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Residents-as-Teachers Curricula: A Critical Review

Post, Robert E. MD; Quattlebaum, R Glen MD, MPH; Benich, Joseph J. III MD

Academic Medicine:
doi: 10.1097/ACM.0b013e3181971ffe
GME Curricula
Abstract

Purpose: Residents serve as medical students’ primary teachers for practical clinical skills. The purpose of this study is to provide an updated systematic review of the literature on residents-as-teachers curricula to determine the most evidence-based curricula and evaluation strategy.

Method: In 2008, the authors performed a systematic review of the literature with PubMed using the MESH terms “internship and residency” and “teaching,” as well as a key word search of the term “residents as teachers.” The search was limited to publications in English from 1975 to 2008.

Results: A total of 24 studies met inclusion criteria. Eleven (45.8%) were uncontrolled studies, seven (29.2%) were randomized control trials, and six (25%) were nonrandomized controlled trials. The mean sample size of all studies was 39.6. Evaluation was performed by a variety of means including objective structured teaching exams (5; 20.8%), videotape evaluations (6; 25.0%), learner evaluations (11; 45.8%), and self-questionnaires (7; 29.2%). The mean intervention length was 7.6 hours, and the most common intervention was based on the One-Minute Preceptor.

Conclusions: Research on residents-as-teachers curricula is limited by both the number of studies and their methodology. Despite this, the results demonstrated that residents-as-teachers curricula can significantly improve residents’ teaching skills. In addition, the studies’ methodologies have improved over time. Using these data, the authors recommend an evidence-based intervention and evaluation, which would include a three-hours-or-longer intervention (and, if possible, periodic reinforcement) based on the One-Minute Preceptor. The evaluation should be a randomized controlled trial using an objective structured teaching examination.

Author Information

Dr. Post is a resident, Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina.

Dr. Quattlebaum is a resident, Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina.

Dr. Benich is a resident, Department of Family Medicine, Medical University of South Carolina, Charleston, South Carolina.

Correspondence should be addressed to Dr. Post, 295 Calhoun St., Charleston, SC 29425; telephone: (843) 792-2383; fax: (843) 792-3598; e-mail: (postr@musc.edu).

© 2009 Association of American Medical Colleges