Survey of Residents' Attitudes and Awareness Toward Teaching and Student Feedback

摘要

What was known A sizable portion of medical student teaching is done by residents, yet it is not known whether students provide feedback that could improve residents' teaching skills.;What is new A large percentage of residents at 1 teaching institution did not receive student feedback on their teaching abilities.;Limitations Single institution study reduces generalizability; survey research introduces potential for selection bias.;Bottom line While few residents sought out student feedback, a majority believed student feedback would benefit their clinical and teaching performance.;Editor's Note: The online version of this article contains the survey tool used in the study.;Introduction The Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education have identified teaching of medical students as an important part of residency.1,2 Studies show that medical students look to residents as their primary source of knowledge about patient care,3 with 30% of their overall knowledge attributed to coming from residents.4 Attendings report residents have a vital role in teaching,5 and that residents have a better understanding of medical practices if they teach other learners.6 Literature assessing students' opinions of their instructors is mixed, with 1 study reporting that up to a third of medical students had negative opinions of their residents' teaching performances.7 The best way to encourage and improve teaching from residents is still being evaluated, and little evidence is available.8,9 Residents' attitudes toward teaching could be 1 factor, although we could not find any literature assessing this, and the literature on feedback from students to residents also is sparse. Several small studies have shown a benefit to instituting a formal feedback mechanism10,11; however, we are unaware of large-scale studies in this area. The literature assessing validity evidence of student feedback of residents is also sparse, although there are several studies showing that students can reliably and validly rate faculty lecturers,12–18 as well as studies that show that student feedback affects faculty lecturers in a positive way.19–21 In this study we aim to broaden our understanding of feedback by assessing residents' awareness of student feedback, how feedback is received, and residents' attitudes toward student feedback. We also identify attitudes about teaching more commonly found in residents who seek feedback.;Methods The Oregon Health & Science University (OHSU) is an academic tertiary referral hospital with 24 residency programs and the only medical school in the state of Oregon. OHSU uses several ways for residents to get student medical feedback, including an online system, at least twice yearly faculty advisor meetings, and informal opportunities for face-to-face feedback during rotations. A preliminary survey was developed by K.K.T. and J.K. with input from local graduate medical education administrators. J.K. is involved in student curriculum development at OHSU and heads the neurology clerkship. A final survey was developed after 11 fellows completed the survey and provided feedback on ease of completion and comprehension of questions. Surveys were sent to all 604 residents at our institution in December 2012 using an online-based question service (SurveyMonkey). Replies were linked to residents' e-mail addresses to ensure there were no duplicate responses. Weekly reminders were sent out for 3?weeks. Participation was voluntary; however, small prizes were offered to randomly selected respondents to encourage participation. Data were collected, deidentified, and tabulated by a member of our local graduate medical education office before being sent to the primary investigators for analysis. The study was approved by the Institutional Review Board at OHSU. Statistical analysis combined review of open-ended questions by authors on individual questions alongside contingency table assessments an