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Clinical Teaching (clinical + teaching)
Selected AbstractsClinical teaching and clinical outcomes: teaching capability and its association with patient outcomesMEDICAL EDUCATION, Issue 7 2006Ophyr Mourad Background, There is little research on the impact of medical education on patient outcome. We studied whether teaching capability is associated with altered short-term patient outcomes. Methods, We performed a multicentre retrospective cross-sectional study involving 40 clinician teachers who had attended on the general internal medicine services in hospitals affiliated with the University of Toronto along with the clinical outcomes of consecutive patients treated for community-acquired pneumonia, congestive heart failure, chronic obstructive pulmonary disease and gastrointestinal bleeding (n = 4377) between 1999 and 2001. Doctors were characterised by teaching effectiveness scores (n = 677) as high-rated or low-rated according to house staff ratings. Results, There was no correlation between the teaching effectiveness scores and the mean length of stay for those patients treated for community-acquired pneumonia (high-rated = 10.3 versus low-rated = 8.1 days, P = 0.058), congestive heart failure (high-rated = 10.1 versus low-rated = 9.9 days, P = 0.978), chronic obstructive pulmonary disease (high-rated = 9.4 versus low-rated = 9.9 days, P = 0.419) and gastrointestinal bleeding (high-rated = 6.3 versus low-rated = 6.8 days, P = 0.741). In addition, we observed no significant correlation between teaching effectiveness scores and 7-day, 28-day and 1-year readmission rates for all pre-specified diagnoses. Conclusion, There is no large correlation between teaching effectiveness scores and short-term patient outcomes, suggesting that doctor teaching capabilities, as perceived by house staff, does not generally impact clinical care. [source] Clinical teaching: maintaining an educational role for doctors in the new health care environmentMEDICAL EDUCATION, Issue 10 2000D Prideaux Context and objectives Good clinical teaching is central to medical education but there is concern about maintaining this in contemporary, pressured health care environments. This paper aims to demonstrate that good clinical practice is at the heart of good clinical teaching. Methods Seven roles are used as a framework for analysing good clinical teaching. The roles are medical expert, communicator, collaborator, manager, advocate, scholar and professional. Results The analysis of clinical teaching and clinical practice demonstrates that they are closely linked. As experts, clinical teachers are involved in research, information retrieval and sharing of knowledge or teaching. Good communication with trainees, patients and colleagues defines teaching excellence. Clinicians can ,teach' collaboration by acting as role models and by encouraging learners to understand the responsibilities of other health professionals. As managers, clinicians can apply their skills to the effective management of learning resources. Similarly skills as advocates at the individual, community and population level can be passed on in educational encounters. The clinicians' responsibilities as scholars are most readily applied to teaching activities. Clinicians have clear roles in taking scholarly approaches to their practice and demonstrating them to others. Conclusion Good clinical teaching is concerned with providing role models for good practice, making good practice visible and explaining it to trainees. This is the very basis of clinicians as professionals, the seventh role, and should be the foundation for the further development of clinicians as excellent clinical teachers. [source] The Impact of the Demand for Clinical Productivity on Student Teaching in Academic Emergency DepartmentsACADEMIC EMERGENCY MEDICINE, Issue 12 2004Todd J. Berger MD Objective: Because many emergency medicine (EM) attending physicians believe the time demands of clinical productivity limit their ability to effectively teach medical students in the emergency department (ED), the purpose of this study was to determine if there is an inverse relationship between clinical productivity and teaching evaluations. Methods: The authors conducted a prospective, observational, double-blind study. They asked senior medical students enrolled in their EM clerkship to evaluate each EM attending physician who precepted them at three academic EDs. After each shift, students anonymously evaluated 10 characteristics of clinical teaching by their supervising attending physician. Each attending physician's clinical productivity was measured by calculating their total relative value units per hour (RVUs/hr) during the nine-month study interval. The authors compared the total RVUs/hr for each attending physician to the medians of their teaching evaluation scores at each ED using a Spearman rank correlation test. Results: Seventy of 92 students returned surveys, evaluating 580 shifts taught by 53 EM attending physicians. Each attending physician received an average of 11 evaluations (median score, 5 of 