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Nejadkoorki H, Norouzi A, Salajegheh F, Salajegheh M. Psychometric evaluation of Maastricht clinical teaching questionnaire based on the cognitive apprenticeship model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 12:434. [PMID: 38464664 PMCID: PMC10920695 DOI: 10.4103/jehp.jehp_1528_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/22/2023] [Indexed: 03/12/2024]
Abstract
BACKGROUND The Maastricht Clinical Teaching Questionnaire is a valid and reliable instrument for measuring the quality of clinical teaching. This study was aimed at translation and psychometric evaluation of the Persian version of this questionnaire to evaluate clinical teaching based on the cognitive apprenticeship model. MATERIALS AND METHODS The translation of the questionnaire was performed according to Guillemins framework. Reliability was examined by calculating Cronbach's alpha coefficient. Confirmatory factor analysis was studied among 120 medical students. Content validity was assessed by calculating the content validity index and content validity ratio. Face validity was evaluated by conducting interviews with students using concurrent verbal probing and thinking aloud. RESULTS Cronbach's alpha coefficient for the whole scale was 0.95. The content validity index was 0.92, and the content validity ratio was 0.82. Confirmatory factor analysis resulted in a seven-factor model and demonstrated an adequate fit with the data. CONCLUSION The Persian version of the Maastricht Clinical Teaching Questionnaire with seven factors including modeling, coaching, scaffolding, articulation, reflection, exploration, and learning environment appears to be a valid and reliable instrument for the evaluation of clinical teaching in Iranian universities of medical sciences.
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Affiliation(s)
- Hamid Nejadkoorki
- Department of Medical Education, Medical Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Norouzi
- Education Development Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Faranak Salajegheh
- Clinical Research Development Unit, School of Medicine, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahla Salajegheh
- Department of Medical Education, Medical Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
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Wurth S, Maisonneuve H, Moussa MA, Campion B, Caire Fon N, Peltier C, Audétat MC. Development of complex pedagogical competencies and reflexivity in clinical teachers via distance learning: a mixed methods study. MEDICAL EDUCATION ONLINE 2023; 28:2265163. [PMID: 37818594 PMCID: PMC10569352 DOI: 10.1080/10872981.2023.2265163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023]
Abstract
Clinical reasoning is the cornerstone to healthcare practice and teaching it appropriately is of utmost importance. Yet there is little formal training for clinical supervisors in supervising this reasoning process. Distance education provides interesting opportunities for continuous professional development of healthcare professionals. This mixed methods study aimed at gaining in-depth understanding about whether and how clinical teachers can develop complex pedagogical competencies through participation in a Massive Open Online Course on the supervision of clinical reasoning (MOOC SCR). Participants self-assed their clinical supervision skills before and after partaking in the MOOC SCR through the Maastricht Clinical Teachers Questionnaire. Item scores and the distribution of response proportions before and after participation were compared using paired t-tests and McNemar's tests respectively. In parallel, the evolution of a subset of MOOC participants' pedagogical practice and posture was explored via semi-structured interviews throughout and beyond their MOOC participation using simulated and personal situational recalls. The verbatim were analysed with standard thematic analysis. Quantitative and qualitative findings converged and their integration demonstrated that partaking in the MOOC SCR promoted the development of complex pedagogical competencies and reflexivity with the participants. This was quantitatively evidenced by significantly higher self-assessed supervision skills and corresponding attitudes after completing the MOOC. The qualitative data provided rich descriptions of how this progression in pedagogical practice and posture occurred in the field and how it was shaped by participants' interaction with the MOOC's content and their motivations to progress. Our findings provide evidence for the development of pedagogical skills and corresponding attitudes for the supervision of clinical reasoning through participation in the MOOC SCR and contribute to the literature body on the opportunities that distance learning provides for the development of pedagogical competencies. The extent to which the pedagogical underpinnings of the MOOC contributed to these developments remains to be determined.
