The neurology resident as teacher

Abstract

Abstract-There is a need to improve the quality of teaching done by neurology residents because neurology residents are intimately involved in medical student education. This article reviews the available literature on techniques to improve the teaching ability of resident physicians. Eight randomized prospective studies were identified from health and education databases. The outcomes measured were student ratings of residents or objective ratings of interactions between residents and students. The skills curriculum provided a more robust response, and the objective standardized teaching examination (OSTE) provided a standardized outcome. There continues to be a need for studies specifically addressing the teaching by neurology residents and fellows. NEUROLOGY 2004;63:1334 -1338 R esident physicians spend up to 25% of their time teaching medical students and other residents.1,2 The American Association of Medical Colleges (AAMC) has recognized that resident teaching has an important impact on medical education.3 This is borne out by surveys that show medical students feel the teaching done by residents is important to their education. 4 Within neurology, resident teaching is required as a part of residency. The neurology residency review committee of the Accreditation Council for Graduate Medical Education (ACGME) sets the standards for accreditation of neurology residencies and states: "Teaching of other residents, medical students, nurses, and other health care personnel, formally and informally, is a required aspect of the resident's education in neurology." 5To improve resident teaching skills, residencies have begun to incorporate teaching programs, typically in the form of training sessions. A recent survey of family medicine, internal medicine, psychiatry, general surgery, and obstetrics/gynecology residents found that 55% of all residency programs offered instruction to its residents in teaching skills. 6 Unfortunately, the published surveys do not include neurology residencies, and the rate of resident teaching programs in neurology is not known.The AAMC, an advocacy group for medical student and resident education, and the Liaison Committee on Medical Education (LCME), the accreditation group for medical schools, advocate for improving teaching skills for residents. These organizations feel that these skills are particularly important for residents who teach "core clinical clerkships" for thirdyear medical students. 7 The education subcommittee of the American Academy of Neurology has previously recommended the neurology clerkship be in the third year. 8 This group feels that neurology is an important part of third-year medical education because of the prevalence of neurologic diseases that will be cared for by primary care physicians. If the AAMC and LCME feel strongly that residents who teach third-year clerks should have specific training and neurology is to be a third-year clerkship, then it follows that neurology residencies should prepare its residents to teach as well.Despite the emphasis from ...

Measuring and assessing the competencies of preceptors in health professions: a systematic scoping review.

“…Seventeen competencies with associated methods of assessment were identified, as outlined in Table 2. The methods used to identify competencies of preceptors included expert opinion based on literature reviews and qualitative synthesis (8,9,11,60,61) , Delphi approaches (10,29,32) , and qualitative studies examining the qualities of preceptors that preceptees value most (27,37,42,44,45,51) . Fifteen studies identified competencies, but assessment had not been implemented or reported (8-11, 27, 29, 32, 37, 38, 41, 45, 48, 56, 58, 60) , with only four studies detailing performance indicators for the competencies described (8)(9)(10)(11) .…”

“…The competencies being measured and the mode of measurement also needs to be aligned. Gill (2004) notes that the ultimate goal would be to link preceptor performance and preceptee learning (61) . Whilst Griffith (2000) linked preceptee performance in an exam with perceived preceptor quality, the competencies that led to those preceptors being rated highly were not detailed (39) .…”

Measuring and assessing the competencies of preceptors in health professions: a systematic scoping review.

“…Seventeen competencies with associated methods of assessment were identified, as outlined in Table 2. The methods used to identify competencies of preceptors included expert opinion based on literature reviews and qualitative synthesis (5,6,8,57,58) , Delphi approaches (7,26,29) , and qualitative studies examining the qualities of preceptors that preceptees value most (24,34,39,41,42,48) . Fifteen studies identified competencies, but assessment had not been implemented or reported (5-8, 24, 26, 29, 34, 35, 38, 42, 45, 53, 55, 57) , with only four studies detailing performance indicators for the competencies described (5)(6)(7)(8) .…”

Challenges to neurology residency education in today's health care environment

“…Residencies need to incorporate more teaching programs to train residents in these important skills. 20 Self-determination theory argues that measures that stimulate intrinsic sources of motivation to learn are more effective than measures that control motivation through regulations and requirements. 21 Restructuring the culture and learning environment to satisfy the basic psychological need for autonomy and competence among residents should further enhance motivation to learn.…”