| Abstract/Notes |
Introduction: Clinical teaching is a complex undertaking that encompasses a number of variables including instructional, personal, and interpersonal attributes. Instruments that rate teaching effectiveness, including both positive and negative feedback, can help clinical instructors improve their teaching. The focus of this study was to determine whether student ratings of clinical teaching effectiveness change significantly over a six-month clinic rotation in a chiropractic college outpatient clinic. The rating form, adopted and modified (with permission) from an instrument used at the Cleveland Clinic in Ohio, is reported to represent important theoretical clinical teaching constructs and stated to be reliable, valid and generalizable across 144 residency and fellowships at that institution. The hypothesis tested was that rating results feedback, given to clinical teachers, would lead to an increase in the rating item means of clinical teaching effectiveness over a six-month clinic rotation. Method: Bimonthly rating interval responses to the Canadian Memorial Chiropractic College Cleveland Clinical Teaching Effectiveness Instrument for the period June 2002 to May 2003, used in this study, were initially collected by the chiropractic college clinic administration. Prior to use in this study, a confidentiality preserving process was used to ensure that the privacy of the rated faculty was protected. The instrument includes sixteen items on clinical teaching behaviors using a five-point Likert scale with an additional non-numerical Not Applicable/Don’t Know response. There were 153 students assigned to 22 clinical faculty during that time period. Of the total clinical faculty, 11 had sufficient rating form data to include them in the study. The non-parametric Wilcoxon Signed Ranks Test was used to test the differences between time periods. Results: The results show that the item means of the rating instrument are high initially and remained high over a six-month rotation. The reliability alpha, for all items, was high at 0.95 and 0.96 for the first and last rating interval respectively. One hundred seventy-six item response means were calculated across 11 clinical faculty showing that 64% of item means increased, 22% decreased and 14% remained unchanged. Significant change, at the p<0.10 level, was seen in six item means (3%) that decreased and thirty-six item means (20%) that increased over a six-month rotation. Discussion: Rating item means were found to increase over a six-month rotation. While the high mean results suggest a ceiling effect and difficulty in differentiating between clinical teachers of higher or lower ability, they also suggest that the faculty were generally teaching effectively, as rated by students. Two-thirds of the item means increased over a six-month rotation with one-fifth of those means increasing significantly. As the instrument responses are shared with the clinical faculty at bimonthly intervals a plausible explanation for the increased ratings over a six-month rotation is that clinical faculty reflect upon the results and take them into consideration as they go about their teaching responsibilities. This abstract is reproduced with the permission of the publisher. |