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Affiliation(s)
- Sophie Wurth
- Unit for Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Hubert Maisonneuve
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Mohamed Amir Moussa
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Baptiste Campion
- Institute of Higher Studies in Social Communications, Brussels School of Journalism and Communication, Brussels, Belgium
| | - Nathalie Caire Fon
- Family Medicine and Emergency Medicine Department, Medicine, Université de Montréal, Montréal, Canada
| | - Claire Peltier
- Unit for Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Faculty of Educational Sciences, Université Laval, Quebec City, Canada
| | - Marie-Claude Audétat
- Unit for Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Institute for Primary Care, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Effective Veterinary Clinical Teaching in a Variety of Teaching Settings. Vet Sci 2022; 9:vetsci9010017. [PMID: 35051101 PMCID: PMC8779673 DOI: 10.3390/vetsci9010017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/29/2021] [Accepted: 01/03/2022] [Indexed: 12/04/2022] Open
Abstract
This review explores different modalities for clinical teaching of veterinary learners globally. Effective clinical teaching aims to prepare graduates for a successful career in clinical practice. Unfortunately, there is scant literature concerning clinical teaching in veterinary medicine. Our intent for this review is to stimulate and/or facilitate discussion and/or research in this important area. We discuss the different forms that veterinary clinical teaching can take, depending on their setting, which can be university-based clinical activities, work-based in commercial clinical practices, or in a traditional academic setting with little to no real-time exposure to clients and patients. We suggest that each of these modalities has a place in clinical teaching of veterinary learners at any point in the curriculum but that a mix of these approaches will likely provide an improved experience for the learner. Further, we discuss strategies to improve clinical teaching in these different settings. Potential strategies related to the teaching skills of clinical instructors could include training in delivery of clinical teaching in a variety of learning settings, and instructors’ official recognition, including opportunities for career progression. Potential strategies to improve clinical teaching in different teaching settings would vary with the learning settings. For example, in traditional academic settings, case-based learning with incorporation of simulation models is one proposed strategy. The involvement of learners in ‘teach-others’ is a strategy for both traditional academic and clinical settings. Finally, clearly addressing Day One competencies is required in any clinical teaching setting.
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Elster MJ, O'Sullivan PS, Muller-Juge V, Sheu L, Kaiser SV, Hauer KE. Does being a coach benefit clinician-educators? A mixed methods study of faculty self-efficacy, job satisfaction and burnout. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:45-52. [PMID: 34406613 PMCID: PMC8371581 DOI: 10.1007/s40037-021-00676-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Coaching is a growing clinician-educator role. Self-efficacy is a powerful faculty motivator that is associated positively with job satisfaction and negatively with burnout. This study examines self-efficacy, job satisfaction, and burnout in coaches and other clinician-educators. METHODS We conducted a mixed methods study using a quantitative survey followed by qualitative interviews of faculty at the University of California, San Francisco. Coaches (funded 20% full-time equivalents), faculty with other funded education positions ("funded"), and faculty without funded education positions ("unfunded") completed a 48-item survey addressing self-efficacy (teaching, professional development, and scholarship), job satisfaction, and burnout. Data were analyzed using analysis of variance followed by post-hoc tests and chi-square tests. To elaborate quantitative results, we conducted qualitative interviews of 15 faculty and analyzed data using framework analysis. RESULTS 202 of 384 faculty (52.6%) responded to the survey; 187 complete surveys were analyzed. Teaching self-efficacy was similar across groups. Coaches and funded educators had significantly higher professional development self-efficacy and job satisfaction than unfunded educators. Burnout was more prevalent in coaches and unfunded educators. Qualitative analysis yielded three themes: sources of reward, academic identity, and strategies to mitigate burnout. Educator roles provide reward that enhances self-efficacy and job satisfaction but also generate competing demands. Coaches cited challenges in forming professional identities and working with struggling learners. DISCUSSION The coaching role provides faculty with benefits similar to other funded educator roles, but the particular demands of the coach role may contribute to burnout.
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Affiliation(s)
- Martha J Elster
- Department of Pediatrics, University of California, San Francisco, CA, USA.
| | - Patricia S O'Sullivan
- Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, CA, USA
- Department of Surgery, University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | | | - Leslie Sheu
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Sunitha V Kaiser
- Departments of Pediatrics and Clinical Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Karen E Hauer
- Department of Medicine, University of California, San Francisco School of Medicine, San Francisco, CA, USA
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Konishi E, Saiki T, Kamiyama H, Nishiya K, Tsunekawa K, Imafuku R, Fujisaki K, Suzuki Y. Improved cognitive apprenticeship clinical teaching after a faculty development program. Pediatr Int 2020; 62:542-548. [PMID: 31834972 DOI: 10.1111/ped.14095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 11/15/2019] [Accepted: 12/10/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND While it is well known that the cognitive apprenticeship is an effective workplace-based teaching approach for clinical teachers, the effects of faculty development (FD) have not been analyzed from that perspective. The purpose of this study was to investigate self-assessment by clinical teachers of their educational perceptions and behaviors after a FD program using the cognitive apprenticeship model. METHODS Board-certified pediatricians who participated in a 3-day FD program on practical clinical teaching were asked to complete questionnaires. Fifty participants completed two questionnaires prior to and 3 and 6 months after the FD program: the first was on the participants' general perceptions and behaviors in relation to their own clinical education and the second was a self-assessment using the Maastricht Clinical Teaching Questionnaire (MCTQ) that was developed based on the cognitive apprenticeship model. RESULTS The general survey demonstrated that 78% of the participants experienced positive changes in their educational perceptions 6 months after FD. Self-assessment using the MCTQ showed that the scores in the categories of "articulation," "exploration," and "safe learning environment" remained significantly improved 6 months after the FD program. CONCLUSIONS The participants' self-perceived improvement in behaviors was sustainable for 6 months after participation the FD program. The results of the MCTQ show that through their experiences in the FD program, the participants seemingly transformed their clinical teaching to become interactive facilitators, encouraging self-directed learning. Our results also suggest that the MCTQ can be used for self-assessment of clinical teachers and to enhance the effectiveness of the FD program.
