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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
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Medicina 2017, 53(5), 339-347; https://doi.org/10.1016/j.medici.2017.08.002 (registering DOI)

Evaluation of clinical teaching quality in competency-based residency training in Lithuania

1
Department of Preventive Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
2
Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
3
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
4
Radboudumc Health Academy, Nijmegen, The Netherlands
*
Author to whom correspondence should be addressed.
Received: 31 May 2017 / Revised: 17 August 2017 / Accepted: 28 August 2017 / Published: 7 September 2017
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Abstract

Background and aim: In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into the competency-based medical education curriculum (CBME). In 2015, we implemented the validated EFFECT questionnaire together with the EFFECTSystem for quality assessment of clinical teaching in residency training.
The aim of this study was to investigate the influence of characteristics of the resident (year of training) and clinical teacher (gender, age, and type of academic position) on teaching quality, as well as to assess areas for teaching quality improvement.
Materials and methods: Residents from 7 different residency study programs filled out 333 EFFECT questionnaires evaluating 146 clinical teachers. We received 143 self-evaluations of clinical teachers using the same questionnaire. Items were scored on a 6-point Likert scale. Main outcome measures were residents' mean overall (MOS), mean subdomain (MSS) and clinical teachers' self-evaluation scores. The overall comparisons of MOS and MSS across study groups and subgroups were done using Student's t test and ANOVA for trend. The intraclass correlation coefficient (ICC) was calculated in order to see how residents' evaluations match with self-evaluations for every particular teacher. To indicate areas for quality improvement items were analyzed subtracting their mean score from the respective (sub) domain score.
Results: MOS for domains of ‘‘role modeling’’, ‘‘task allocation’’, ‘‘feedback’’, ‘‘teaching methodology’’ and ‘‘assessment’’ valued by residents were significantly higher than those valued by teachers (P < 0.01). Teachers who filled out self-evaluation questionnaires were rated significantly higher by residents in role modeling subdomains (P < 0.05). Male teachers in (sub)domains ‘‘role modeling: CanMEDS roles and reflection’’, ‘‘task allocation’’, ‘‘planning’’ and ‘‘personal support’’ were rated significantly higher than the female teachers (P < 0.05). Teachers aged 40 years or younger were rated higher (P < 0.01). Residents ratings by type of teachers' academic position almost in all (sub)domains differed significantly (P < 0.05). No correlation observed between MOS of a particular teacher and MOS as rated by residents (ICC = 0.055, P = 0.399). The main areas for improvement were ‘‘feedback’’ and ‘‘assessment’’.
Conclusions: Resident evaluations of clinical teachers are influenced by teachers' age, gender, year of residency training, type of teachers' academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers educational support and the implementation of e-portfolio.
Keywords: FFFECT; Clinical teaching; Quality Residents; Competency-based medical education FFFECT; Clinical teaching; Quality Residents; Competency-based medical education
This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License (CC BY-NC-ND) (CC BY-NC-ND).

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Vaižgėlienė, E.; Padaiga, Ž.; Rastenytė, D.; Tamelis, A.; Petrikonis, K.; Fluit, C. Evaluation of clinical teaching quality in competency-based residency training in Lithuania. Medicina 2017, 53, 339-347.

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