Abstract
Background Residency programs are required to develop residents as teachers. Much of the formal teaching by residents occurs in group settings; the existing published tools did not collect validity evidence for assessment of resident-led large group teaching. We aim to create a tool for faculty to assess resident teaching in this setting. Methods Initial content for the tool came from literature review and our personal experience leading resident-as-teacher curricula. Resident focus groups provided stakeholder input, informing the first round of tool revisions. A modified Delphi panel of 14 international faculty experts, over 2 rounds of revisions, provided feedback on the tool's elements. Anchors were designed and finalized after a third Delphi round. Study investigators piloted the tool with 10 video recordings of senior residents teaching from the 3 sites. Cronbach's alpha was calculated for internal consistency and intraclass correlation (ICC) for interrater reliability. Results The tool has 6 domains: learning climate, goals and objectives, content, promotion of understanding and retention, session management, and closure. Each domain contains 12 sub-elements which are described by 37 observable behaviors. The Cronbach's alpha was 0.88. The ICC was good or excellent for 13/37 sub-elements (35%), fair or poor for 22/37 sub-elements (59%) and the remaining 2 elements had no ICC score given no variability in rater scores. Conclusion A tool for faculty assessment of resident-led large group teaching was developed using robust methodology. In the pilot study, the assessed behaviors have good internal consistency, but low interrater reliability without rater training. In the next study phase, we will develop tool utilization standards, train faculty raters, and apply the tool to a larger video sample of resident teaching. We will collect validity evidence for the tool including ability to discriminate between novice and advanced teachers and its correlation with teaching milestones.
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