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Affiliation(s)
- Eri Konishi
- Medical Education Development Center, Gifu University Graduate School of Medicine, Gifu, Japan.,Department of Pediatrics, Matsue Red Cross Hospital, Matsue, Japan.,Committee of Education, Japan Pediatric Society, Tokyo, Japan
| | - Takuya Saiki
- Medical Education Development Center, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Kamiyama
- Committee of Education, Japan Pediatric Society, Tokyo, Japan.,Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan
| | - Katsumi Nishiya
- Committee of Education, Japan Pediatric Society, Tokyo, Japan.,Center for Medical Education, Kansai Medical University, Osaka, Japan
| | - Koji Tsunekawa
- Medical Education Development Center, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Rintaro Imafuku
- Medical Education Development Center, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Kazuhiko Fujisaki
- Medical Education Development Center, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Yasuyuki Suzuki
- Medical Education Development Center, Gifu University Graduate School of Medicine, Gifu, Japan.,Committee of Education, Japan Pediatric Society, Tokyo, Japan
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Rodino AM, Wolcott MD. Assessing Preceptor Use of Cognitive Apprenticeship: Is the Maastricht Clinical Teaching Questionnaire (MCTQ) a Useful Approach? TEACHING AND LEARNING IN MEDICINE 2019; 31:506-518. [PMID: 31064222 DOI: 10.1080/10401334.2019.1604356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Construct: The authors investigated the utility of the Maastricht Clinical Teaching Questionnaire (MCTQ) to assess preceptor use of cognitive apprenticeship teaching methods. Background: The MCTQ is an instrument first studied in medical and veterinary education; it was shown to produce valid and reliable data when evaluating how well preceptors engage in cognitive apprenticeship. Additional validity evidence, however, is needed to determine if the MCTQ is useful and applicable in other healthcare professions, such as pharmacy. Approach: Student pharmacists and pharmacy residents at a large academic medical center completed the MCTQ to evaluate pharmacist preceptors. A confirmatory factor analysis (CFA) was used to determine how consistent the data were with the 5-factor structure of the cognitive apprenticeship teaching methods (e.g., modeling, coaching, articulation, exploration, and safe learning environment). A structural equation model (SEM) was used to evaluate the relationship between the 5 factors. Preceptor and student perceptions were also collected to evaluate the response process and potential consequences of using the instrument. Results: Thirty-eight learners (2nd-year and 4th-year student pharmacists and pharmacy residents) submitted 157 evaluations. The CFA showed appreciable fit with the 5-factor structure of the cognitive apprenticeship framework after 2 modifications (removal of 1 item and moving 1 item to a different factor). The SEM had poor model fit compared to previous studies, and an exploratory analysis suggests that there is a complex relationship between the various teaching methods. Preceptors and students highly agreed that the instrument was valuable for providing feedback. Conclusion: The MCTQ has additional validity evidence that supports it as a viable instrument to assess preceptor engagement in teaching methods consistent with the cognitive apprenticeship framework. Additional research is warranted to explore the relationship between components in the cognitive apprenticeship framework to determine how preceptors can best focus their efforts to improve clinical teaching.
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Affiliation(s)
- Anne M Rodino
- Department of Pharmacy, University of North Carolina Hospital, Chapel Hill, North Carolina, USA
| | - Michael D Wolcott
- Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
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Al Ansari A, Tabbara KS. Evaluating the Reliability and Validity of the Maastricht Clinical Teaching Questionnaire in Bahrain. Oman Med J 2019; 34:427-433. [PMID: 31555419 PMCID: PMC6745430 DOI: 10.5001/omj.2019.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives The Maastricht Clinical Teaching Questionnaire (MCTQ) was developed to evaluate clinical teachers’ supervisory skills during undergraduate clinical rotations. Evidence exists supporting the reliability and validity of this questionnaire. Our study sought to examine the reliability and validity of the MCTQ in a Middle Eastern context. Methods Between 2016 and 2017, we evaluated a total of 549 medical students in their final year who were undergoing clinical rotations using the MCTQ. The construct validity was assessed using exploratory and confirmatory factor analysis. Internal consistency reliability was measured using Cronbach’s alpha. Factor scores were compared with other outcomes to explore the relationship with other relevant variables. Results A four-factor model demonstrated an adequate fit with the data. The findings showed good internal consistency reliability. The following results were obtained for the four-factor model: chi-square divided by degrees of freedom was 5.026, and the comparative index, goodness of fit index, normalized fit index, and non-normalized fit index were all above 0.800 (0.955, 0.858, 0.950, and 0.952, respectively). The standardized root mean square residual was 0.016, and the root mean square error of approximation score was 0.086. Acceptable reliability was achieved with 10 evaluations per teacher. We observed a strong correlation between factors and overall judgment. Conclusions Our study suggests that the MCTQ is a valid and reliable instrument to evaluate teachers’ performance during clinical rotations in Bahrain.
