The Impact of Content Specific Resident Teaching on the Knowledge and Clinical Skills of Medical Students
Date
2021-08
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Abstract
Residents are positioned to create safe learning environments where medical students are comfortable asking questions and presenting ideas. However, residents frequently teach without training or confidence in their teaching ability. Resident-as-teacher training improves observed teaching skill, but little is known about their impact on medical student learning. A realist review was conducted to describe the impact of resident-as-teacher training on the knowledge, skills, and perceptions of medical students. Studies reporting medical student outcomes following exposure to trained resident-teachers were identified in five databases and independently reviewed by two investigators. Analysis of contextual factors suggested that longer, dispersed, and mandatory interventions that targeted a larger number of residents with low prior ratings of teaching effectiveness were more likely to show a positive effect on student ratings of resident teaching. The provision of highly rated training sessions that improve residents’ confidence and self-ratings of teaching ability was the proposed mechanism. There were no studies that elicited changes in medical student knowledge or skills, suggesting that improved teaching ability may not translate into improved student performance unless the content of the teaching is congruent with the examination. A sequential explanatory mixed methods study was then completed to explore the impact of introducing a resident-led and content specific curriculum on medical student performance on certifying examinations. Quantitative analysis demonstrated an increased percentage of medical students passing the surgery OSCE station. However, there was no difference in performance on the surgery MCQ or student ratings of resident teaching. Student ratings of the surgery rotation significantly declined. Qualitative analysis of medical student and resident focus groups revealed poor utilization of the curriculum resources designed for knowledge transfer, while the clinical skills elements were readily integrated into clinical activities. Overall, resident-as-teacher training can improve medical student perceptions of resident-led teaching, but independently have little effect on measures of knowledge and skill. Providing residents with learning objectives and teaching resources that are appropriate for the clinical environment can improve medical student performance on standardized examinations. Creating the time required to address the learning needs of medical students remains an ongoing barrier to teaching amid busy clinical rotations.
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Keywords
Clerkship, Resident-as-Teacher, Content Specificity, Realist Review
Citation
Zondervan, N. (2021). The impact of content specific resident teaching on the knowledge and clinical skills of medical students (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.