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      The resident-as-teacher educational challenge: a needs assessment survey at the National Autonomous University of Mexico Faculty of Medicine

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          Abstract

          Background

          The role of residents as educators is increasingly recognized, since it impacts residents, interns, medical students and other healthcare professionals. A widespread implementation of resident-as-teacher courses in developed countries' medical schools has occurred, with variable results. There is a dearth of information about this theme in developing countries. The National Autonomous University of Mexico (UNAM) Faculty of Medicine has more than 50% of the residency programs' physician population in Mexico. This report describes a needs assessment survey for a resident as teacher program at our institution.

          Methods

          A cross-sectional descriptive survey was developed based on a review of the available literature and discussion by an expert multidisciplinary committee. The goal was to identify the residents' attitudes, academic needs and preferred educational strategies regarding resident-as-teacher activities throughout the residency. The survey was piloted and modified accordingly. The paper anonymous survey was sent to 7,685 residents, the total population of medical residents in UNAM programs in the country.

          Results

          There was a 65.7% return rate (5,186 questionnaires), a broad and representative sample of the student population. The residents felt they had knowledge and were competent in medical education, but the majority felt a need to improve their knowledge and skills in this discipline. Most residents (92.5%) felt that their role as educators of medical students, interns and other residents was important/very important. They estimated that 45.5% of their learning came from other residents. Ninety percent stated that it was necessary to be trained in teaching skills. The themes identified to include in the educational intervention were mostly clinically oriented. The educational strategies in order of preference were interactive lectures with a professor, small groups with a moderator, material available in a website for self-learning, printed material for self-study and homework, and small group web-based learning.

          Conclusions

          There is a large unmet need to implement educational interventions to improve residents' educational skills in postgraduate educational programs in developing countries. Most perceived needs of residents are practical and clinically oriented, and they prefer traditional educational strategies. Resident as teachers educational interventions need to be designed taking into account local needs and resources.

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          Most cited references14

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          Women in medicine--is there a problem? A literature review of the changing gender composition, structures and occupational cultures in medicine.

          Internationally, there are increasing numbers of women entering medicine. Although all countries have different health care systems and social contexts, all still show horizontal (women concentrated in certain areas of work) and vertical (women under represented at higher levels of the professions) segregation. There is much discussion and competing explanations about the implications of the increasing numbers of women in the medical profession. The purpose of this review was to explore the evidence, issues and explanations to understand the effects of the changing composition of the medical profession. This review identified evidence that delineates some of the effects of gender on the culture, practice and organisation of medicine. There are problems with some of the research methodologies and we identify areas for further research. To understand the effects of the changing gender composition of medicine it will be necessary to use more sophisticated research designs to explore the structural, economic, historical and social contexts that interact to produce medical culture. This will provide a basis for exploring the impact and implications of these changes and has immediate relevance for workforce planning and understanding both the changing nature of health professions' education and health care delivery.
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            Residents-as-teachers curricula: a critical review.

            Residents serve as medical students' primary teachers for practical clinical skills. The purpose of this study is to provide an updated systematic review of the literature on residents-as-teachers curricula to determine the most evidence-based curricula and evaluation strategy. In 2008, the authors performed a systematic review of the literature with PubMed using the MESH terms "internship and residency" and "teaching," as well as a key word search of the term "residents as teachers." The search was limited to publications in English from 1975 to 2008. A total of 24 studies met inclusion criteria. Eleven (45.8%) were uncontrolled studies, seven (29.2%) were randomized control trials, and six (25%) were nonrandomized controlled trials. The mean sample size of all studies was 39.6. Evaluation was performed by a variety of means including objective structured teaching exams (5; 20.8%), videotape evaluations (6; 25.0%), learner evaluations (11; 45.8%), and self-questionnaires (7; 29.2%). The mean intervention length was 7.6 hours, and the most common intervention was based on the One-Minute Preceptor. Research on residents-as-teachers curricula is limited by both the number of studies and their methodology. Despite this, the results demonstrated that residents-as-teachers curricula can significantly improve residents' teaching skills. In addition, the studies' methodologies have improved over time. Using these data, the authors recommend an evidence-based intervention and evaluation, which would include a three-hours-or-longer intervention (and, if possible, periodic reinforcement) based on the One-Minute Preceptor. The evaluation should be a randomized controlled trial using an objective structured teaching examination.
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              A literature review of "resident-as-teacher" curricula: do teaching courses make a difference?

              To examine the evaluation methods of resident teaching courses and to estimate the effectiveness of these teaching courses. We searched the literature from 1975 to May 2003 using the PubMed MESH terms internship and residency and teaching; 1,436 articles were identified and 77 contained information regarding teaching courses. Fourteen articles contained information regarding outcomes of resident teaching courses and were selected for intensive review. Five uncontrolled pre-post studies used resident self-reported teaching skills/behaviors as outcome measures; all reported some improvement in self-reported skills. Three uncontrolled pre-post studies examined live or videotaped resident teaching encounters and all revealed improvement in some teaching skills. One uncontrolled trial and three nonrandomized controlled trials used learner evaluations of resident teaching behaviors as outcomes and all revealed an improvement in ratings of residents after course participation. Four randomized controlled trials of resident teaching curricula are included in this review. One study did not show any quantitative benefit of a resident teaching course on performance on an objective structured teaching evaluation. Two studies assessing resident teaching evaluations before and after course participation showed conflicting results. One study noted improvements in resident teaching skills assessed through videotape analysis. Resident teaching courses improve resident self-assessed teaching behaviors and teaching confidence. Teaching courses are linked to improved student evaluations. Further studies must be completed to elucidate the best format, length, timing, and content of resident teaching courses and to determine whether they have an effect on learner performance.
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                Author and article information

                Journal
                BMC Med Educ
                BMC Medical Education
                BioMed Central
                1472-6920
                2010
                16 February 2010
                : 10
                : 17
                Affiliations
                [1 ]Secretaría de Educación Médica, Facultad de Medicina de la Universidad Nacional Autónoma de México, Ave. Universidad 3000, Ciudad Universitaria, México, D.F., 04510 México
                [2 ]Dirección, Facultad de Medicina de la Universidad Nacional Autónoma de México, México, D.F., México
                [3 ]División de Estudios de Posgrado e Investigación, Facultad de Medicina de la Universidad Nacional Autónoma de México, México, D.F., México
                [4 ]Secretaría del Consejo Técnico, Facultad de Medicina de la Universidad Nacional Autónoma de México, México, D.F., México
                Article
                1472-6920-10-17
                10.1186/1472-6920-10-17
                2830225
                20156365
                d6bc1e9b-ec20-4703-9d96-c5d8209ba2cb
                Copyright ©2010 Sánchez-Mendiola et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 9 July 2009
                : 16 February 2010
                Categories
                Research Article

                Education
                Education

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