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Affiliation(s)
- Ahmed Al Ansari
- Training and Education Department, Bahrain Defense Force Hospital, Riffa, Bahrain.,Medical Education Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Khaled Saeed Tabbara
- Department of Microbiology, Immunology and Infection Diseases, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Evaluation of teaching in a student-led clinic environment: Assessing the reliability of a questionnaire. INT J OSTEOPATH MED 2019. [DOI: 10.1016/j.ijosm.2018.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bindels E, Boerebach B, van der Meulen M, Donkers J, van den Goor M, Scherpbier A, Lombarts K, Heeneman S. A New Multisource Feedback Tool for Evaluating the Performance of Specialty-Specific Physician Groups: Validity of the Group Monitor Instrument. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:168-177. [PMID: 31306280 DOI: 10.1097/ceh.0000000000000262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Since clinical practice is a group-oriented process, it is crucial to evaluate performance on the group level. The Group Monitor (GM) is a multisource feedback tool that evaluates the performance of specialty-specific physician groups in hospital settings, as perceived by four different rater classes. In this study, we explored the validity of this tool. METHODS We explored three sources of validity evidence: (1) content, (2) response process, and (3) internal structure. Participants were 254 physicians, 407 staff, 621 peers, and 282 managers of 57 physician groups (in total 479 physicians) from 11 hospitals. RESULTS Content was supported by the fact that the items were based on a review of an existing instrument. Pilot rounds resulted in reformulation and reduction of items. Four subscales were identified for all rater classes: Medical practice, Organizational involvement, Professionalism, and Coordination. Physicians and staff had an extra subscale, Communication. However, the results of the generalizability analyses showed that variance in GM scores could mainly be explained by the specific hospital context and the physician group specialty. Optimization studies showed that for reliable GM scores, 3 to 15 evaluations were needed, depending on rater class, hospital context, and specialty. DISCUSSION The GM provides valid and reliable feedback on the performance of specialty-specific physician groups. When interpreting feedback, physician groups should be aware that rater classes' perceptions of their group performance are colored by the hospitals' professional culture and/or the specialty.
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Affiliation(s)
- Elisa Bindels
- Ms. Bindels: PhD Candidate, Department of Medical Psychology, Amsterdam Center for Professional Performance and Compassionate Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands, and Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. Dr. Boerebach: Staff Advisor, Department of Medical Psychology, Amsterdam Center for Professional Performance and Compassionate Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Ms. van der Meulen: PhD Candidate, Department of Medical Psychology, Amsterdam Center for Professional Performance and Compassionate Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands, and Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. Dr. Donkers: Assistant Professor, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. Dr. van den Goor: PhD Candidate, Department of Medical Psychology, Amsterdam Center for Professional Performance and Compassionate Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands, and Q3 Consult, Zeist, the Netherlands. Dr. Scherpbier: Professor, Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. Dr. Lombarts: Professor, Department of Medical Psychology, Amsterdam Center for Professional Performance and Compassionate Care, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Dr. Heeneman: Professor, Department of Pathology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Mlodzik-Czyzewska MA, Chmurzynska A. The State of Nutrigenomic Education in Poland. Lifestyle Genom 2018; 11:90-98. [PMID: 30439706 DOI: 10.1159/000494332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/04/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Poland, 45 higher education institutions offer degrees in dietetics. However, only 20 of these offer nutrigenomics or nutrigenetics courses. OBJECTIVES The purpose of this study was to assess the current state of nutri-genomic education in Poland and to evaluate the level of nutrigenomic knowledge held by dieticians. METHODS A cross-sectional survey was performed to examine the self-reported attitudes of 193 dietetics students and dietetics professionals who graduated from 33 Polish higher-level institutions. RESULTS The great majority of respondents were familiar with nutrigenomics and had a positive attitude to it, and this attitude was independent of whether they participated in nutrigenomics courses. Sixty-six percent of the respondents had received training in nutrigenomics, but nutrigenomic education did not meet the expectations of 57% of dieticians. Dieticians possess low levels of self-reported knowledge of nutrigenomics, and only about 15% of respondents know how to effectively communicate information on genetic risk to patients and understand the effect of nutrients on molecular mechanisms. Despite this lack of knowledge, 59% of respondents had a positive attitude to nutri-genomics, and 63% of them had a great interest in broadening their knowledge. Subjects who had participated in nutrigenomics courses exhibited a better understanding of several areas of nutrigenomics. They were especially interested in practical aspects of nutrigenomics, such as the essence of personalized diets and the practical application of nutrigenomics. CONCLUSIONS In conclusion, Polish dieticians have a positive attitude to nutrigenomics but do not perceive themselves as well educated in this field, which is partly due to systemic problems. The study shows the need for improvements in nutrigenomic education in Poland.