6) and generated a mean of 5.68 RVUs/hr during the study period. The correlation between evaluation median scores and RVUs/hr was ,0.08 (p = 0.44). Conclusions: The authors found no statistically significant relationship between clinical productivity and teaching evaluations. While many EM attending physicians perceive patient care responsibilities to be too time consuming to allow them to be good teachers, the authors found that a subset of our more productive attending physicians are also highly rated teachers. Determining what characteristics distinguish faculty who are both clinically productive and highly rated teachers should help drive objectives for faculty development programs. [source] Teaching Techniques in the Clinical Setting: the Emergency Medicine PerspectiveACADEMIC EMERGENCY MEDICINE, Issue 10 2004David A. Wald DO Abstract The emergency department (ED) provides a unique educational experience that is distinct from both inpatient and ambulatory care settings. Because of the high acuity, interesting pathology, and rapid patient turnover, the ED is an ideal location to train medical students. Numerous teaching opportunities exist within the domain of the ED. In the preclinical years, the ED setting provides medical students with an introduction to clinical medicine and may serve as a venue for teaching basic history and physical examination skills. In the clinical years, medical students are exposed to a wide range of undifferentiated patients. Besides common medical and surgical complaints, many medical students will encounter clinical scenarios that they otherwise would have little direct contact with. Encounters such as the acutely poisoned or intoxicated patient, environmental emergencies, interaction with out-of-hospital providers, and patients requiring emergency procedures are just a few situations that make emergency medicine a distinct clinical specialty. These and other student,patient encounters can provide the teaching physician an opportunity to focus case-based teaching on a number of elements including complaint-directed medical interviewing and physical examination skills, development of case-specific differential diagnosis, diagnostic evaluation, implementation of patient management plans, and patient disposition. In this review article, the authors discuss various ways to approach and improve clinical teaching of medical students, including: opportunities for teaching in the ED, teaching procedural skills, student case presentations, clinical teaching styles, qualities of an effective clinical teacher, and barriers to effective clinical teaching. [source] A pilot study of the use and perceived utility of a scale to assess clinical dental teaching within a UK dental school restorative departmentEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2009S. Woolley Abstract Introduction:, Feedback on individual teaching performance gives an important contribution and support to the reflective practices of educators. Unfortunately, feedback is an infrequent exercise provided to dental teachers about their teaching practices. The Effective Clinical Dental Teaching (ECDT) scale has been used previously to assess clinical teachers, but has not been used within the UK. Methods:, This study looks at the use of the ECDT scale in the setting of a UK dental school, as a method of feedback collection and delivery in seven domains of clinical teaching. The ECDT was used to evaluate the teaching of 16 clinical teachers by dental undergraduates, and to investigate the opinions of these clinical teachers and clinical dental students about the utility of this scale. Results:, The study identified that there was a disparity between self and student perception of teaching. The total ECDT scores ranged from a minimum of 55% 66.6/125 to a maximum of 90% 113.8/125, with a mean group score of 73% 91.6/125. Most clinicians evaluated by students scored above 3/5 for all teaching domains, although there appeared to be significant differences between the four teacher groups. The majority of staff and students were in favour of the use of such a scale to support the progression and development of teaching styles. Conclusion:, The ECDT scale is a useful tool for highlighting the areas of strength and deficiency within clinical dental teaching. Its use may complement peer review for individual teachers and identify future topics for staff development sessions. Further research is recommended to identify the individual strengths and weaknesses that different types of teacher may bring to curriculum teaching. [source] Improving the quality of clinical teaching in a restorative clinic using student feedbackEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2008Callum Youngson Abstract Introduction:, A large proportion of the undergraduate curriculum is spent within Restorative Dentistry at the University of Liverpool. As well as supportive "phantom head" courses the undergraduates receive significant amounts of teaching within the clinics themselves. In 2004, to help inform the clinical tutors as to their areas of strengths and weaknesses, undergraduates were