Hospitalists as teachers - How do they compare to subspecialty and general medicine faculty?
Hospitalists as teachers - How do they compare to subspecialty and general medicine faculty?
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DOI：
10.1111/j.1525-1497.2004.20907.x
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发表时间：
2004-01-01
影响因子：
5.7
通讯作者：
Williams, MV
中科院分区：
文献类型：
--
作者：
Kripalani, S;Pope, AC;Williams, MV
目的：比较综合内科病房住院医师、全科医师和专科医师的教学效果评价。设计:横断面。周边环境：一所大型市中心公立教学医院。参与者：共有423名医学生和院务人员评估63名主治医生。测量和主要结果：我们使用麦吉尔临床导师评估（CTE）来测量教学效果，这是一项经过验证的25项调查，并审查了额外的书面评论。有效率为81%。在150分的综合测量中，住院医生的平均得分（134.5[95%置信区间（CI）， 130.2至138.8]）超过专科医生的平均得分（126.3 [95% CI， 120.4至132.1]），P = 0.03。全科医师的评分（135.0 [95% CI, 131.2 ~ 138.8]）也高于专科医师，P = 0.01。1990年代毕业于医学院的内科医生的得分（136.0 [95% CI, 133.0 ~ 139.1]）高于其他地方的内科医生（129.1 [95% CI, 125.1 ~ 133.1]）， P = 0.006。这些趋势在调整协变量后仍然存在，但只有毕业年份仍然具有统计学意义，P = 0.05。对书面评论的定性分析显示，受训者重视热情的教师、实践循证医学、参与病人护理、与病人和其他团队成员建立良好关系的教师。这些特征最常被注意到的是住院医生和全科医生。结论：在全科病房，医学生和住院医师认为医院医师和全科主治医师比专科医师更有效。这种效果可能与受培训生高度重视的教师表现出的特定特征和行为有关，例如对教学和循证医学的热情。
OBJECTIVE: To compare evaluations of teaching effectiveness among hospitalist, general medicine, and subspecialist attendings on general medicine wards.DESIGN: Cross-sectional.SETTING: A large, inner-city, public teaching hospital.PARTICIPANTS: A total of 423 medical students and house staff evaluating 63 attending physicians.MEASUREMENTS AND MAIN RESULTS: We measured teaching effectiveness with the McGill Clinical Tutor Evaluation (CTE), a validated 25-item survey, and reviewed additional written comments. The response rate was 81%. On a 150-point composite measure, hospitalists' mean score (134.5 [95% confidence interval (CI), 130.2 to 138.8]) exceeded that of subspecialists (126.3 [95% CI, 120.4 to 132.1]), P = .03. General medicine attendings (135.0 [95% CI, 131.2 to 138.8]) were also rated higher than subspecialists, P = .01. Physicians who graduated from medical school in the 1990s received higher scores (136.0 [95% CI, 133.0 to 139.1]) than did more distant graduates (129.1 [95% CI, 125.1 to 133.1]), P = .006. These trends persisted after adjusting for covariates, but only year of graduation remained statistically significant, P = .05. Qualitative analysis of written remarks revealed that trainees valued faculty who were enthusiastic teachers, practiced evidence-based medicine, were involved in patient care, and developed a good rapport with patients and other team members. These characteristics were most often noted for hospitalist and general medicine attendings.CONCLUSIONS: On general medicine wards, medical students and residents considered hospitalists and general medicine attendings to be more effective teachers than subspecialists. This effect may be related to the preferred faculty members exhibiting specific characteristics and behaviors highly valued by trainees, such as enthusiasm for teaching and use of evidence-based medicine.