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Affiliation(s)
| | - Agata Chmurzynska
- Institute of Human Nutrition and Dietetics, Poznań University of Life Sciences, Poznań, Poland,
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Schriver M, Cubaka VK, Vedsted P, Besigye I, Kallestrup P. Development and validation of the ExPRESS instrument for primary health care providers' evaluation of external supervision. Glob Health Action 2018; 11:1445466. [PMID: 29547066 PMCID: PMC5945230 DOI: 10.1080/16549716.2018.1445466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background: External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. Aim: To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. Methods: “External supervision: Provider Evaluation of Supervisor Support” (ExPRESS) was developed in 18 steps, primarily in Rwanda. Content validity was optimised using systematic search for related instruments, interviews, translations, and relevance assessments by international supervision experts as well as local experts in Nigeria, Kenya, Uganda and Rwanda. Construct validity and reliability were examined in two separate field tests, the first using exploratory factor analysis and a test–retest design, the second for confirmatory factor analysis. Results: We included 16 items in section A (‘The most recent experience with an external supervisor’), and 13 items in section B (‘The overall experience with external supervisors’). Item-content validity index was acceptable. In field test I, test–retest had acceptable kappa values and exploratory factor analysis suggested relevant factors in sections A and B used for model hypotheses. In field test II, models were tested by confirmatory factor analysis fitting a 4-factor model for section A, and a 3-factor model for section B. Conclusions: ExPRESS is a promising tool for evaluation of the quality of support of primary health care providers in external supervision of primary health care facilities in resource-constrained settings. ExPRESS may be used as specific feedback to external supervisors to help identify and address gaps in the supervision they provide. Further studies should determine optimal interpretation of scores and the number of respondents needed per supervisor to obtain precise results, as well as test the functionality of section B.
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Affiliation(s)
- Michael Schriver
- a Center for Global Health, Department of Public Health , Aarhus University , Aarhus , Denmark
| | - Vincent Kalumire Cubaka
- a Center for Global Health, Department of Public Health , Aarhus University , Aarhus , Denmark.,b School of Medicine and Pharmacy, College of Medicine and Health Sciences , University of Rwanda , Kigali , Rwanda
| | - Peter Vedsted
- c Research Unit for General Practice, Department of Public Health , Aarhus University , Aarhus , Denmark
| | - Innocent Besigye
- d Department of Family Medicine, School of Medicine , Makerere University , Kampala , Uganda
| | - Per Kallestrup
- a Center for Global Health, Department of Public Health , Aarhus University , Aarhus , Denmark
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Bearman M, Tai J, Kent F, Edouard V, Nestel D, Molloy E. What should we teach the teachers? Identifying the learning priorities of clinical supervisors. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2018; 23:29-41. [PMID: 28315114 DOI: 10.1007/s10459-017-9772-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/09/2017] [Indexed: 06/06/2023]
Abstract
Clinicians who teach are essential for the health workforce but require faculty development to improve their educational skills. Curricula for faculty development programs are often based on expert frameworks without consideration of the learning priorities as defined by clinical supervisors themselves. We sought to inform these curricula by highlighting clinical supervisors own requirements through answering the research question: what do clinical supervisors identify as relative strengths and areas for improvement in their teaching practice? This mixed methods study employed a modified version of the Maastricht Clinical Teaching Questionnaire (mMCTQ) which included free-text reflections. Descriptive statistics were calculated and content analysis was conducted on textual comments. 481 (49%) of 978 clinical supervisors submitted their mMCTQs and associated reflections for the research study. Clinical supervisors self-identified relatively strong capability with interpersonal skills or attributes and indicated least capability with assisting learners to explore strengths, weaknesses and learning goals. The qualitative category 'establishing relationships' was the most reported strength with 224 responses. The qualitative category 'feedback' was the most reported area for improvement, with 151 responses. Key areas for curricular focus include: improving feedback practices; stimulating reflective and agentic learning; and managing the logistics of a clinical education environment. Clinical supervisors' self-identified needs provide a foundation for designing engaging and relevant faculty development programs.
