Third-year medical students' perceptions of effective teaching behaviors in a multidisciplinary ambulatory clerkship.

Abstract

The authors sought third-year medical students' perceptions of ambulatory preceptors' teaching effectiveness across primary care disciplines. Third-year students at the University of Pittsburgh School of Medicine spent three-week rotations each in ambulatory internal medicine, pediatrics, family medicine, and an elective. After the 12-week clerkship, students anonymously evaluated the full-time and volunteer preceptors using a five-point Likert-type evaluation (1 = hardly at all; 5 = to a great degree) that had eight items addressing preceptor teaching behaviors, six items on attaining clerkship goals and an assessment of overall teaching effectiveness, the outcome variable of interest. The authors analyzed 276 evaluation forms (58% response rate) collected from July 2001 to June 2002. They found a mean effectiveness rating of 4.4 (SD.9) and no differences between genders, specialties, and faculty appointment types (p >.2 for each). The 14 items were associated with teaching effectiveness in univariate analysis (p <.01 for each). In multivariate analyses, effectiveness was associated with four preceptor behaviors: inspired confidence in medical skills, explained decisions, treated students with respect, and provided a role model (R(2) =.33). Effectiveness was associated with three items about attaining clerkship goals: allowed opportunity for improving clinical skills, practiced ethical medicine, and encouraged evidence-based medicine (R(2) =.20). Several teaching behaviors and measures of attaining clerkship goals influenced students' perceptions of teaching effectiveness. Involving students in a humanistic but rigorous approach to medicine and being a physician students wanted to emulate seem particularly important. These aspects appear potentially amenable to faculty development efforts.