invited to complete an anonymous questionnaire on the quality of teaching they received from their clinical supervisors. This process has been repeated subsequently in 2005 and 2006. Method:, A 19 parameter questionnaire, employing a 5-point Likert scale and space for open comments, was circulated to every clinical undergraduate student. Questionnaires were returned anonymously and all data collected by one researcher. Descriptive statistical analysis was performed and the staff provided with individual feedback within the context of the overall departmental profile. The pooled data from each of the years was then compared to determine if any changes had occurred. Statistical analysis used Kruskal Wallis tests to determine whether these were statistically significant. Results:, Although the range varied, median scores of 4 (agree) were gained for each question each year. Following statistical analysis 18 of the parameters showed a statistically significant improvement (P < 0.05) between 2004 and 2006 with only one remaining constant throughout. Conclusion:, It would appear that the use of a questionnaire based feedback system can result in a tangible and demonstrable improvement in the delivery of clinical teaching. [source] Quality of root canal fillings performed by undergraduate dental students on single-rooted teeth,EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 2 2006C. D. Lynch Introduction:, Root canal therapy is an accepted and successful form of tooth conservation. Educational guidelines require dental schools to ensure that their graduates are competent on graduation at performing root canal therapy. The aim of this investigation was to assess the technical quality of root canal fillings placed by undergraduate students in single-rooted teeth. Materials and methods:, A total of 100 radiographs of root canal fillings placed by undergraduate students in single-rooted teeth were examined under even illumination in a darkened room using ×2 magnification. These were graded as ,adequate', where the root canal filling was within 2 mm of the radiographic apex, ,under-filled', where the root canal filling was >2 mm from the radiographic apex, and ,over-filled', where the root canal filling was extruded beyond the radiographic apex. The presence of voids, fractured instruments, and root perforations were also noted. Results:, All teeth were obturated with gutta-percha and sealer (Roth Cement), using a cold lateral condensation technique. Of 100 teeth, 10% (n = 10) had voids. Of the remainder, 70% (n = 63) were judged to be ,acceptable', 21% (n = 19) were ,under-filled', and 9% (n = 8) were ,over-filled'. There was no evidence of fractured instruments or root perforations in any root filling examined. Conclusions:, The quality of root canal fillings placed in single-rooted teeth by undergraduate dental students at the University Dental School and Hospital, Cork was acceptable (63% of root fillings placed in single rooted teeth were graded as ,adequate'). The probable reasons for this are multi-factorial, but may be linked to the amount of pre-clinical and clinical teaching in endodontics at the University Dental School and Hospital, Cork. It should be remembered that factors other than radiographic quality/evidence must be considered when determining the outcome of root canal therapy. [source] Graduate Medical Education Downsizing: Perceived Effects of Participating in the HCFA Demonstration Project in New York StateACADEMIC EMERGENCY MEDICINE, Issue 2 2001Linda L. Spillance MD Abstract. Objective: Financial support for graduate medical education (GME) is shrinking nationally as Medicare cuts GME funds. Thirty-nine hospitals in New York State (NYS) voluntarily participated in a Health Care Financing Administration demonstration project (HCFADP),the goal of which was to reduce total residency training positions by 4-5%/year over a five-year period, while increasing primary care positions. The objective of this study was to determine the effect of downsizing on emergency department (ED) staffing and emergency medicine (EM) residency training. Methods: Structured interviews and surveys of NYS program directors (PDs) were conducted in October,December 1999. Simple frequencies are reported. Results: One hundred percent of 17 PDs completed the interviews and seven of 12 participants in the HCFADP returned surveys. Twelve of 17 programs participated in HCFADP and two programs downsized outside HCFADP. Seven of 12 participants lost EM positions. Six of 12 programs were forced to exclude outside residents from rotating in their ED, leading to a need for one participating program and one non-participating program to find alternative sites for trauma. Five of 12 institutions provided resident staffing data, reporting a reduction in ED resident coverage in year 1 of the project of 9-40%. Programs compensated by increasing the number of shifts worked (4/12), increasing shift length (1/12), decreasing pediatric ED shifts (1/12), decreasing elective or research time (2/12), and decreasing off-service rotations (4/12). Six departments hired physician assistants or nurse