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Affiliation(s)
- Margaret Bearman
- Centre for Research into Assessment and Digital Learning (CRADLE), Deakin University, Geelong, Australia.
| | - Joanna Tai
- Centre for Research into Assessment and Digital Learning (CRADLE), Deakin University, Geelong, Australia
| | - Fiona Kent
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- WISER Unit, Monash Health, Melbourne, Australia
| | - Vicki Edouard
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Debra Nestel
- Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Monash Institute of Health and Clinical Education, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Elizabeth Molloy
- Department of Medical Education, University of Melbourne, Melbourne, Australia
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Pinelli NR, McLaughlin JE, Khanova J, Eckel SF, Vu MB, Weinberger M, Roth MT. Identifying the Presence of Cognitive Apprenticeship in the Layered Learning Practice Model. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2018; 82:6155. [PMID: 29491496 PMCID: PMC5822939 DOI: 10.5688/ajpe6155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/17/2017] [Indexed: 06/08/2023]
Abstract
Objective. To identify the presence of cognitive apprenticeship themes in the layered learning practice model (LLPM). Methods. Attending pharmacists who had implemented an LLPM completed an individual 90-minute face-to-face semi-structured interview. Three researchers independently reviewed transcripts to identify cognitive apprenticeship themes according to the framework's dimensions and sub-dimensions. Results. Of 25 eligible attending pharmacists, 24 (96%) agreed to participate. All core dimensions of the cognitive apprenticeship framework emerged during the interviews; however, preceptors varied in how they used the framework in the training of pharmacy learners at different levels. This variability was especially apparent within the sub-dimensions of the content and method domains. Conclusion. This study demonstrates that all four cognitive apprenticeship principles are being used in the clinical environments operationalizing the LLPM. These findings suggest that cognitive apprenticeship is an applicable and relevant educational framework when engaging multiple learners in clinical education environments.
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Affiliation(s)
- Nicole R. Pinelli
- UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
- University of North Carolina Medical Center, Chapel Hill, North Carolina
| | | | - Julia Khanova
- UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Stephen F. Eckel
- UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
- University of North Carolina Medical Center, Chapel Hill, North Carolina
| | - Maihan B. Vu
- UNC Center for Health Promotion and Disease Prevention, Chapel Hill, North Carolina
- CHAI Core, Lineberger Comprehensive Cancer Center, Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Morris Weinberger
- Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Mary T. Roth
- UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
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Lyons K, McLaughlin JE, Khanova J, Roth MT. Cognitive apprenticeship in health sciences education: a qualitative review. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2017; 22:723-739. [PMID: 27544386 DOI: 10.1007/s10459-016-9707-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 08/11/2016] [Indexed: 05/23/2023]
Abstract
Cognitive apprenticeship theory emphasizes the process of making expert thinking "visible" to students and fostering the cognitive and meta-cognitive processes required for expertise. The purpose of this review was to evaluate the use of cognitive apprenticeship theory with the primary aim of understanding how and to what extent the theory has been applied to the design, implementation, and analysis of education in the health sciences. The initial search yielded 149 articles, with 45 excluded because they contained the term "cognitive apprenticeship" only in reference list. The remaining 104 articles were categorized using a theory talk coding scheme. An in depth qualitative synthesis and review was conducted for the 26 articles falling into the major theory talk category. Application of cognitive apprenticeship theory tended to focus on the methods dimension (e.g., coaching, mentoring, scaffolding), with some consideration for the content and sociology dimensions. Cognitive apprenticeship was applied in various disciplines (e.g., nursing, medicine, veterinary) and educational settings (e.g., clinical, simulations, online). Health sciences education researchers often used cognitive apprenticeship to inform instructional design and instrument development. Major recommendations from the literature included consideration for contextual influences, providing faculty development, and expanding application of the theory to improve instructional design and student outcomes. This body of research provides critical insight into cognitive apprenticeship theory and extends our understanding of how to develop expert thinking in health sciences students. New research directions should apply the theory into additional aspects of health sciences educational research, such as classroom learning and interprofessional education.
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Affiliation(s)
- Kayley Lyons
- UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- UNC School of Education, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jacqueline E McLaughlin
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Julia Khanova
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mary T Roth
- Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Stephan A, Cheung G. Clinical teaching and supervision in postgraduate psychiatry training: the trainee perspective. Australas Psychiatry 2017; 25:191-197. [PMID: 27879425 DOI: 10.1177/1039856216679539] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We aimed to explore psychiatry trainees' perspectives on clinical teaching and supervision as well as how this might be improved. METHOD New Zealand trainees ( n=51) completed online the Maastricht Clinical Teaching Questionnaire (MCQT) and three open-ended questions. RESULTS The majority rated 'agree' or 'strongly agree' to all items of the MCQT. Weaknesses in the feedback process including observation, feedback provision, and formulating learning goals were highlighted. College training requirements and workplace environment were identified as factors impacting on clinical teaching and supervision. CONCLUSIONS A model was proposed to enhance awareness of the various factors involved in the feedback process.
