Changing trends in residents-as-teachers across graduate medical education.

BACKGROUND: Teaching residents how to teach is a critical part of residents' training in graduate medical education (GME). The purpose of this study was to assess the change in resident-as-teacher (RaT) instruction in GME over the past 15 years in the US. METHODS: We used a quantitative and qualitative survey of all program directors (PDs) across specialties. We compared our findings with a previous work from 2000-2001 that studied the same matter. Finally, we qualitatively analyzed PDs' responses regarding the reasons for implementing and not implementing RaT instruction. RESULTS: Two hundred and twenty-one PDs completed the survey, which yields a response rate of 12.6%. Over 80% of PDs implement RaT, an increase of 26.34% compared to 2000-2001. RaT instruction uses multiple methods with didactic lectures reported as the most common, followed by role playing in simulated environments, then observing and giving feedback. Residents giving feedback, clinical supervision, and bedside teaching were the top three targeted skills. Through our qualitative analysis we identified five main reasons for implementing RaT: teaching is part of the residents' role; learners desire formal RaT training; regulatory bodies require RaT training; RaT improves residents' education; and RaT prepares residents for their current and future roles. CONCLUSION: The use of RaT instruction has increased significantly in GME. More and more PDs are realizing its importance in the residents' formative training experience. Future studies should examine the effectiveness of each method for RaT instruction.

A small group learning model for evidence-based medicine.

BACKGROUND: Evidence-based medicine (EBM) skills are invaluable tools for residents and practicing physicians. The purpose of this study is to evaluate the effectiveness of small-group learning models in teaching fundamental EBM skills. METHODS: The intervention consisted of an EBM bootcamp divided into four 2-hour sessions across 4-week rotations. Residents worked in small groups of three to four to explore fundamentals of EBM through interactive dialogue and mock clinical scenario practice. The intervention's effectiveness was evaluated using pre- and post-assessments. RESULTS: A total of 40 (93.0%) residents out of a potential 43 participated in the EBM bootcamps across the 3 years. There was significant improvement of 3.28 points on self-assessed EBM skills from an average of 9.66-12.945 out of a maximum score of 15 (P=0.000). There was significant improvement of 1.68 points on the EBM skills test from an average of 6.02-7.71 out of a maximum score of 9 (P=0.00). All residents (100%) agreed or strongly agreed that EBM is important for a physician's clinical practice. This view did not change after the training. CONCLUSION: A brief small-group interactive workshop in EBM basic skills at the start of residency was effective in developing fundamental EBM skills.

Global Health in Family Medicine Residency Programs: A Nationwide Survey of US Residency Directors: A CERA Study.

BACKGROUND AND OBJECTIVES: Interest in global health (GH) has increased significantly among medical trainees in the past 3 decades. Despite the potential for family medicine to be a major contributor to GH, there are no recent, large-scale studies of GH education and experiences in family medicine training. This study was designed to assess current opportunities, educational activities, resident interest, perceived program benefits, and barriers to international and domestic GH training in US family medicine residencies. METHODS: Data for this study were elicited as part of a 2015 survey conducted by the Council of Academic Family Medicine (CAFM) Educational Research Alliance (CERA). The nationwide, web-based survey was sent to 452 family medicine residency program directors. RESULTS: A total of 257 program directors completed the GH portion of the survey. A total of 74.3% of programs offered international or domestic GH experiences. Program directors identified preparing physicians to practice underserved medicine and teaching community medicine or public health as primary goals for GH training. Program directors also reported that GH opportunities were important for attracting future residents. Programs offered a variety of preparatory activities to their residents. Funding and time constraints were identified as the primary barriers to GH training in residency. CONCLUSIONS: Global health continues to be a focus of interest in the training of family medicine residents while attracting the passion of student applicants and residents.

Resident-as-teacher in family medicine: a CERA survey.

BACKGROUND AND OBJECTIVES: Teaching has been increasingly recognized as a primary responsibility of residents. Residents enjoy teaching, and their majority report interest in the continuation of teaching activities after graduation. Resident-as-teacher programs have emerged nationally as a means of enhancing teaching skills. This study examined the current use of residents-as-teachers programs in family medicine residencies through a national survey of family medicine residency program directors. METHODS: This survey project was part of the Council of Academic Family Medicine Education Research Alliance (CERA) 2014 survey to family medicine program directors that was conducted between February 2014 and May 2014. RESULTS: The response rate of the survey was 49.6% (224/451). The majority (85.8%) of residency programs offer residents formal instruction in teaching skills. The vast majority (95.6%) of programs mandated the training. The average total hours of teaching instruction residents receive while in residency training was 7.72. The residents are asked to formally evaluate the teaching instruction in 68.1% of the programs. Less than a quarter (22.6%) of residency programs offer the teaching instruction in collaboration with other programs. "Retreat, workshop, and seminars" were identified as the main form of instruction by 33.7% of programs. In 83.3% of programs not offering instruction, lack of resources was identified as the primary barrier. CONCLUSIONS: The majority of family medicine residency programs provide resident-as-teacher instructions, which reflects increasing recognition of importance of the teaching role of residents. Further research is needed to assess the effectiveness of such instruction on residents' teaching skills and their attitudes toward teaching.