Describing clinical teachers' characteristics and behaviours using critical incidents and repertory grids

North Tyneside General Hospital, Rake Lane, North Shields, UK.
Medical Education (Impact Factor: 3.2). 08/2006; 40(7):645-53. DOI: 10.1111/j.1365-2929.2006.02510.x
Source: PubMed


Completion of a rating questionnaire is the method used most frequently to evaluate a teacher's performance. Questionnaires that largely assess 'high-inference' teaching characteristics, such as 'enthusiasm' and 'friendliness', require the observer to make a judgement about the teacher but do not describe what the teacher actually did and so have limited use in providing feedback. Measures of 'low-inference' teaching behaviours (i.e. those that are concrete and observable), such as frequency, amount or types of verbal interaction, do not demonstrate how these are linked to good teaching.
To describe high-inference teacher characteristics and define the associated low-inference behaviours.
A purposive sample of consultants, postgraduate and undergraduate students, nurse lecture practitioners and patients were selected for semistructured interviews using repertory grids and critical incidents to elicit preferred characteristics and behaviours of clinical teachers. Interviews were audiotaped, transcribed and then content-analysed using a framework to pair teachers' characteristics and their behaviours.
We identified a variety of preferred high-inference characteristics and their associated observable and recordable low-inference behaviours.
We carried out a study that included all participants in clinical teaching and found that participants differed in their preferred characteristics and behaviours. It is important for future research to look at behaviours interdependently, rather than alone, and to take into account the evidence that participants tend to infer characteristics rather than think in terms of behaviours. This information will be used to inform the development of a formative tool for evaluating clinical teaching.

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    • "The main themes identified were medical/clinical knowledge, clinical and technical skills/competence, clinical reasoning, positive relationships with students and a supportive learning environment, communication skills and enthusiasm. Characteristics displayed by clinical teachers and how these are interpreted by students were the focus in the research of Chitsabesan et al. (2006), where subjective, 'high-inference' characteristics were measured. For example, enthusiasm and rapport were viewed as highinference characteristics, which were linked with objective 'low-inference' behaviours such as smiling and using a student's name. "
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    • "Many instruments for providing feedback to clinical teachers are based on roles that are defined in the literature about good clinical teaching.(Bandiera et al. 2005; Boor et al. 2008; Chitsabesan et al. 2006; Fluit et al. 2012; Harden and Crosby 2000; Hesketh 2001; Irby et al. 1991; Kilminster and Jolly 2000; Parsell and Bligh 2001; Paukert and Richards 2000; Snell et al. 2000; Sutkin et al. 2008; Ullian et al. 1994). Several authors have expressed concerns with many of these instruments as they do not cover all important aspects of clinical teaching, lack a clear theoretical framework and/or have insufficient validity evidence (Fluit et al. 2010; Beckman 2004). "
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    • "Sadly, our respondents' characterization of "tyrant" preceptors supports other similar findings. Adverse interactions with preceptors have variously been characterized as an issue of style [20] or educator professionalism [21] and as involving disrespectful interactions, belittlement, humiliation, bullying, harassment and abuse [22-27]. Our findings add to a fairly limited literature describing the consequences of such adverse interactions [22-24,28] and, further, provide an explanation of why students responded in the way that they did in our setting. "
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