Thursday, July 9, 2009

The perceptions of attending doctors of the role of residents as teachers of undergraduate clinical students.

Busari and colleagues reported the results of their questionnaire survey of 76 obstetricians and pediatricians at two big academic units in the Netherlands. (Medical Education 2003; 37: 241 - 247). The respondents thought that teaching by registrars was beneficial for students and registrars alike.

Most of the participating consutants felt that departments should emphasise the importance of teaching; that registrars’ teaching ability should be evaluated as part of their clinical evaluation, that teaching is a part of being a registrar and registrars would benefit from prior training in how to teach.

In another study, Ogburn and colleagues mention some statistics related to registrars as teachers. (Obstetrics and gynecology residents as teachers of medical students: Predictors of excellence; American Journal of Obstetrics and Gynecology (2005) 193, 1831–4).

They mention that 25% of registrars’ activities involve supervising, instructing, and evaluating medical students. American undergraduate students reckon that a third of their knowledge derives from registrar teaching and that 50% of teaching during obstetrics and gynecology rotations are done by registrars. The authors are surprised by the fact that teaching ability is not considered as acriterion used to select new registrars. They found in, in a retrospective study, that the most significant predictors of being identified as an excellent teacher by medical students were work experience, age, and male gender. They suggest that these may be considered in the selection of registrars. (Seriously  the older male!)

2 comments:

  1. Hi Wilhelm

    I understand that teaching is a part of a registrars' job description, however I wonder how many of these registrars have any desire to teach. This must surely have a negative input on their teaching ability.

    In addition to which, the registrars themselves are busy specialising and may not feel very comfortable with the added responsibility of having to supervise "an underling".

    Teaching is supposedly a requirement for all Professional nurses too, fortunately they are not directly involved in formal education but often have to act as a mentor to a student in a ward, theatre, ICU. I know that those that do not enjoy teaching often neglect the students. We receive numerous complaints from the students.

    Are there any medical schools that have recruited clinical teachers to "specialise" in teaching?

    Is it fair to "force" someone to teach if this is not their focus?

    I think that your idea is an excellent one, i.e. teaching some teaching skills to the registrars. It would be interesting to see how many develop a passion for teaching and how it influences those that do not enjoy teaching.

    Regards

    Bronwen

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  2. Hi Bronwen

    The problem is that teaching is not part of the registrar's job description presently. Neither is previous teaching experience considered in the appointment of new registrars. I am hopeful that this will be addressed in future. Nonetheless, the registrar works as coordinator of the firm's day-to-day activities. The SI's form an integral part of this firm. The students' duties require continuous input from those in charge of them, also from the patient's point of view. As mentioned, ability to teach is a required outcome in registrar assessment in some overseas countries. The rationale is that virtually all doctors have to teach in their future jobs - either students, nursing staff, junior doctors and even patients or interest groups. There are also other arguments, such as improved learning (and imptoved academic performance)by registrars who are involved in teaching.

    I know that UCT has recruited dr Athol Kent as clinical teacher and as far as I know that is his main task. Will Elize Archer not fall into this category as well?

    I have data from a small questionnaire study where our own registrars clearly stated that they prefer having students working with them - clearly also to assist with clinical service providing. This is not fair to the students if they are not guided in what they are doing? This is an important aspect for which I have allocated time in the proposed course. I do not think that it is unfair to expect registrars to teach. Certainly not more than expecting someone who has decided to become an infertility specialist to spend two years of doing obstetrics while being a registrar. This has to be written into the course outcomes, which I hope to do. If the e-learning course works locally, I think it will be a positive step towards convincing the College of Medicine to include it in its requirements for registrar evaluation.

    I agree that one has to keep a close watch on the outcomes of the course. I have a few ideas about how this could be done - will include that in further postings.

    Regards

    Wilhelm

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