Mentoring experience and its effects on medical interns.

INTRODUCTION: Effective mentoring helps interns in the early stages of their medical career to reach personal and professional goals. This study investigated the mentoring experience of Korean interns during medical internship and evaluated mentoring effects to facilitate the development of future mentoring programmes. METHODS: Participants were interns being trained at Chonnam National University Hospital, South Korea, in 2011. Interns were asked to complete a questionnaire about their mentoring experiences and job satisfaction. RESULTS: A total of 61 medical interns participated in the study, giving a response rate of 70.1%. Among these interns, 26 (42.6%) had mentoring experiences, with an average of 2.3 ± 1.9 mentors per mentee. Mentees usually discussed career planning and concerns regarding their personal and social lives with their mentors. Perceived quality of the mentor was significantly more important for male mentees than for female mentees. Female interns without a mentor made significantly less effort to seek a mentor than their male counterparts. Having and not having a mentor resulted in significant differences in the interns' job satisfaction. CONCLUSION: Fewer than half of the medical interns had mentoring experiences. Results suggest that the mentoring relationship may be less satisfying and more challenging for female interns. Effective mentoring may not only help interns plan their medical career, but also increase job satisfaction. Mentoring programmes during medical internship should be expanded and supported, as it is the initial step in a medical career.

Advance organizers in a gross anatomy dissection course and their effects on academic achievement.

We presented two kinds of advance organizers (AOs), video clips and prosection, for a gross anatomy dissection course and compared their effects on academic achievement and student perception of the learning experience. In total, 141 students at Chonnam National University Medical School were randomly assigned to two groups: Group 1 (n = 70) was provided with video clips AO, whereas Group 2 (n = 71) was provided with prosection AO, the use of cadaveric specimens dissected by the course instructor. Student self-assessment scores regarding the learning objectives of upper limb anatomy improved significantly in both groups. Academic achievement scores in Group 2 were significantly higher than those in Group 1, although the self-assessment scores were not significantly different between the groups. Additionally, students in Group 2 responded significantly more positively to the statements about perception of the learning experience such as helping them understand the course content and concepts, decreasing anxiety about the dissection course, and participating actively in the dissection. It would seem that the application of prosection as an AO improved academic achievement and increased student engagement and satisfaction. This study will contribute to designing effective AOs and developing a teaching and learning strategy for a gross anatomy dissection course.

Aligning teaching practices with an understanding of quality teaching: a faculty development agenda.

BACKGROUND: To guide the future faculty development practices in a better manner, it is important to determine how clinical teachers perceive their own skill development. AIM: The objective of this study was to examine the extent to which clinical teachers aligned their teaching practices, as measured with a self-rating instrument, with their understanding of what constitutes good clinical teaching. METHOD: A sample of 1523 residents and 737 faculty members completed the clinical teaching perception inventory (CTPI) online and ranked 28 single-word descriptors that characterized clinical teachers along a seven-point scale in two measures, "My Ideal Teacher" and "Myself as a Teacher." RESULTS: Faculty and residents showed strikingly similar discrepancies, in both their magnitudes and directions, between their ratings of "My Ideal Teacher" and those of "Myself as a Teacher." Both residents and faculty found it most difficult to develop the stimulating, well-read, and innovative nature to meet their own standards. CONCLUSIONS: Data did not support our hypothesis that faculty would demonstrate stronger congruence between "My Ideal Teacher" and "Myself as a Teacher" than residents. Medical faculty would benefit from future faculty development practices that are designed to assist them in becoming stimulating, well-read, and innovative teachers, while using less control and caution in their teaching.

Residents' and faculty's beliefs about the ideal clinical teacher.

