medigraphic.com
ISSN 2007-5057 (Print)
Investigación en Educación Médica

2021, Number 37

<< Back Next >>

Inv Ed Med 2021; 10 (37)

The Resident as Teacher in Family Medicine: Experimental Study with a Faceto- Face Course and its Online Version

Méndez LJF, Sánchez-Mendiola M

Language: Spanish
References: 35
Page: 31-41
PDF size: 646.19 Kb.


ABSTRACT

Background: Medical specialty residents have a wide variety of activities, including teaching other residents, interns, medical and nursing students. Formal courses about the resident-as-teacher concept are scarce in Latin America. Online learning is a modality that allows delivery of courses to busy professionals with complicated schedules, like medical residents, providing time management and the possibility of dedicating time to course activities practically anywhere. The goal of this study was to develop a resident-as-teacher online course for Family Medicine residents, and to compare its effectiveness with its face-to-face version.
Method: A randomized controlled trial was performed, with a stratified sample of 2nd year Family Medicine residents, at the Mexican Institute of Social Security in Mexico City. One group received the face-to-face version of a “resident-as-teacher” course designed at UNAM Faculty of Medicine, and the other group had an online modality adapted version of the course. Faculty and content in both courses were the same. The outcome measures were self-assessment of knowledge and skills with a retrospective pre-post questionnaire, an objective multiple-choice question test for knowledge, and teaching competencies measured with an Objective Structured Teaching Examination (OSTE).
Results: 42 residents participated: group 1 (n=22) underwent the online modality (G1EL), and group 2 (n=20) experienced the face-to-face version (G2P). 15 Residents from group 1, and 14 from group 2 completed all the assessment instruments. G1EL had better performance than G2P in the knowledge test (p‹0.05) and in the OSTE clinical teaching station (p‹0.05). The other comparisons had no significant differences.
Conclusions: The educational effectiveness of a residentas- teacher online course in Family Medicine residents was similar to a face-to-face course with similar content. There was a higher impact in knowledge acquisition and in one teaching competency. The online modality in these courses should be explored in other contexts and specialties.


REFERENCES

  1. Greenberg LW, Goldberg RM, Jewett LS. Teaching in clinical setting: factors influencing residents’ perceptions, confidence and behavior. Med Educ. 1984;18:360-65.

  2. Graue Wiechers E, Ponce de León M, Sánchez Mendiola M. El Residente como Educador Médico. En: Graue Wiechers E, Sánchez Mendiola M, Durante Montiel I, Rivero Serrano O (eds.). La Educación en las Residencias Médicas. México, D.F.: Editores de Textos Mexicanos; 2010. Cáp. 10, pp. 79-91.

  3. Méndez-López JF, Mendoza-Espinosa H, Torruco-García U, Sánchez-Mendiola M. El médico residente como educador. Inv Ed Med. 2013;2(7):154-61.

  4. Sánchez-Mendiola M, Graue-Wiechers E, Ruiz-Pérez L, García- Durán R, Durante-Montiel I. The Resident-as-Teacher educational challenge: A needs assessment survey at the National Autonomous University of Mexico Faculty of Medicine. BMC Medical Education. 2010;10:17. Disponible en: http://www.biomedcentral.com/1472-6920/10/17

  5. Sánchez Mendiola M, Torruco García U, Méndez López J, Mendoza Espinosa H. El médico residente como educador. En: Sánchez Mendiola M, Lifshitz Guinzberg A, Vilar Puig P, Martínez González A, Varela Ruiz M, Graue Wiechers E. (eds.). Educación Médica: Teoría y Práctica. México D.F.: Editorial Elsevier. 2015. Cap. 45, pp. 301-6.

  6. Ellaway R, Masters K. AMEE Guide 32: e-Learning in medical education Part 1: Learning, teaching and assessment. Med Teach. 2008;30(5):455-73.

  7. Masters K, Ellaway R. AMEE Guide e-Learning in medical education Guide Part 2: Technology, management and design. Med Teach. 2008;30(5):474-89.

  8. Cook DA, Levinson AJ, Garside S, Dupras DM, Erwin PJ, Montori VM. Internet-based learning in the health professions: a meta-analysis. JAMA. 2008;300(10):1181‐96. doi:10.1001/jama.300.10.1181

  9. Morrison EH, Rucker L, Boker JR, et al. A pilot randomized, controlled trial of a longitudinal residents-as-teachers curriculum. Acad Med. 2003;78(7):722‐729. doi:10.1097/00001888- 200307000-00016

  10. Morrison EH, Rucker L, Boker JR, et al. The effect of a 13- hour curriculum to improve residents’ teaching skills: a randomized trial. Ann Intern Med. 2004;141(4):257‐63. doi:10.7326/0003-4819-141-4-200408170-00005

  11. Morrison EH, Boker JR, Hollingshead J, Prislin MD, Hitchcock MA, Litzelman DK. Reliability and validity of an objective structured teaching examination for generalist resident teachers. Acad Med. 2002;77(10 Suppl):S29‐S32. DOI: 10.1097/00001888-200210001-00010

  12. Hill AG, Yu TC, Barrow M, Hattie J. A systematic review of resident-as-teacher programmes. Med Educ. 2009;43(12): 1129‐1140. doi:10.1111/j.1365-2923.2009.03523.x

  13. Post RE, Quattlebaum RG, Benich JJ 3rd. Residents-asteachers curricula: a critical review. Acad Med. 2009;84(3): 374‐80. DOI: 10.1097/ACM.0b013e3181971ffe

  14. Dewey CM, Coverdale JH, Ismail NJ, et al. Residents-as-teachers programs in psychiatry: a systematic review. Can J Psychiatry. 2008;53(2):77‐84. DOI: 10.1177/070674370805300202

  15. Al Achkar M, Hanauer M, Morrison EH, Davies MK, Oh RC. Changing trends in residents-as-teachers across graduate medical education. Adv Med Educ Pract. 2017;8:299‐306. Published 2017 Apr 28. doi:10.2147/AMEP.S127007

  16. Lacasse M, Ratnapalan S. Teaching-skills training programs for family medicine residents: systematic review of formats, content, and effects of existing programs. Can Fam Physician. 2009;55(9):902‐3.e35.

