for maintaining academics' job satisfaction and employee retention. The study will be useful for university management in improving overall job satisfaction as it suggests some strategies for employee satisfaction practices.

Beyond limitations: Improving how we handle uncertainty in health professions education research

The researchers' assumptions invariably influence research outcomes. This is true for both qualitative and quantitative studies. Assumptions or choices regarding underlying theories, causal relations, study setting and population, sampling strategies, participant non-response, data collection, data analysis, and researchers' perceptions and interpretations of results are among factors that can induce uncertainty in research findings. Researchers tend to treat these factors as potential study limitations, but how they may impact research findings is rarely explicated and, therefore, mostly unknown. In this article, we approach uncertainty as unavoidable in research and argue that communicating about uncertainty can inform researchers, policy makers and practitioners about the validity and applicability of the study findings for their interests and contexts. We illustrate approaches to address, interpret, and explicate uncertainty in medical education research in both qualitative and quantitative paradigms. Across research paradigms, we call on researchers to consider the uncertainty in their research findings, employ appropriate methods to explore its extent and effects in their work, and communicate it explicitly in their research papers. This will help to advance our understanding of the nature and implications of the emerging knowledge in our field.

Development and validation of an instrument for measuring the quality of teamwork in teaching teams in postgraduate medical training (TeamQ)

Background

Teamwork between clinical teachers is a challenge in postgraduate medical training. Although there are several instruments available for measuring teamwork in health care, none of them are appropriate for teaching teams. The aim of this study is to develop an instrument (TeamQ) for measuring teamwork, to investigate its psychometric properties and to explore how clinical teachers assess their teamwork.

Method

To select the items to be included in the TeamQ questionnaire, we conducted a content validation in 2011, using a Delphi procedure in which 40 experts were invited. Next, for pilot testing the preliminary tool, 1446 clinical teachers from 116 teaching teams were requested to complete the TeamQ questionnaire. For data analyses we used statistical strategies: principal component analysis, internal consistency reliability coefficient, and the number of evaluations needed to obtain reliable estimates. Lastly, the median TeamQ scores were calculated for teams to explore the levels of teamwork.

Results

In total, 31 experts participated in the Delphi study. In total, 114 teams participated in the TeamQ pilot. The median team response was 7 evaluations per team. The principal component analysis revealed 11 factors; 8 were included. The reliability coefficients of the TeamQ scales ranged from 0.75 to 0.93. The generalizability analysis revealed that 5 to 7 evaluations were needed to obtain internal reliability coefficients of 0.70. In terms of teamwork, the clinical teachers scored residents' empowerment as the highest TeamQ scale and feedback culture as the area that would most benefit from improvement.

Conclusions

This study provides initial evidence of the validity of an instrument for measuring teamwork in teaching teams. The high response rates and the low number of evaluations needed for reliably measuring teamwork indicate that TeamQ is feasible for use by teaching teams. Future research could explore the effectiveness of feedback on teamwork in follow up measurements.

Effect of the learning climate of residency programs on faculty's teaching performance as evaluated by residents

Background

To understand teaching performance of individual faculty, the climate in which residents’ learning takes place, the learning climate, may be important. There is emerging evidence that specific climates do predict specific outcomes. Until now, the effect of learning climate on the performance of the individual faculty who actually do the teaching was unknown.

Objectives

This study: (i) tested the hypothesis that a positive learning climate was associated with better teaching performance of individual faculty as evaluated by residents, and (ii) explored which dimensions of learning climate were associated with faculty’s teaching performance.

Methods and Materials

We conducted two cross-sectional questionnaire surveys amongst residents from 45 residency training programs and multiple specialties in 17 hospitals in the Netherlands. Residents evaluated the teaching performance of individual faculty using the robust System for Evaluating Teaching Qualities (SETQ) and evaluated the learning climate of residency programs using the Dutch Residency Educational Climate Test (D-RECT). The validated D-RECT questionnaire consisted of 11 subscales of learning climate. Main outcome measure was faculty’s overall teaching (SETQ) score. We used multivariable adjusted linear mixed models to estimate the separate associations of overall learning climate and each of its subscales with faculty’s teaching performance.

Results

In total 451 residents completed 3569 SETQ evaluations of 502 faculty. Residents also evaluated the learning climate of 45 residency programs in 17 hospitals in the Netherlands. Overall learning climate was positively associated with faculty’s teaching performance (regression coefficient 0.54, 95% confidence interval: 0.37 to 0.71; P<0.001). Three out of 11 learning climate subscales were substantially associated with better teaching performance: ‘coaching and assessment’, ‘work is adapted to residents’ competence’, and ‘formal education’.

Conclusions

Individual faculty’s teaching performance evaluations are positively affected by better learning climate of residency programs.