practitioners, two hired faculty, and two hired resident moonlighters. Six of 12 programs withdrew from HCFADP and returned to previous resident numbers. Eight of 12 PDs thought that they had decreased time for clinical teaching. Conclusions: A 4-5% reduction in residency positions was associated with a marked reduction in ED resident staffing and EM residency curriculum changes. [source] Clinical teachers' approaches to nursingJOURNAL OF CLINICAL NURSING, Issue 5-6 2010Helen Forbes Aims and objectives., The aim of the study was to investigate clinical teachers' experiences of nursing and clinical teaching of undergraduate university students. This article reports on clinical teachers' approaches to nursing, which is one part of that study. Background., A lack of knowledge and understanding exists about how clinical teachers approach nursing. There is a likely relationship between approaches to nursing and what is focused on when teaching undergraduate nursing students in the clinical setting. It is therefore important to understand the variation in how clinical teachers approach nursing. Design., Phenomenography. Method., Semi-structured interviews of 20 practicing nurses currently employed as clinical teachers from a range of Australian universities were conducted. Data were analysed using a phenomenographic approach. Results., Key aspects of variation in clinical teacher approaches to nursing were identified. The results suggest that clinical teachers approach nursing in one of two ways, either a patient-focused approach or a nurse-focused approach. The research findings extend knowledge that will assist with preparation and support of clinical teachers. Conclusion., Knowledge of the different approaches to nursing provides a structure for helping clinical teachers increase their awareness of both their approach to nursing and the implications for their nursing and teaching. Relevance to clinical practice., Awareness of complex approaches to nursing may be required for multidisciplinary care. [source] Clinical education facilitators: a literature reviewJOURNAL OF CLINICAL NURSING, Issue 6 2005Veronica Lambert BNS Aims and objectives., The aim of this literature review, set within an Irish context, is to present a broad overview of former and existing clinical support personnel, explore the concept of facilitation and examine what is known about the role of the clinical education facilitator. Background., The importance of providing a supportive clinical environment to enhance clinical teaching and learning is strongly portrayed in the literature. While the past two decades have borne witness to various clinical support personnel, the literature identifies conflicting demands that these personnel face. No suggestions are advanced as to how to overcome these difficulties, which inevitably influence the quality and quantity of their clinical teaching role. An identifiable gap exists over who has prime responsibility for clinical teaching. It is timely that alternative possibilities for organizing clinical teaching are investigated. A new post emerging in practice settings is that of the clinical education facilitator who is meant to be the key linchpin in clinical areas for reducing the theory,practice gap. Method., Relevant literature for this review was sourced using the computerized databases CINAHL, Medline and Synergy. Manual searching of relevant nursing journals and sourcing of secondary references extended the search. Government reports and other relevant documents were obtained through pertinent websites. Results., Papers that explicitly examined the concept of facilitation and explored the posts of clinical education facilitators were included; six research papers were accessed and reviewed. In addition seven non-empirical papers were included. Conclusions., It is clear that considerable lack of role clarity resides over what constitutes clinical facilitation and the role of the clinical facilitator. Thus, it is paramount to strengthen this support role with Irish empirical evidence. Relevance to clinical practice., A major advantage in having a ward-based clinical education facilitator is the benefit of having access to someone who can concentrate solely on clinical education and support with attempts to narrow the theory,practice divide. [source] Public health in the undergraduate medical curriculum , can we achieve integration?JOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2000David H. Stone MD, FFPHM, FRCP (Glasg) Abstract Public health is widely regarded by medical students as peripheral or even irrelevant to the acquisition of clinical knowledge and skills. This paper attempts to set out some of the reasons for this, to encourage innovative approaches to integrating public health with clinical teaching and to offer a theoretical framework of integrated public health education for curriculum development and evaluation. The points of convergence between public health and clinical practice should not be regarded as self-evident. A practical demonstration of the application of public health principles to clinical problem solving may be the