BACKGROUND AND OBJECTIVES: The objective of this study was to examine how residents and faculty in family medicine compare in their beliefs about ideal clinical teaching. METHODS: We studied 205 residents and 148 faculty in family medicine who completed the Clinical Teaching Perception Inventory (CTPI) online between April 2001 and July 2008. The participants ranked 28 single-word descriptors that characterized clinical teachers along a 7-point-scale ranging from "least like my ideal teacher" to "most like my ideal teacher." RESULTS: Both residents and faculty indicated that the ideal clinical teachers should be stimulating, encouraging, competent, and communicating and should not be conventional, cautious, or controlling. However, residents rated probing and innovative significantly lower than did faculty. CONCLUSIONS: Clinical faculty and residents in family medicine have a shared view of the ideal clinical teacher. However, residents and faculty differed in their ratings on the descriptors "Probing" and "Innovative." This difference might at least in part stem from where residents and faculty are located along a continuum from novice to mature expert.

On whose shoulders we stand: lessons from Exemplar medical educators.

The hiring of educators in medical schools (faculty who study the educational process and prepare others to become educators) has been one of the most successful educational innovations ever. Starting in 1954, through a collaboration between the Schools of Medicine and Education at the University of Buffalo, the innovation has spread to over half of the medical schools in the United States and to medical schools in several other countries. Practically every medical school and specialty now hires educators to conduct faculty development, evaluate learners, and develop or revise curricula. This article focuses on lessons learned by six-first-generation educators hired in medical education. These individuals made unique contributions that improved the process of educating and evaluating future physicians. Among their most important contributions have been the use of standardized patients, faculty development to improve instruction, and the use of clinical decision making theory. In addition, these professional educators created a home and career path for other professionals and nurtured protégés to continue the work they started. Ten lessons are reported from structured interviews using a standardized protocol. These lessons will hopefully inform current and future medical educators to help them sustain the effective collaboration between medical schools and educators.

The on-line Clinical Teaching Perception Inventory: a "snapshot" of medical teachers.

BACKGROUND AND OBJECTIVES: Medical educators need practical and accurate instruments for evaluating clinical teaching. Our purpose was to develop norms for the Clinical Teaching Perception Inventory (CTPI) on a multidisciplinary group of North American faculty and resident teachers. METHODS: A no-cost, on-line inventory (www.residentteachers.com) measured participants' comfort with teaching. Respondents recruited through surveys and professional organizations completed two identical Q-sorts, ranking 28 descriptors first for "my ideal teacher" and then for "myself as a teacher." RESULTS: An international sample of 255 residents and 256 faculty members--including 143 respondents from family medicine--completed the on-line CTPI from April 2001 to March 2003. Resident and faculty teachers agreed on top descriptors for ideal clinical teachers: stimulating, encouraging, competent, communicates, and well-read. Resident teachers revealed larger discrepancies between "self" and "ideal" scores than faculty participants did. Many respondents wished to be more stimulating and well-read, highlighting perceived needs for teaching skills development. Between the subsamples of 143 family medicine teachers and 368 non-family medicine teachers, scores were virtually indistinguishable. CONCLUSIONS: A multidisciplinary sample of 511 faculty and resident teachers agreed on key characteristics of ideal clinical teachers. Generalist educators and others can use the on-line CTPI at no cost to assess their self-perceptions as clinical teachers.

The effect of a 13-hour curriculum to improve residents' teaching skills: a randomized trial.