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Affiliation(s)
- Alice Stephan
- Director of Training (Psychiatry), Upper Central North Island, Waikato District Health Board, Hamilton, New Zealand
| | - Gary Cheung
- Senior Lecturer, Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
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16
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Huete Á, Julio R, Rojas V, Herrera C, Padilla O, Solís N, Pizarro M, Etcheberry L, Sarfatis A, Pérez G, Díaz LA, Delfino A, Muñoz E, Rivera H, Parra DA, Bitran M, Riquelme A. Evaluation of Radiology Teachers' Performance and Identification of the "Best Teachers" in a Residency Program: Mixed Methodology and Pilot Study of the MEDUC-RX32 Questionnaire. Acad Radiol 2016; 23:779-88. [PMID: 27060856 DOI: 10.1016/j.acra.2016.02.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 02/20/2016] [Accepted: 02/21/2016] [Indexed: 10/22/2022]
Abstract
RATIONALE AND OBJECTIVES Radiology teachers are well trained in their specialty; however, when working in academic institutions, faculty development and promotion through the education pathway tends to be based on their teaching knowledge and skills. The aim of this study is to assess psychometric properties of the Medicina Universidad Católica-Radiology 32 items (MEDUC-RX32), an instrument designed to evaluate the performance of postgraduate radiology teachers and to identify the best teachers. MATERIALS AND METHODS Mixed methodology was used, including qualitative and quantitative phases. The psychometric properties of the MEDUC-RX32 survey were performed by factor analysis (validity), Cronbach alpha coefficient, and G coefficient (reliability). The residents assessed their teachers and simultaneously voted for the "best teacher," which was used as a gold standard for the receiver operating characteristic curves construction comparing their votes with the global score. RESULTS A total of 28 residents answered 164 surveys. The global score was 6.23 ± 0.8 (scale from 1 to 7). The factor analysis showed six domains of the resident's perception: (1) tutorial teaching, feedback, and independent learning; (2) communication and teamwork; (3) learning objectives; (4) respectful behavior; (5) radiological report; and (6) teaching and care support. The tutor's strengths were related with respectful behavior and teamwork. The instrument is highly reliable with a Cronbach alpha of 0.937 and a G coefficient of 0.831 (with a minimum of 8 residents). The MEDUC-RX32 instrument has a sensitivity of 91.7% and specificity of 83.3% to identify tutors as best teachers with at least one vote with an area under the receiver operating characteristic curve of 0.931 with a cutoff of 5.94. CONCLUSIONS The MEDC-RX32 instrument is a multidimensional, valid, and highly reliable method to evaluate radiology teachers, identifying teachers with excellence in tutorial teaching in a postgraduate radiology program.
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Fluit CRMG, Feskens R, Bolhuis S, Grol R, Wensing M, Laan R. Repeated evaluations of the quality of clinical teaching by residents. PERSPECTIVES ON MEDICAL EDUCATION 2013; 2:87-94. [PMID: 23670697 PMCID: PMC3656177 DOI: 10.1007/s40037-013-0060-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Many studies report on the validation of instruments for facilitating feedback to clinical supervisors. There is mixed evidence whether evaluations lead to more effective teaching and higher ratings. We assessed changes in resident ratings after an evaluation and feedback session with their supervisors. Supervisors of three medical specialities were evaluated, using a validated instrument (EFFECT). Mean overall scores (MOS) and mean scale scores were calculated and compared using paired T-tests. 24 Supervisors from three departments were evaluated at two subsequent years. MOS increased from 4.36 to 4.49. The MOS of two scales showed an increase >0.2: 'teaching methodology' (4.34-4.55), and 'assessment' (4.11-4.39). Supervisors with an MOS <4.0 at year 1 (n = 5) all demonstrated a strong increase in the MOS (mean overall increase 0.50, range 0.34-0.64). Four supervisors with an MOS between 4.0 and 4.5 (n = 6) demonstrated an increase >0.2 in their MOS (mean overall increase 0.21, range -0.15 to 53). One supervisor with an MOS >4.5 (n = 13) demonstrated an increase >0.02 in the MOS, two demonstrated a decrease >0.2 (mean overall increase -0.06, range -0.42 to 0.42). EFFECT-S was associated with a positive change in residents' ratings of their supervisors, predominantly in supervisors with relatively low initial scores.