most effective means of overcoming resistance. Almost anywhere that clinical services are provided is suitable for this purpose. Community clinics, health centres or general practices have obvious appeal but acute hospitals have important advantages arising from students' preoccupation with clinical medicine. The main aim of integrated public health teaching is to facilitate the students' acquisition of knowledge, skills and attitudes that promote the effective application of public health approaches to clinical practice. The interrelationships between clinical practice and public health may be represented in the form of a grid. The vertical headings are the clinical skills that relate to the different stages of the natural history of disease , from the pre-disease state through diagnosis, treatment and follow up. The horizontal headings describe four key public health dimensions: epidemiology, behaviour/lifestyle, environment and health policy. The text in the boxes suggests appropriate topics for discussion. The grid is also potentially useful for course documentation and content evaluation. [source] Describing clinical teachers' characteristics and behaviours using critical incidents and repertory gridsMEDICAL EDUCATION, Issue 7 2006Praminthra Chitsabesan Context, Completion of a rating questionnaire is the method used most frequently to evaluate a teacher's performance. Questionnaires that largely assess ,high-inference' teaching characteristics, such as ,enthusiasm' and ,friendliness', require the observer to make a judgement about the teacher but do not describe what the teacher actually did and so have limited use in providing feedback. Measures of ,low-inference' teaching behaviours (i.e. those that are concrete and observable), such as frequency, amount or types of verbal interaction, do not demonstrate how these are linked to good teaching. Objectives, To describe high-inference teacher characteristics and define the associated low-inference behaviours. Methods, A purposive sample of consultants, postgraduate and undergraduate students, nurse lecture practitioners and patients were selected for semistructured interviews using repertory grids and critical incidents to elicit preferred characteristics and behaviours of clinical teachers. Interviews were audiotaped, transcribed and then content-analysed using a framework to pair teachers' characteristics and their behaviours. Results, We identified a variety of preferred high-inference characteristics and their associated observable and recordable low-inference behaviours. Discussion, We carried out a study that included all participants in clinical teaching and found that participants differed in their preferred characteristics and behaviours. It is important for future research to look at behaviours interdependently, rather than alone, and to take into account the evidence that participants tend to infer characteristics rather than think in terms of behaviours. This information will be used to inform the development of a formative tool for evaluating clinical teaching. [source] Reliability of the Clinical Teaching Effectiveness InstrumentMEDICAL EDUCATION, Issue 9 2005H H Van Der Hem-Stokroos Introduction, The Clinical Teaching Effectiveness Instrument (CTEI) was developed to evaluate the quality of the clinical teaching of educators. Its authors reported evidence supporting content and criterion validity and found favourable reliability findings. We tested the validity and reliability of this instrument in a European context and investigated its reliability as an instrument to evaluate the quality of clinical teaching at group level rather than at the level of the individual teacher. Methods, Students participating in a surgical clerkship were asked to fill in a questionnaire reflecting a student,teacher encounter with a staff member or a resident. We calculated variance components using the urgenova program. For individual score interpretation of the quality of clinical teaching the standard error of estimate was calculated. For group interpretation we calculated the root mean square error. Results, The results did not differ statistically between staff and residents. The average score was 3.42. The largest variance component was associated with rater variance. For individual score interpretation a reliability of >,0.80 was reached with 7 ratings or more. To reach reliable outcomes at group level, 15 educators or more were needed with a single rater per educator. Discussion, The required sample size for appraisal of individual teaching is easily achievable. Reliable findings can also be obtained at group level with a feasible sample size. The results provide additional evidence of the reliability of the CTEI in undergraduate medical education in a European setting. The results also showed that the instrument can be used to measure the quality of teaching at group level. [source] A survey of staff attitudes to increasing medical undergraduate education in a district general hospitalMEDICAL EDUCATION, Issue 7 2005John Macdonald Introduction, Medical student numbers in Britain are increasing rapidly, beyond