Supervisory needs of research doctoral students in a university teaching hospital setting.

BACKGROUND/HYPOTHESIS: Teaching hospitals affiliated with universities are now common sites for research higher degree supervision. We hypothesised that the hospital environment poses unique challenges to supervision compared with the traditional university research institute setting. AIMS: This study aimed to identify and rank important supervision issues in a clinical setting from the students' perspective. METHODS: Using the Delphi method to explore issues and facilitate consensus, small group discussions were conducted with 10 research doctoral students from a tertiary teaching hospital. RESULTS: We identified supervision issues that are unique to the hospital-based context. These include the demands placed on supervisors combining clinical and supervisory roles, the challenges of academic medical/scientific writing and career issues for students who are already established in their professions. Other issues identified, common to all doctoral students, include differing expectations between students and supervisors (with students wanting support for their career plans, training in research skills and increasing autonomy and responsibility), supervisor access, quality and frequency of meetings, lack of training in writing and dealing with conflicts. CONCLUSION: Our research identified that postgraduate students of supervisors who combine clinical and supervisory roles report significant issues with supervision, some of which are unique to the clinical setting. Clinician researchers who supervise postgraduate students need to balance clinical and supervisory responsibilities, identify and negotiate student expectations early in candidature and provide career counselling to students who are already highly experienced. Furthermore, clinician supervisors should undertake postgraduate supervisor training programme tailored to the hospital setting to better support their students.

'I enjoy teaching but...': Paediatricians' attitudes to teaching medical students and junior doctors.

AIM: To explore consultant paediatricians' attitudes, motivations, and barriers to training medical students and junior doctors. METHODS: Qualitative research involving 24 paediatricians (with a diversity of specialties, experience, age, gender, teaching activity and employment status) from a tertiary paediatric hospital and clinical school in Sydney, Australia. Participants were engaged in semi-structured focus group discussions which explored their attitudes to teaching medical students and junior doctors, their role and experience of teaching, their training in medical education, perceived barriers to teaching, and possible solutions to these barriers. Data from the transcriptions of the focus group discussions were coded using the constant comparative method and analysed for themes using NVivo 7 software. Differences in responses between participants were explored. RESULTS: All participants reported enjoying teaching. However, a number of factors which occurred at the consultant, learner and institution level affected the enjoyment or challenge of teaching. Consultant factors included time commitments, knowledge of and confidence in the learner's course, and comfort with teaching. Learner factors included level of knowledge, attendance, interest and enthusiasm, and cultural changes. Institution factors included acknowledgement of teaching contribution, communication, teaching support and resources, and attitude to teaching. These factors and the consultant's relationship with the learner and institution impacted on their ownership, involvement, and commitment to teaching. CONCLUSIONS: Consultant paediatricians identified challenges to their involvement and commitment to teaching. Actions to address these challenges and improve the relationship between the consultant and the learner and the consultant and the institution may enhance the consultant's commitment to teaching.

Inductive teaching method-an alternate method for small group learning.

BACKGROUND: Different forms of small group interactive teaching have found an increasing role in medical education in the recent past. OBJECTIVES: This study aimed to evaluate the efficacy of topic-based small group tutorials and compare between two such tutorials, the directed tutorial where the tutor takes the initiative and the inductive tutorial which places the initiative on the student. METHODS: Final-year medical students were exposed to alternate sessions of directed and inductive teaching during their rotation in paediatric surgery. For inductive teaching, the topic was announced and the students took turns in asking questions and answering them, the tutor stepping in only when required. The tutor both initiated and guided the discussion in the directed method. Students assessed the tutorials and compared the two learning methods evaluating eight different parameters using a Likert scale. Statistical significance was tested using the Wilcoxon signed ranks test. RESULTS: Feedback was available from 49 out of 52 students. The tutorials were ranked highly for all parameters studied. The inductive method was better for comfort, interest, memory, inspiration to read more, comprehension and for correlation with previous knowledge (P < 0.05). The directed method was superior for the content covered in a given time (P < 0.001). CONCLUSIONS: The topic-based tutorials were effective. The inductive method by adding a reflective component, appeared to facilitate deep learning. Further research will determine its suitability for formal introduction into the curriculum.

Videoconferencing surgical tutorials: bridging the gap.

The expansion in medical student numbers has been associated with a move to increase the amount of time students spend in rural and remote locations. Providing an equivalent educational experience for students in surgical subspecialties in this setting is a logistical challenge. We sought to address this issue by providing synchronous tutorials in paediatric surgery using videoconferencing (VC) at two rural sites with the tutor located at a metropolitan paediatric clinical school. Between March 2005 and July 2006, 43 graduate students in the University of Sydney Medical Program were assigned to receive the paediatric component of the course at one of two sites within the School of Rural Health. During this 9-week rotation, students were involved in two or three surgical tutorials by videoconference. Students were then invited to complete a confidential, anonymous 20-point structured evaluation using a Likert scale. Valid responses were received from 40 students, a response rate of 93%. There were 21 females (52%), with 21 students based in Dubbo and 19 in Orange. Students agreed or strongly agreed that VC surgical tutorials were useful, the content well covered and student involvement encouraged (mean scores 4.7, 4.5 and 4.5; standard deviation 0.56, 0.72 and 0.72, respectively). Overall, the majority of students strongly agreed that participation in VC of surgical tutorials was valuable (mean 4.68, standard deviation 0.57). VC surgical tutorials were highly valued by graduate medical students as an educational method. Our data suggest that tutorials can be successfully provided at remote sites using VC.