BACKGROUND: Although resident physicians often teach, few trials have tested interventions to improve residents' teaching skills. A pilot trial in 2001-2002 found that 13 trained resident teachers taught better than did untrained control residents. OBJECTIVE: To determine whether a longitudinal residents-as-teachers curriculum improves residents' teaching skills. DESIGN: Randomized, controlled trial from May 2001 to February 2002 (pilot trial) and March 2002 to April 2003. SETTING: 4 generalist residencies affiliated with an urban academic medical center. PARTICIPANTS: 62 second-year residents: 23 in the 2001-2002 pilot trial and 39 more in 2002-2003; 27 of the 39 participants were medicine residents required to learn teaching skills. INTERVENTION: A 13-hour curriculum in which residents practiced teaching and received feedback during 1-hour small-group sessions taught twice monthly for 6 months. MEASUREMENTS: A 3.5-hour, 8-station, objective structured teaching examination that was enacted and rated by 50 medical students before and after the intervention. Two trained, blinded raters independently assessed each station (inter-rater reliability, 0.75). RESULTS: In the combined results for 2001-2003, the intervention group (n = 33) and control group (n = 29) were similar in sex, specialty, and academic performance. On a 1 to 5 Likert scale, intervention residents outscored controls on overall improvement score (post-test-pretest difference, 0.74 vs. 0.07; difference between intervention and control groups, 0.68 [95% CI, 0.55 to 0.81]; P < 0.001) by a magnitude of 2.8 standard deviations and on all 8 individual stations. The intervention residents improved 28.5% overall, whereas the scores of control residents did not increase significantly (2.7%). In 2002-2003, 19 intervention residents similarly outscored 19 controls (post-test-pretest difference, 0.83 vs. 0.14; difference between intervention and control groups, 0.69 [CI, 0.53 to 0.84]; P < 0.001). Twenty-seven medicine residents required to learn teaching skills achieved scores similar to those of volunteers. LIMITATIONS: The study was conducted at a single institution. No "real life" assessment with which to compare the results of the objective structured teaching examination was available. CONCLUSIONS: Generalist residents randomly assigned to receive a 13-hour longitudinal residents-as-teachers curriculum consistently showed improved teaching skills, as judged by medical student raters. Residents required to participate improved as much as volunteers did.

A pilot randomized, controlled trial of a longitudinal residents-as-teachers curriculum.

PURPOSE: To determine whether a longitudinal residents-as-teachers curriculum improves generalist residents' teaching skills. METHOD: From May 2001 to February 2002, 23 second-year generalist residents in four residencies affiliated with the University of California, Irvine, College of Medicine, completed a randomized, controlled trial of a longitudinal residents-as-teachers program. Thirteen intervention residents underwent a 13-hour curriculum during one-hour noon conferences twice monthly for six months, practicing teaching skills and receiving checklist-guided feedback. In a 3.5-hour, eight-station objective structured teaching examination (OSTE) enacted and rated by 15 senior medical students before and after the curriculum, two trained, blinded raters independently assessed each station with detailed, case-specific rating scales (rating scale reliability = 0.96, inter-rater reliability = 0.78). RESULTS: The intervention and control groups were similar in academic performance, specialty distribution, and gender (chi(2) = 0.434, p =.81). On a five-point Likert scale (5 = best teaching skills), intervention and control residents showed similar mean pretest OSTE scores (2.83 vs. 2.88, p =.736). The intervention group improved their mean overall OSTE scores 22.3% (more than two standard deviations) from 2.83 (pretest) to 3.46 (post-test; p <.0005; 95% CI 0.53 to 0.72). Intervention residents also improved significantly on six of eight OSTE stations. Within the control group, no pretest-to-post-test change achieved statistical significance. Mann-Whitney and Wilcoxon signed-rank tests confirmed these results. CONCLUSIONS: Generalist residents randomly assigned to receive a 13-hour longitudinal residents-as-teachers curriculum consistently showed improved OSTE scores. Future research should clarify which aspects of residents-as-teachers curricula most effectively improve educational outcomes.

Reach out and teach someone: generalist residents' needs for teaching skills development.

BACKGROUND AND OBJECTIVES: Family practice residents and students receive substantial teaching from senior residents. Yet, we lack data about residents' needs for teaching skills development, particularly in generalist training. This multicenter, interdisciplinary study describes the learning needs of generalist residents for becoming more effective teachers. METHODS: One hundred medical students, residents, and faculty infamily medicine, internal medicine, and pediatrics participated in 11 focus groups and 4 semi-structured key informant interviews at the University of California, Irvine and the University of California, Los Angeles in 2000-2001. RESULTS: Participants agreed that resident teachers fulfill critical roles in medical education, providing powerful, skills-based teaching that can tangibly benefit both residents themselves and their junior learners. House staff often facilitate students' best learning experiences despite inherent risks in serving as teachers and professional role models. Residents need teaching skills training that prepares them to lead clinical teams and teach students essential skills that include history taking and physical examination, critical reasoning, charting, and procedures. CONCLUSIONS: Generalist residents fulfill important roles as practical clinical teachers and role models for junior learners. Future research should address how resident teachers affect learners' clinical skills, academic performance, and professionalism.