Medical teachers' perspectives on development and use of objectives

Experienced medical teachers were interviewed regarding creation and use of objectives for instruction. This paper summarizes reported advantages and disadvantages of objectives, describes reported changes in strategy with experience, and provides advice on the creation and use of objectives. Medical teachers agree that the process of writing objectives leads to clarification of intuitively held teaching goals and thus leads to better teaching and testing decisions. To achieve this benefit, an instructor must invest considerable time, effort and creativity in the process. The path of least resistance in writing objectives often leads to goals which serve no useful function and may be harmful to the teaching-learning process.     

Changing attitudes of medical teachers towards medical education

If medical education is to improve, this is largely dependent upon the attitudes of clinical teachers towards their own teaching and their students' learning. The aims and objectives of our workshop method of medical teacher training therefore includes some in the affective domain. Based on the theory of cognitive dissonance the experience-linked practical problem solving approach of the workshop encourages behaviour change, presuming this to cause 'attitude change'. Testing by means of a specially constructed and validated Likert-type attitude scale shows that attitudes do improve significantly and consistently over the 5 days of our workshops. A follow-up study shows these effects to be maintained and taken back to the participants' own medical schools.     

Instruction on death and dying for the medical student

With instruction on death and dying beginning to be included in the curricula of many medical schools and the likelihood that this development will spread, it is timely to examine the best ways in which the subject can be taught. The most important need at this stage is the creation of objectives. Nine objectives have been briefly outlined which have either been reported on by teachers in the field or which seem to be pertinent to death education. The focus on objectives rests on the premise that the format and content of courses will follow largely from the goals that are selected. Questions of who should teach death and dying, when it should be taught and what format should be used, are discussed.     

The validity of clerkship performance evaluations

The validity of narrative evaluations of clinical performance in medical school was investigated for three successive classes of medical school graduates. The criteria were ratings obtained from residency supervisors one year after entering the programme. Bivariate correlational analysis, multiple regression analysis and canonical redundancy analysis were performed to examine the associations between the evaluations by teachers of competence in medical school clerkships and the subsequent ratings by residency supervisors. The results, best summarized in the canonical analysis, showed two relationships between the two sets of measures (lambda 1 = 0.54 and lambda 2 = 0.47). The first relationship revealed an overall-competence-in-medicine dimension; the second suggested an interpersonal-skills/professional-maturity dimension. Overall, knowledge of clerkship performance accounted for 15% of the variance in residency ratings. The findings suggest the need to improve the assessment of professional maturity and behaviour during medical school.     

A teachers' guide to teaching medical interviewing

Success in teaching a course in medical interviewing requires competence on the part of instructors, who also need training, and have to provide a structured approach. Problems encountered by course coordinators at the Department of Family Medicine, University of Miami School of Medicine, Miami, Florida have been: (1) a shortage of skilled teachers; (2) inadequate motivation of instructors for teaching the course; (3) differences in content, teacher's style, and outcomes from small groups; and (4) ambiguities in structure or guidelines provided for teachers. The development of a teacher's guide, giving specific objectives and step-by-step methods for teaching significantly improved teacher satisfaction and commitment to the course, as well as student learning.     

Training clinical teachers in psychiatry to teach interviewing skills to medical students

To study the feasibility of training all clinical teachers in psychiatry to teach interviewing skills to medical students, 24 (unselected clinicians were assigned to one of four different training methods. They received either experiential or didactic instruction, and their initial teaching sessions were either supervised or unsupervised. A total of 287 medical students subsequently received feedback training from these teachers. While all students showed significant increases in skill after training, those taught by experientially trained teachers showed the greatest gains. Neither supervision nor the teachers' own interviewing skills exerted significant effects on students' performance. It is concluded that with only brief training unselected clinicians can become effective teachers of essential interviewing skills. Feedback training in such skills can, therefore, be incorporated into existing curricula without major disruption of other requirements.     

Variation in medical students'' approaches to diagnosis: a basis for initiating conceptual change among teachers and students

OBJECTIVES: This study examines Finnish medical students' approaches to diagnosis and investigates further how medical teachers can use information about variation in their students' approaches to diagnosis to foster teaching in medical school. DESIGN: The medical students responded to the Conceptions and Experiences of Diagnosis Inventory (CEDI). SETTING: Faculty of Medicine, University of Helsinki. SUBJECTS: Ninety medical students in their clinical years and eight clinical teachers from the same Faculty of Medicine. RESULTS: The 11 subscales of the CEDI formed two contrasting factors: the first reflecting variation in 'non-virtuously' labelled, and the second in 'virtuously' labelled, aspects of diagnosis. CONCLUSIONS: Cluster analyses revealed subgroup characteristics of students' diagnostic processes that are of potential benefit to both students and teachers. Teacher interviews indicated that, for students, the CEDI may act as a self-assessment tool to help develop their diagnostic and metacognitive skills. For teachers, the CEDI was seen to offer important information about their students' conceptions of diagnosis and diagnostic skills.     

Guidelines for competency-based instruction in psychiatry

This paper presents guidelines for teachers who wish to design competency-based instructional activities in psychiatry. Developed over a 3 year period, these guidelines outline the methods used by teachers to construct competency-based seminars and clinical rotations.
The guidelines describe the process of stating knowledge objectives, performance objectives and experiential objectives for psychiatric trainees to attain prior to completion of training in a given area. Selection of appropriate teaching strategies as well as criteria and conditions for assessment of the residents' abilities are also reviewed.
Comments regarding the authors' experience using these guidelines with teachers are offered.     

Teaching in medicine: an elective course for third-year students

An elective course titled 'Teaching in Medicine' was given to eight third-year medical students in response to the policy of the University of British Columbia medical school to expand its elective offerings. Course objectives focused on the skills that doctors need to fulfil their role of teacher of patients, students or colleagues. Instructional methods included directed reading, group discussions, microteaching, evaluation of videotaped samples of teacher behaviour, role play, demonstration and practice in developing and using audiovisual materials, and analysis of research in teaching and learning in medicine. The course culminated in each student presenting a major teaching session which was videotaped and assessed by the student and course teachers. All students rated the course as excellent. This paper describes the course and the teacher and student perceptions of it. The experience of this medical school is that a course of this nature is extremely worthwhile.     

Medical statistics: content and objectives of a core course for medical students

Summary. British medical school teachers of medical statistics aspire to teach statistical concepts without requiring medical students to undertake every statistical technique in the book. In the typical course of 20–30 hours, about 50 topics are taught, usually requiring the student to perform a technique. In a survey of current practice in 20 courses it is shown that a core syllabus of 36 topics, including 14 techniques to be performed, is feasible for almost all existing courses. Clear student learning objectives now need to be agreed to encapsulate this syllabus.