House staff attitudes toward teaching.
About: This article is published in Academic Medicine.The article was published on 1970-03-01 and is currently open access. It has received 106 citations till now. The article focuses on the topics: Teaching method.
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TL;DR: Conventional wisdom dictates that auscultation not only provides important clinical information in itself but also is a cost-effective means to select additional tests but also how it might, in comparison with other testing methods, provide a source of information of independent clinical value.
Abstract: For most of this century, the stethoscope has served as a critical diagnostic tool in cardiovascular evaluation. With the advent of numerous new diagnostic modalities, however, especially ultrasonic imaging and Doppler techniques, cardiac auscultation is receiving less emphasis in teaching and practice.1 To compound this problem further, phonocardiography, ie, the graphic recording of heart sounds, which had served as a valuable means for teaching and documenting auscultation, has been largely discarded in this country. Although medical training directors and their students generally believe that cardiac auscultation is a skill that physicians should master,1 there appears to be a widespread belief that this skill is of secondary importance because the same information is readily obtainable through newer technological means. Possibly as a result of this attitude, there is no structured teaching of cardiac auscultation in three fourths of American internal medicine programs and two thirds of cardiology programs.1 This will inevitably lead to poor practice and teaching of this technique at all levels of training. Although not as well documented, the same process of attrition is probably affecting the other cognitive skills of history taking and bedside examination.2 3 4
Conventional wisdom dictates that auscultation not only provides important clinical information in itself but also is a cost-effective means to select additional tests.5 To support these assumptions, however, we must evaluate contemporary information concerning not only how auscultation can be used for additional test selection but also how it might, in comparison with other testing methods, provide a source of information of independent clinical value. For this reason, we shall examine a few specific examples in which auscultation can be used to achieve these ends. To maximize information gained through auscultation, however, we must attempt to identify sources of inaccuracy and suggest methods to correct these …
125 citations
TL;DR: To clarify the prevalence and characteristics of residents-as-teachers curricula in U.S. graduate medical education, a group of investigators surveyed directors of residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME), as well as deans and directors of offices of graduatemedical education (GME) at LCME-accredited medical schools.
Abstract: Resident physicians provide a substantial proportion of the teaching that medical students and junior residents receive, spending numerous hours every week teaching. As stated in the Graduate Medical Education Core Curriculum of the Association of American Medical Colleges (AAMC), residents’ teaching skills are vitally important, particularly for those residents who teach third-year medical students in the so-called ‘‘core clinical clerkships,’’ which traditionally include internal medicine, pediatrics, obstetrics–gynecology, surgery, psychiatry, and family medicine. Although the residency review committee of only one of these specialties (psychiatry) currently mandates residents’ training in teaching skills, the Liaison Committee on Medical Education (LCME) states that residents should ‘‘participate in teaching [clerkship] students’’ and ‘‘be prepared for their roles as teachers and evaluators.’’ Residency programs vary in their teaching-skills training for residents. Bing-You and Tooker found in a 1993 survey of internal medicine residencies that only 20% offered teaching-skills improvement programs for their residents. In most specialties, no published studies have ever documented how many such residents-as-teachers programs exist. To clarify the prevalence and characteristics of residents-as-teachers curricula in U.S. graduate medical education, a group of investigators collaborating with the AAMC’s Section for Graduate Medical Education surveyed directors of residency programs accredited by the Accreditation Council for Graduate Medical Education (ACGME), as well as deans and directors of offices of graduate medical education (GME) at LCME-accredited medical schools.
123 citations
TL;DR: It is indicated that a limited amount of formal instruction in teaching can effect a change in the teaching attitudes and behaviour of residents in addition to their level of confidence and the way in which teachers, students and peers evaluate them.
Abstract: Because residents are expected to assume a significant share of the teaching responsibilities of peers and students, the authors surveyed first-, second- and third-year paediatric residents at the Children's Hospital National Medical Center in July 1979 to examine those factors influencing their perceptions, confidence and behaviour with regard to teaching. The experimental group received 8 hours of instruction on teaching and learning, which included workshops and feedback sessions. The results indicate that a limited amount of formal instruction in teaching can effect a change in the teaching attitudes and behaviour of residents in addition to their level of confidence and the way in which teachers, students and peers evaluate them.
90 citations
TL;DR: This paper found that students perceived residents as teachers more than attendings in their clinical clerkship assessment, which paralleled students' increased selection of a surgical career, which benefited attending efforts.
Abstract: Background A fundamental function of attending faculty is to teach and mentor medical students, but the benefit of the resident’s role is recognized increasingly. Methods Our Standardized Institutional Clinical Clerkship Assessment allows students to rate 27 factors relative to a clinical clerkship. Scores from 1998 to 2005 were used to evaluate our surgical clerkship program and to compare resident and attending teachers. Student surgery career choices also were monitored. Results Medical students routinely scored residents more highly than attending faculty. Attendings’ scores did not improve; however, residents’ teaching and overall clerkship scores improved during the study period and paralleled students’ increased selection of a surgical career. Conclusions Students perceived residents as teachers more than attendings. Residents may have significant influence over students’ career choice by their teaching and mentoring activities, which benefit attending efforts.
86 citations
TL;DR: In all specialties, rigorous research in evidence-based teacher training for residents will help prepare academic medical centers to meet the diverse and changing learning needs of today's physicians-in-training.
Abstract: Resident physicians spend numerous hours every week teaching medical students and fellow residents, and only rarely are they taught how to teach. They can, however, be taught to teach more effectively. Teaching skills improvement initiatives for residents are taking a more prominent place in the educational literature. Limited evidence now suggests that better resident teachers mean better academic performance by learners. A small but important body of research supports selected interventions designed to improve residents' teaching skills, but not all studies have demonstrated significant educational benefits for learners. An increasing number of valid and reliable instruments are available to assess residents' clinical teaching, including objective structured teaching examinations and rating scales. In all specialties, rigorous research in evidence-based teacher training for residents will help prepare academic medical centers to meet the diverse and changing learning needs of today's physicians-in-training.
80 citations