the capacity of most teaching hospitals, with more clinical teaching taking place in district general hospitals (DGHs). Surveys show that students value the intensive clinical teaching, smaller student numbers and perceived greater friendliness in DGHs. This paper explores DGH staff attitudes to teaching , their level of initial enthusiasm, their attitudes to current teaching, its effect on the hospital and to the sustainability of DGH undergraduate teaching , as both student numbers and service workloads continue to rise. Methods, Semi-structured interviews with 6 key informants were used to generate themes for a 19-question pre-piloted anonymous postal questionnaire sent to all 68 staff involved in undergraduate medical teaching in Northampton General Hospital. Results, The total response included 85% of consultants. Responses in the 3 staff groups were similar. Most respondents felt enthusiastic at the prospect of medical students, although they realised that this would be intellectually challenging and increase time pressures. These predictions were largely fulfilled. Respondents felt that in comparison to teaching hospitals the DGH teaching was more clinically based and consultant-led, with more approachable staff. Currently 41 respondents (82%) felt that they had inadequate teaching time. A majority felt that the arrival of students had improved patient care and that their department had benefited. Thirty-seven responders (74%) felt that the planned doubling of student numbers would impose an unsustainable departmental load, and would compromise teaching quality. The change felt most necessary to support additional teaching was increased clinical medical staff. Better co-ordination between the DGH and the medical school was also felt necessary. The most popular choice for the distribution of extra teaching finance was to the teacher's directorate, i.e. speciality [33 (66%)]. Forty-four (86%) felt that increased student numbers would have a significant impact on the character of the hospital. The 108 free-text comments (2.1 per respondent) centred on hospital character and the benefits of students. Conclusions, This study shows a considerable initial enthusiasm for teaching in DGH staff, which is persisting despite increasing student numbers. However, the current teaching load is seen to be substantial. Teaching more students is likely to produce major problems, based on lack of teaching time and increasingly heavy service commitments rather than lack of patients. This is likely to be a widespread problem for DGHs. Failure to ensure adequate teaching staff and facilities as well as co-ordination could threaten the sustainability of this potentially valuable teaching initiative. [source] Teaching and learning in the clinical setting: a qualitative study of the perceptions of students and teachersMEDICAL EDUCATION, Issue 11 2003Patsy Stark Objective, To describe the perceptions of medical students and clinical teachers of teaching and learning in the clinical setting. Design, Qualitative study of focus groups with undergraduate medical students and semistructured interviews with hospital consultant clinical teachers. Setting, The School of Medicine, University of Leeds and the Leeds Teaching Hospitals Trust, UK. Participants, Fourth year medical students and consultant clinical teachers. Main outcome measures, Analysis of narratives to identify students' perceptions of clinical teaching and consultants' views of their delivery of undergraduate clinical teaching. Results, Students believed in the importance of consultant teaching and saw consultants as role models. However, they perceived variability in the quality and reliability of teaching between physicians and surgeons. Some traditional teaching venues, especially theatre, are believed to be of little clinical importance. Generally, consultants enjoyed teaching but felt under severe pressure from other commitments. They taught in a range of settings and used various teaching strategies, not all of which were perceived to be ,teaching' by students. Conclusions, While students and teachers are educational partners, they are not always in agreement about the quality, quantity, style or appropriate setting of clinical teaching. To enable teachers to provide more high quality teaching, there needs to be support, opportunities and incentives to understand curricular developments and acquire teaching skills. [source] Refuting patients' obligations to clinical training: a critical analysis of the arguments for an obligation of patients to participate in the clinical education of medical studentsMEDICAL EDUCATION, Issue 3 2001Jude T Waterbury Context The clinical teaching of medical students is essential to the continuation of medicine, but it has a major impact on the patient's health care and autonomy. Some people believe that there is a moral obligation for patients to participate in this training. Such an obligation, real or perceived, may endanger patients' autonomy. Objectives The author makes a critical analysis of the main arguments he encounters supporting such an obligation. These arguments are: (1) the furthering of medical education; (2) compensation when uninsured or unable to pay; (3) an equitable return for the care received in a teaching hospital, and (4) fulfilment of a student's need for (and some say right to) clinical training. Methods Related literature is reviewed in search of evidence and/or support for such arguments. Conclusions The review reveals that these arguments either cannot be verified or do not necessarily place any obligations on the patient. It is argued that, while a medical student may have a right to clinical education, the obligation to fulfil this right rests with the medical university and not on the patients of its teaching hospitals. Solutions Several proposals are made about how to satisfy this need without infringing on the patient's right to refuse participation, explaining the patient's rights and role in clinical teaching, and the use of standardized patients where necessary. [source] Clinical teaching: maintaining an educational role for doctors in the new health care environmentMEDICAL EDUCATION, Issue 10 2000D Prideaux Context and objectives Good clinical teaching is central to medical education but there is concern about maintaining this in contemporary, pressured health care environments. This paper aims to demonstrate that good clinical practice is at the heart of good clinical teaching. Methods Seven roles are used as a framework for analysing good clinical teaching. The roles are medical expert, communicator, collaborator, manager, advocate, scholar and professional. Results The analysis of clinical teaching and clinical practice demonstrates that they are closely linked. As experts, clinical teachers are involved in research, information retrieval and sharing of knowledge or teaching. Good communication with trainees, patients and colleagues defines teaching excellence. Clinicians can ,teach' collaboration by acting as role models and by encouraging learners to understand the responsibilities of other health professionals. As managers, clinicians can apply their skills to the effective management of learning resources. Similarly skills as advocates at the individual, community and population level can be passed on in educational encounters. The clinicians' responsibilities as scholars are most readily applied to teaching activities. Clinicians have clear roles in taking scholarly approaches to their practice and demonstrating them to others. Conclusion Good clinical teaching is concerned with providing role models for good practice, making good practice visible and explaining it to trainees. This is the very basis of clinicians as professionals, the seventh role, and should be the foundation for the further development of clinicians as excellent clinical teachers. [source] The Genetic Counseling Video Project (GCVP): Models of practice,AMERICAN JOURNAL OF MEDICAL GENETICS, Issue 4 2006D. Roter Abstract Genetic counseling is conceptualized as having both "teaching" and "counseling" functions; however, little is known about how these functions are articulated in routine practice. This study addresses the question by documenting, on videotape, the practices of a national sample of prenatal and cancer genetic counselors (GCs) providing routine pre-test counseling to simulated clients (SCs). One hundred and seventy-seven GCs recruited at two annual conferences of the National Society of Genetic Counselors (NSGC) were randomly assigned to counsel one of six female SCs of varying ethnicity, with or without a spouse, in their specialty. One hundred and fifty-two videotapes were coded with the Roter Interaction Analysis System (RIAS) and both GCs and SCs completed evaluative questionnaires. Two teaching and two counseling patterns of practice emerged from cluster analysis. The teaching patterns included: (1) clinical teaching (31%) characterized by low psychosocial, emotional and facilitative talk, high levels of clinical exchange, and high verbal dominance; and (2) psycho-educational teaching (27%) characterized by high levels of both clinical and psychosocial exchange, low levels of emotional and facilitative talk, and higher verbal dominance. The counseling patterns included: (1) supportive counseling (33%) characterized by low psychosocial and clinical exchange, high levels of emotional and facilitative talk, and low verbal dominance; and (2) psychosocial counseling (9%) with high emotional and facilitative talk, low clinical and high psychosocial exchange, and the lowest verbal dominance. SCs ratings of satisfaction with communication, the counselor's affective demeanor, and the counselor's use of non-verbal skills were highest for the counseling model sessions. Both the teaching and counseling models seem to be represented in routine practice and predict variation in client satisfaction, affective demeanor, and nonverbal effectiveness. © 2006 Wiley-Liss, Inc. [source] Teachers: Recognising Excellence in Medical Education: a student-led award schemeTHE CLINICAL TEACHER, Issue 3 2010Nicola Louise Wheeler Summary Background:, The standard of clinical teaching is acknowledged by undergraduate medical students