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Affiliation(s)
- Cornelia R M G Fluit
- Academic Educational Institute, Radboud University Nijmegen Medical Centre, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | - Remco Feskens
- Department of Methods and Statistics, Utrecht University, Utrecht, the Netherlands
| | - Sanneke Bolhuis
- Academic Educational Institute, Radboud University Nijmegen Medical Centre, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Richard Grol
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Michel Wensing
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| | - Roland Laan
- Academic Educational Institute, Radboud University Nijmegen Medical Centre, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
- Department of Rheumatology, Radboud University Nijmegen Medical Centre, 306 IWOO, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
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Fluit C, Bolhuis S, Grol R, Ham M, Feskens R, Laan R, Wensing M. Evaluation and feedback for effective clinical teaching in postgraduate medical education: validation of an assessment instrument incorporating the CanMEDS roles. MEDICAL TEACHER 2012; 34:893-901. [PMID: 22816979 DOI: 10.3109/0142159x.2012.699114] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Providing clinical teachers in postgraduate medical education with feedback about their teaching skills is a powerful tool to improve clinical teaching. A systematic review showed that available instruments do not comprehensively cover all domains of clinical teaching. We developed and empirically test a comprehensive instrument for assessing clinical teachers in the setting of workplace learning and linked to the CanMEDS roles. METHODS In a Delphi study, the content validity of a preliminary instrument with 88 items was studied, leading to the construction of the EFFECT (evaluation and feedback for effective clinical teaching) instrument. The response process was explored in a pilot test and focus group research with 18 residents of 6 different disciplines. A confirmatory factor analyses (CFA) and reliability analyses were performed on 407 evaluations of 117 supervisors, collected in 3 medical disciplines (paediatrics, pulmonary diseases and surgery) of 6 departments in 4 different hospitals. RESULTS CFA yielded an 11 factor model with a good to excellent fit and internal consistencies ranged from 0.740 to 0.940 per domain; 7 items could be deleted. CONCLUSION The model of workplace learning showed to be a useful framework for developing EFFECT, which incorporates the CanMEDS competencies and proved to be valid and reliable.
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Affiliation(s)
- Cornelia Fluit
- Radboud University Nijmegen Medical Centre, HB Nijmegen, the Netherlands.
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Boerboom TBB, Mainhard T, Dolmans DHJM, Scherpbier AJJA, Van Beukelen P, Jaarsma ADC. Evaluating clinical teachers with the Maastricht clinical teaching questionnaire: how much 'teacher' is in student ratings? MEDICAL TEACHER 2012; 34:320-326. [PMID: 22455701 DOI: 10.3109/0142159x.2012.660220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Students are a popular source of data to evaluate the performance of clinical teachers. Instruments to obtain student evaluations must have proven validity. One aspect of validity that often remains underexposed is the possibility of effects of between-student differences and teacher and student characteristics not directly related to teaching performance. AIM The authors examined the occurrence of such effects, using multilevel analysis to analyse data from the Maastricht clinical teaching questionnaire (MCTQ), a validated evaluation instrument, in a veterinary curriculum. METHODS The 15-item MCTQ covers five domains. The authors used multilevel analysis to divide the variance in the domain scores in components related to, respectively, teachers and students. They estimated subsequent models to explore how the MCTQ scores are dependent on teacher and student characteristics. RESULTS Significant amounts of variance in student ratings were due to between-teacher differences, particularly for learning climate, modelling and coaching. The effects of teacher and student characteristics were mostly non-significant or small. CONCLUSION Large portions of variance in MCTQ scores were due to differences between teachers, while the contribution of student and teacher characteristics was negligible. The results support the validity of student ratings obtained with the MCTQ for evaluating teacher performance.
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Affiliation(s)
- Tobias B B Boerboom
- Quality Improvement of Veterinary Education, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
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Boerboom TBB, Jaarsma D, Dolmans DHJM, Scherpbier AJJA, Mastenbroek NJJM, Van Beukelen P. Peer group reflection helps clinical teachers to critically reflect on their teaching. MEDICAL TEACHER 2011; 33:e615-e623. [PMID: 22022915 DOI: 10.3109/0142159x.2011.610840] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Student evaluations can help clinical teachers to reflect on their teaching skills and find ways to improve their teaching. Studies have shown that the mere presentation of student evaluations is not a sufficient incentive for teachers to critically reflect on their teaching. AIM We evaluated and compared the effectiveness of two feedback facilitation strategies that were identical except for a peer reflection meeting. METHOD In this study, 54 clinical teachers were randomly assigned to two feedback strategies. In one strategy, a peer reflection was added as an additional step. All teachers completed a questionnaire evaluating the strategy that they had experienced. We analysed the reflection reports and the evaluation questionnaire. RESULTS Both strategies stimulated teachers to reflect on feedback and formulate alternative actions for their teaching practice. The teachers who had participated in the peer reflection meeting showed deeper critical reflection and more concrete plans to change their teaching. All feedback strategies were considered effective by the majority of the teachers. CONCLUSIONS Strategies with student feedback and self-assessment stimulated reflection on teaching and helped clinical teachers to formulate plans for improvement. A peer reflection meeting seemed to enhance reflection quality. Further research should establish whether it can have lasting effects on teaching quality.
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Affiliation(s)
- Tobias B B Boerboom
- Quality Improvement of Veterinary Education, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
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