  17. Wamsley MA, Julian KA, Wipf JE. A literature review of “resident-as-teacher” curricula: do teaching courses make a difference? J Gen Intern Med. 2004;19(5 Pt 2):574‐81. doi:10.1111/j.1525-1497.2004.30116.x

  18. Reinbold S. Using the ADDIE model in designing library instruction. Med Ref Serv Q. 2013;32(3):244‐56. doi:10.108 0/02763869.2013.806859

  19. Bhanji F, Gottesman R, de Grave W, Steinert Y, Winer LR. The retrospective pre-post: a practical method to evaluate learning from an educational program. Acad Emerg Med. 2012;19(2):189‐94. doi:10.1111/j.1553-2712.2011.01270.x

  20. Hill LG, Betz DL. Revisiting the Retrospective Pretest. American Journal of Evaluation. 2005;26(4):501-17. doi: 10.1177/1098214005281356.

  21. Paniagua M, Swygert KA, Eds. Cómo elaborar preguntas para evaluaciones escritas en las áreas de ciencias básicas y clínicas. National Board of Medical Examiners. Philadelphia, PA, USA. 2016. Disponible en: https://www.nbme. org/sites/default/files/2020-01/DownloadingtheGold- Book_ES.pdf

  22. Trowbridge RL, Snydman LK, Skolfield J, Hafler J, Bing- You RG. A systematic review of the use and effectiveness of the Objective Structured Teaching Encounter. Med Teach. 2011;33(11):893‐903. doi:10.3109/0142159X.2011.577463

  23. Fakhouri Filho SA, Nunes MDPT. Objective structured teaching examination (OSTE): an underused tool developed to assess clinical teaching skills. A narrative review of the literature. Sao Paulo Med J. 2019;137(2):193‐200. Published 2019 Jun 10. doi:10.1590/1516-3180.2018.0308161118

  24. Graue Wiechers E, Sánchez Mendiola M, Durante Montiel I, Rivero Serrano O. (eds.). La Educación en las Residencias Médicas. Editores de Textos Mexicanos, México, D.F. 2010. ISBN 978-607-7817-01-7.

  25. Mercado Cruz E, Sánchez Mendiola M. El residente como educador en urgencias: una evaluación de sus necesidades educativas. Inv Ed Med 2020;9(33):7-17. https://doi. org/10.22201/facmed.20075057e.2020.33.19176

  26. McKeon BA, Ricciotti HA, Sandora TJ, et al. A Consensus Guideline to Support Resident-as-Teacher Programs and Enhance the Culture of Teaching and Learning. J Grad Med Educ. 2019;11(3):313‐318. doi:10.4300/JGME-D-18-00612.1

  27. Steinert Y, Mann K, Centeno A, Dolmans D, Spencer J, Gelula M, Prideaux D. A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME Guide No. 8. Med Teach. 2006; 28(6):497-526.

  28. Lisa K. Son, Dominic A. Simon. Distributed Learning: Data, Metacognition and Educational Implications. Educ Psychol Rev. DOI 10.1007/s10648-012-9206-y. Disponible en: http:// www.gwern.net/docs/2012-son.pdf

  29. Cook D. The failure of e-learning research to inform educational practice, and what we can do about it. Med Teach. 2009;31(2):158-62.

  30. Aiyer M. Woods G. Lomabrd G. MeyerL, Vanka A. Change in residents’ perception of teaching: following a one day “Resident as Teachers “(RaT) workshop. South Med J. 2008; 10(5):495-502.

  31. Morhaf Al Achkar M, Hanauer M, Morrison EH, Davies MK, Oh RC. Changing trends in residents-as-teachers across graduate medical education. Adv Med Educ Pract. 2017:8:299- 306. Consultado en: https://www.dovepress.com/changingtrends- in-residents-as-teachers-across-graduate-medicaleduca- peer-reviewed-article-AMEP

  32. Reyes C, Florenzano P, Contreras A, González A, Beltrán D, Aravena C, Grassi B. Un curso de docencia clínica para residentes mejora la autopercepción de preparación para enseñar. Rev Med Chile. 2012;140:1431-6.

  33. Olascoaga A. Curso de docencia para residentes: evaluación de un programa. Educ Med. 2020;21(3):187-92. doi:10.1016/j. edumed.2018.07.010

  34. Bayter E, Cordoba A, Messier J. Residentes como docentes en la Fundación Universitaria de Ciencias de la Salud (FUCS), proyecto de residentes formadores. Repert Med Cir. 2017;26(1):27-34. doi: 10.1016/j.reper.2017.03.0010

  35. Riveros-Ruiz J, Gutiérrez-Aguado A, Correa-López L, De la Cruz-Vargas J. Competencias del médico residente como educador en una universidad privada del Perú. Educ Med. 2020. https://doi.org/10.1016/j.edumed.2019.12.007




2020     |     www.medigraphic.com