Measuring attending physician performance in a general medicine outpatient clinic

Hayward, Rodney A.; Williams, Brent C.; Gruppen, Larry D.; Rosenbaum, David

doi:10.1007/bf02602402

Cited by 25 publications

(22 citation statements)

References 11 publications

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“…Cardiologists utilise a deeper fund of knowledge than general internists, and specialists may be perceived by residents as being more knowledgeable than generalists, possibly explaining why cardiologists performed equally well on the item ÔDemonstrated a broad fund of knowledgeÕ. While teaching medical students and residents, we have noticed that a preponderance of classical physical findings derives from the cardiovascular examination, perhaps explaining why cardiologists performed Although numerous studies of clinical teaching assessment instruments have examined assessment scores using factor analysis, [6][7][8][9]11,[13][14][15][16]19,23,27,28 we are not aware of studies of learner-on-faculty assessments investigating the stability of factors from 1 medical specialty to the next. We are aware, however, of a study showing that assessment items completed by first through fourth year surgical residents reduce to a single-factor model, whereas the same items completed by fifth year surgical residents reduce to a 2-factor model with subscales labelled ÔabilityÕ and Ôinterpersonal skillsÕ.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 Numerous studies have evaluated the psychometric characteristics of clinical teaching assessments. These studies included ratings of faculty by students, [8][9][10][11][12][13][14][15][16][17] residents 7,18-20 and peers 21,22 in diverse educational settings, such as internal medicine, 19,[21][22][23][24] family medicine, 14,18,25 emergency medicine, 26 gynaecology 13 and surgery. 10,27,28 However, our review of the literature 5 revealed that although factor analytic studies of clinical teaching assessments abound, [7][8][9]11,[13][14][15][16]19,23,27,28 none have described the factorial stability of teaching assessment scores across different medical specialties.…”

Section: Introductionmentioning

confidence: 99%

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Factor instability of clinical teaching assessment scores among general internists and cardiologists

2006

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We observed factor instability of clinical teaching assessment scores from the same instrument administered to general internists and cardiologists. This finding was attributed to salient differences between these specialties' educational environments and highlights the importance of validating assessments for the specific contexts in which they are to be used. Future research should determine whether interpersonal domain scores identify superior teachers and study the reasons why interpersonal and clinical teaching domains are unstable across different educational settings.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Factor instability of clinical teaching assessment scores among general internists and cardiologists

2006

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“…Consequently, the Stanford educational categories were not often modeled to an outstanding degree, which may have decreased the likelihood that evaluators would consistently agree on ratings. Finally, the estimate of appropriate sample size for this study was based on prior studies, one of which utilized resident evaluations (Hayward et al, 1995).…”

Section: Discussionmentioning

confidence: 99%

Evaluating an instrument for the peer review of inpatient teaching

et al. 2003

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The purpose of this study was to assess an instrument for the peer review of inpatient teaching at Mayo. The Mayo Teaching Evaluation Form (MTEF) is an instrument, based on the Stanford seven-category educational framework, which was developed for the peer review of inpatient teaching. The MTEF has 28 Likert-scaled items derived from the Stanford Faculty Development Program form (SFDP-26), the Mayo electronic evaluation form and three additional items. In this study three physician-evaluators used the MTEF to evaluate 10 attending physicians on the Mayo general internal medicine hospital services. Cronbach's alphas were used to assess the internal consistency of the MTEF, and Kendall's coefficient of concordance was used to summarize the inter-rater reliability. Results of this study reveal that the MTEF is internally consistent, based on average ratings across all evaluators (Cronbach's alpha=0.894). Stanford categories with the highest alphas are Self-Directed Learning, Learning Climate, Communication of Goals, and Evaluation. Categories with lower alphas are Feedback, Understanding and Retention, and Control of Teaching Session. Additionally, the majority of items on the MTEF show significant agreement across all evaluators, and teacher enthusiasm was among the most reliable items. In conclusion, the MTEF is overall internally consistent for the peer review of inpatient teaching at Mayo. Hence, the MTEF may be a useful element in the peer evaluation of teaching at our institution.

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“…Our survey instrument has not been previously validated or examined for reliability in other groups. However, it is similar in design to others used to measure residents' attitudes about educational experiences, 17,18 and our feedback questions were specifically designed to address aspects of feedback that other authors had shown to be important. 3,4,6 Lastly, our residents may be atypical in their responses to feedback, and residents in other programs may react differently.…”

Section: Discussionmentioning

confidence: 99%

Oral versus written feedback in medical clinic

et al. 1998

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OBJECTIVE:To determine whether residents perceived oral, face-to-face feedback about their continuity clinic performance as better than a similar, written version. DESIGN:Single-blind, randomized controlled trial. SETTING:Two university-based, internal medicine residency clinics.PARTICIPANTS: All 68 internal medicine and combined program (medicine-pediatrics, medicine-psychiatry, medicineneurology, and preliminary year) residents and their clinic preceptors. MEASUREMENTS AND MAIN RESULTS:Residents at each program were separately randomized to oral or written feedback sessions with their clinic preceptors. The oral and written sessions followed similar, structured formats. Both groups were later sent questionnaires about aspects of the clinic. Sixty-five (96%) of the residents completed the questionnaire. Eight of the 19 questions dealt with aspects of feedback. A feedback scale was developed from the survey responses to those eight questions ( ␣ ‫؍‬ .86). There were no significant differences in the responses to individual questions or in scale means ( p Ͼ .20) between the two feedback groups. When each university was analyzed separately, one had a higher scale mean (3.10 vs 3.57, p ‫؍‬ .047), but within each university, there were no differences between the oral and written feedback groups ( p Ͼ .20). CONCLUSIONS:No differences were observed between the oral and written feedback groups. In attempting to provide better feedback to their residents, medical educators may better apply their efforts to other aspects, such as the frequency of their feedback, rather than the form of its delivery.KEY WORDS: feedback; medical education; internal medicine; ambulatory care; residents. J GEN INTERN MED 1998;13:155-158.F eedback consists of information provided to learners for the purpose of reinforcing appropriate and correcting inappropriate efforts. It is an essential, but often neglected part of the educational process. Surveys reveal that students consider receiving constructive feedback to be a crucial component of the learning environment. 1 Although they identify certain aspects of feedback as highly important, these are frequently lacking in students' educational experiences. 2 In his observations of excellent teachers of clinical medicine, Irby emphasizes that his subjects universally devoted considerable time and effort to providing quality feedback, and he lists it as a crucial component in quality teaching. 3,4 Clinical educators vary greatly, however, in the style and structure of their feedback sessions, 5 and it is unclear which methods are preferable.Despite agreement on the importance of giving feedback, little information is available regarding practical methods of providing feedback to residents in ambulatory settings. One recent study demonstrated that written feedback could improve residents' teaching skills. 6 Another found that oral feedback improved the documentation in clinic charts, but not other aspects of clinic performance. 7 Previous to this study, the internal medicine residency programs at W...

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Measuring attending physician performance in a general medicine outpatient clinic

Cited by 25 publications

References 11 publications

Factor instability of clinical teaching assessment scores among general internists and cardiologists

Factor instability of clinical teaching assessment scores among general internists and cardiologists

Evaluating an instrument for the peer review of inpatient teaching

Oral versus written feedback in medical clinic

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