Functions and structure of a medical school: Standards for accreditation of medical education programs leading to the MD Degree: Liaison Committee on Medical Education; These activities have been deemed to be so important that Louie et al. The aim of the present review was to assess the significance attributed to programs on teaching skills for residents that have been described in the literature.
We aimed to compare these results with findings in Brazil, in order to provide up-to-date conclusions and recommendations regarding this topic. We searched the literature between January and December , covering the period between and The articles identified as containing information regarding teaching skills for medical residency were selected for intensive review and were analyzed by two authors SAF and MPTN. Searches of primary publications referenced in other articles were also included.
The references in Portuguese that were included in this paper were extracted from the personal files of one author MPTN. Table 1 describes the numbers of texts extracted from each database. The relevant publications included original articles, systematic reviews, critical reviews, randomized controlled trials, guidelines from medical education experts and material from pioneering authors in this field. Table 2 shows the most relevant studies included in this review and summarizes their main characteristics.
Specific agendas for training residents in teaching skills were first developed in the s. Since then, the numbers of residents-as-teachers RaT programs around the world has increased and their methodologies have improved. RaT programs are nowadays part of most residency programs in the United States. Morrison et al.
In , the same authors published new data in which the prevalence was established as Changing trends in residents-as-teachers across graduate medical education.
Adv Med Educ Pract. Ramani et al. Karani et al. How medical students learn from residents in the workplace: a qualitative study. Acquiring teaching skills was seen to involve complex conscious and unconscious activities, through observation and reflection on behaviors.
RaT programs have been particularly successful for several reasons. Medical students like to work with residents and, additionally, appreciate their close supervision. Thus, residents are seen as a positive influence and example of professionalism.
Preparing surgery house officers for their teaching role. Am J Surg. Teaching residents how to teach: a one-year study. How residents perceive their teaching role in the clinical setting: a qualitative study. Moreover, residents spend large amounts of time together with medical students. They are close to them in practical activities and have similar ages and professional development processes.
Most residents feel more satisfaction with their work while experiencing teaching duties. Preparing residents to become more effective teachers: a priority for internal medicine. Am J Med. Resident doctors' understanding of their roles as clinical teachers.
Moreover, these programs are especially attractive because they improve self-confidence in teaching. Residents tend to teach. Snell L. J Grad Med Educ. In a qualitative analysis on a teaching initiation module that had been presented, it was concluded that it was possible to develop pedagogical skills at this stage, in a process that would be coherent with changes to health and education policies.
The effect of a hour curriculum to improve residents' teaching skills: a randomized trial. Ann Intern Med. According to the same authors, residents needed to learn:. Most of the studies on RaT programs have shown that residents achieved significant improvement in teaching skills after some specific training. The first review of the literature on this topic was published in and analyzed 13 studies with different experimental designs. A literature review of "resident-as-teacher" curricula: do teaching courses make a difference?
J Gen Intern Med. A review conducted in assessed 24 studies on residents who were enrolled in several programs and found that in 21 of these studies there was significant enhancement of teaching performance after specific training. Residents-as-teachers curricula: a critical review. Literature review of teaching skills programs for junior medical officers. Int J Med Educ. Kirkpatrick D. Evaluating training programs: the four levels, third edition.
San Francisco: Berrett-Koehler Publishers. Accessed in September The evidence supporting RaT programs appears not to correlate the time spent on training with efficiency in teaching. Even a one-hour intervention showed benefits in a study involving internal medicine residents. Teaching the one-minute preceptor. A randomized controlled trial. A four-week elective course created for senior and family medicine residents paved the way for a paper giving advice on how to create a RaT program.
Twelve tips for preparing residents as teachers. In another systematic review, an efficacy analysis was conducted on residents from a wide spectrum of specialties who participated in single programs. Residents-as-teachers programs in psychiatry: a systematic review. Can J Psychiatry.
On the whole, the interventions and outcomes measured were heterogeneous and the quality of the methodologies varied. The authors felt that these programs brought the opportunity to advance educational research in this field. Residents who teach acquire the material that they teach more effectively than they would if they did it through self-study or through attending lectures.
