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Abstract
Purpose
To identify specific learning activities (and
teaching methods) that students
associate with high-quality teaching in
the inpatient setting.
Method
For ten months in 2003 04, 170 thirdyear medical students recorded data on
learning/feedback activities and teaching
quality via personal digital assistants
during the inpatient portion of a required
two-month medicine clerkship at four
sites affiliated with the Medical College
of Wisconsin. Univariate and multivariate
analyses were performed to assess the
association between learning/feedback
activities and students perceptions of
high-quality teaching.
Results
A total of 2,671 teaching encounters
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Study population
Our study population was 170 third-year
medical students who were rotating on a
required two-month internal medicine
clerkship during July 2003 to April 2004.
All students completed at least one
month of inpatient rotation during the
clerkship and 74 (43%) completed two
months of inpatient service.
Students on their inpatient rotation are
randomly assigned to one of four
different sites: Froedtert Hospital at the
Medical College of Wisconsin, The
Clement J. Zablocki Veterans
Administration Medical Center (VA
medical center), St. Joseph hospital, or St.
Lukes hospital, all in Milwaukee,
Wisconsin. Our study included students
that rotated through any of the four sites,
although Froedtert hospital and the VA
medical center accommodate two thirds
of students each rotation. At Froedtert
and the VA medical center, the teaching
attending on the inpatient service
conducts teaching rounds with the team
approximately four times a week, for 90
minutes, and each team includes one
resident, two interns, and two junior
medical students. They focus on cases
presented by students and interns with
frequent bedside interactions involving
primarily the junior medical students.
These teaching sessions focus on
students case presentation skills, physical
examination skills, data interpretation,
and diagnostic decision making. For all
patients, the teaching attending is the
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Research Report
Table 1
Teaching Methods and Feedback Activities That Occurred During 2,671 Inpatient
Teaching Encounters among 170 Third-Year Medical Students, Medical College
of Wisconsin, Milwaukee, 2003 04
Activity
% Frequency
Bedside teaching
62
Mini-lectures
53
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
Case-based conference
37
29
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
22
Assigning talks
22
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
47
46
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
37
36
26
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
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Discussion
Research Report
Table 2
Multiple Logistic Regressions: Teaching Methods and Feedback Activities
Associated with Perception of High-Quality Teaching among 170 Third-Year
Students during 2,671 Inpatient Teaching Encounters, Medical College of
Wisconsin, Milwaukee, 2003 04
Activity
Odds ratio*
95% CI
p Value
Case-based conference
1.4
1.01.4
.009
Bedside teaching
1.0
.741.4
.90
Assigning talks
1.2
.901.6
.24
2.1
1.32.5
.001
2.2
1.42.6
.001
Mini-lectures
2.4
1.83.2
.001
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
1.1
.901.5
.34
2.0
1.22.8
.001
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
1.6
1.22.3
.002
2.2
1.63.2
.001
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
1.2
.901.7
.3
One-on-one teaching
0.71
.501.0
.06
Being a hospitalist
0.83
.961.0
.09
.........................................................................................................................................................................................................
.........................................................................................................................................................................................................
* Odds ratio 1 the teaching activity was positively related to high-quality teaching. Odds ratio 1 the
teaching activity was negatively related to high-quality teaching.
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Research Report
References
954