Impact of clinical clerkship integrated with clinical ladder on attending physicians' teaching self-efficacy.

BACKGROUND: Self-efficacy plays an important role in enhancing the teaching capabilities of attending physicians (APs). The clinical ladder (CL) is an educational approach developed in the field of nursing education that increases difficulty in an incremental manner. However, no previous study has confirmed the effectiveness of CL in medical education. Therefore, this study aimed to examine the effect of clinical clerkship integrated with clinical ladder (CC-CL) on the self-efficacy of APs. METHODS: Sixth-year medical students participated in CC-CL for 6 months starting from April 2023, and the changes in the self-efficacy of APs were retrospectively evaluated. The students were trained by the APs concurrently, and the achievement levels of each student were shared. The primary outcome measure was the physician teaching self-efficacy questionnaire (PTSQ) score. The PTSQ scores before and after CC-CL were analyzed using the Wilcoxon matched-pair signed-rank test. RESULTS: Fifteen APs from the Department of Pediatric and Child Neurology were included in this study. No significant difference was observed in the total PTSQ scores of the APs before and after CC-CL. However, a significant increase was observed in the PTSQ score of APs who participated for at least 2 h per week over a period of more than 3 months (n = 8) after CC-CL (p = 0.022). Furthermore, APs who had received their pediatrician certification < 10 years ago (n = 8) showed a significant increase in the total PTSQ score after CC-CL (p = 0.022). CONCLUSIONS: CC-CL may play an important role in cultivating the self-efficacy of less experienced APs. Further comparative studies must be conducted in the future to validate the findings of this study.

Psychometric properties of the newly developed Physician Teaching Self-Efficacy Questionnaire (PTSQ).

BACKGROUND: High teaching quality and students' corresponding learning progress are the most important indicators of teachers' work performance. Theory and numerous empirical studies indicate that self-efficacy, a person's belief in her or his ability to accomplish a task, is an important predictor of work performance. Accordingly, it can be assumed that teaching self-efficacy also influences teaching performance and students' learning progress with regard to physicians who teach in undergraduate medical education. Therefore, the aim of this study was to develop and validate an instrument measuring clinical teaching self-efficacy in physicians. METHODS: We developed 16 items reflecting physicians' beliefs to provide high quality clinical teaching when facing regularly occurring critical teaching situations. These constitute the Physician Teaching Self-Efficacy Questionnaire (PTSQ). For its validation, we used data from a sample of 247 physicians from internal medicine and surgery at six German medical faculties. Regarding factorial validity, we performed exploratory structural equation modelling (ESEM) as well as confirmatory factor analysis (CFA). Regarding criterion validity, correlations with the scales of the Physician Teaching Motivation Questionnaire (PTMQ), teaching experience and perceived teaching involvement were calculated. Additionally, we conducted the same analyses with a short 6-item version. RESULTS: ESEM delivered evidence for a three-factor structure with a superordinate general factor, which was confirmed by local and global fit indicators in CFA (RMSEA = .055, TLI = .939, SRMR = .048, CFI = .948). We identified the following three subfactors: teaching self-efficacy with respect to self-regulation, dyadic regulation involving students, and triadic regulation involving students and patients. Internal consistencies indicated acceptable to excellent reliability for all scales (Cronbach's alpha = .77-.90). Theory-consistent correlations with the PTMQ scales, teaching experience, and teaching involvement confirmed criterion validity. Besides excellent global fit, the short version of the PTSQ also fulfilled all other validity criteria. CONCLUSIONS: The PTSQ is a valid instrument to assess physicians' clinical teaching self-efficacy. It could be used in faculty development programmes and for educational research. The short version could be used in situations that are time-critical for physicians in order to ensure high response rates.