Weiss V, Needlman R. To teach is to learn twice. Resident teachers learn more. Arch Pediatr Adolesc Med. Their teaching duties have been linked to greater job satisfaction.
In , a meta-analysis revealed that most studies on residents-as-teachers programs had significant methodological flaws. Some studies revealed positive organizational change Kirkpatrick level 4a.
Residents with better teaching skills seem to have greater knowledge of taught material and better clinical skills. In a retrospective study on senior residents in general surgery covering the period from to , technical ability was assessed through their performance in the Fundamentals of Laparoscopic Surgery examination.
Teaching ability was assessed through evaluations among medical students on a Likert scale. There was evidence that residents who were better teachers had greater knowledge of taught material and a higher degree of laparoscopic skills. J Surg Educ. Snell 24 This author showed that those who were teaching had greater enthusiasm for teaching and greater job satisfaction.
Residents with effective teaching skills may also have a positive effect on patient care. Involvement of residents in teaching activities has been shown to have a positive effect on their communication skills, and good patient communication skills have been associated with better clinical outcomes.
RaT programs have been delivered using many methods, including lectures, small-group discussion, practice with peers, videotape reflections and role-playing.
The total number of hours dedicated to RaT program instruction varies widely. There are also five reasons for not implementing RaT training: 1 lack of time and energy; 2 lack of expertise and resources; 3 newness of the program; 4 limited access to students; and 5 RaT instruction is not desired. Resident doctors contribute significantly to the quality of undergraduate medical training and it is assumed that by participating in the process, they also improve their own professional competency.
We decided to investigate whether there is evidence to support this assumption. Our hypothesis, the physician-as-teacher rule, stated that "A skilled teacher has an increased likelihood of becoming a competent clinician, than a skilled clinician has of becoming a competent teacher".
We conducted a literature review to search for evidence to confirm or refute this assumption. Recommendations were made on why and how training and the important link they provide between the attending in teaching skills should be encouraged.
These included phy- staff and medical students. The figure also shows how the su- sicians spending more time on learning both the content of pervision by attending staff physicians is important and how what to teach and how to teach. Irby also showed why it was effective supervision results in a better quality of education important for clinical teachers to understand the medical for both residents and students.
Their responses indicated that certain was evidence that possessing good teaching skills would result teaching behaviours of the faculty staff needed to be improved. We approached this investigation by answering two instruction improves the teaching skills of residents. The informa- in teaching. The residents considered teaching to be an im- tion generated from this review provided some answers to the portant part of their role and were willing to teach medical central questions, which we discussed in each section.
There students. Other studies corroborated these findings6,9,27 and were explanations suggesting that teaching undergraduate stu- showed that residents were willing to be evaluated for their dents contributed positively to the perceived professional teaching, provided the assessment methods were clear, formal competency of medical residents.
Unfortunately, there were and structured. Jr Med Education ; How residents perceive their teaching role in the clinical setting — a qualitative study. Medical cal residents as well as proper and sufficient supervision by Teacher ; Medical Teacher ; The evidence found was largely subjec- Teaching in the clinical setting:factors tive and lacked validation. Medical Education ; This review also showed that Barrow MV. Why residents should teach: The parallel processes fectively, and who also possessed the basic understanding of teaching and learning.
Clinical Teaching for teaching and learning. An evaluation study of the didactic quality of clerkships. Medical Education additional research is needed to assess the strength of the rela- ; Nonetheless, we wish to empha- A national survey of undergraduate teaching in Obstetrics and Gynaecology. Promoting effective teaching and learning: hospital sional development of physicians and recommend its inclu- consultants identify their needs. Med Education ; Clinical teaching strategies for physicians.
Med Teacher sion in the curricula of postgraduate medical training. Lowry S. Teaching the teachers, Br Med Jr ; Wilkerson L, Irby DM. Strategies for improving teaching practices: A comprehen- References sive approach to faculty development. Academic Med ; Irby DM. Academic Medicine Tonesk X. The house officer as a teacher: What schools expect and measure. Jr Radiology Clerkship Lectures. A Comparison between Residents and Attendant 2. A pro- Radiologist Performances.
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