and their clinical teachers as being variable.1 Furthermore, there is very little recognition by medical schools of the teaching expertise and efforts of clinical teachers.2 Innovation:, In response to these issues, a group of medical students at the University of Birmingham's Medical School have established an awards scheme called Recognising Excellence in Medical Education (REME). This is a student-led award scheme that is supported by the Dean and other senior medical school staff, and by the students' medical society. Method:, This research used two focus groups, one comprising REME award winners and one comprising students who voted in the scheme, to discuss opinions regarding the awards, reasons why the students voted, and how clinical teachers feel about receiving the awards. Discussion:, The focus groups revealed that both students and their clinical teachers were very positive about the award scheme and the impact it has had, both personally and within the hospitals or Trusts of the award winners. The REME awards were viewed as motivating and encouraging for clinical teachers, and were particularly prized as teachers were nominated by their students. [source] 8 The Observed Teaching Encounter: Providing Residents Feedback on Their Teaching SkillsACADEMIC EMERGENCY MEDICINE, Issue 2008Ankur Doshi Introduction:, Emergency medicine residents spend a significant portion of their time teaching junior residents and medical students in the clinical setting. Feedback is an integral component of any teaching curriculum, and therefore, feedback on residents' skill in teaching abilities is an essential part of their learning to teach. We have developed a structured method of providing feedback to senior residents on their teaching competence. Methods:, Upcoming senior residents receive an 8-hour course on clinical teaching during their useful conference time. In our ED, attending faculty and senior "teaching" residents are matched with medical student learners. The Observed Teaching Encounter (OTE) is used during usual clinical ED shifts to reinforce concepts in teaching. During the OTE, the teaching resident is directly observed by a faculty physician while teaching a student learner. A checklist is completed by both the faculty member and the student learner in order to provide feedback to the teaching resident. Assessed skills correlate with teaching theory provided to residents in their didactic curriculum. Written formative comments are provided to the resident from faculty, as well. Results:, Attending faculty, senior residents, and student learners have all provided positive feedback on the OTE. Assessment of residents' retention of knowledge on methodology of teaching is presently in progress as a tool to evaluate the efficacy of the OTE. [source] The Effects of Clinical Workload on Teaching in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 6 2007Sean P. Kelly MD Background:Academic emergency physicians have expressed concern that increased clinical workload and overcrowding adversely affect clinical teaching. Objectives:To evaluate the influence of clinical workload and attending physicians' teaching characteristics on clinical teaching in the emergency department (ED). Methods:This was a prospective observational study using learner satisfaction assessment tools to evaluate bedside teaching. On days when a research assistant was available, all ED residents and attending physicians were queried. A total of 335 resident surveys were administered over nine months (89% response). Clinical workload was measured by perception and patient volume. Teaching quality and characteristics were rated on ten-point scales. A linear mixed-effects model was used to obtain adjusted impact estimates of clinical workload and teaching attributes on teaching scores while controlling for individual attending physicians' teaching ability and residents' grading tendencies. Results:No clinical workload parameter had a significant effect on teaching scores: residents' workload perception (, estimate, 0.024; p = 0.55), attending physicians' workload perception (, estimate, ,0.05; p = 0.28), patient volume in patients per hour (, estimate, ,0.010; p = 0.36), and shift type (, estimate, ,0.19; p = 0.28). The individual attending physician effect was significant (p < 0.001) and adjusted in each case. In another model, the attending physicians' learning environment established (, estimate, 0.12; p = 0.005), clinical teaching skills (, estimate, 0.36; p < 0.001), willingness to teach (, estimate, 0.25; p < 0.001), and interpersonal skills (, estimate, 0.19; p < 0.001) affected teaching scores, but the attending physicians' availability to teach had no significant effect (, estimate, 0.007; p = 0.35). Conclusions:Clinical workload and attending physicians' availability had little effect on teaching scores. Attending physicians' clinical teaching skills, willingness to teach, interpersonal skills, and learning environment established were the important determinants of overall scores. Skilled instructors received higher scores, regardless of how busy they were. [source] | ||||||||||