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Competency and Curriculum of the Resident as Teacher: A Review and Suggestions

교육자로서 전공의 역량과 교육과정의 분석과 제안

  • Park, Janghee (Department of Medical Education, Soonchunhyang University College of Medicine)
  • 박장희 (순천향대학교 의과대학 의학교육학교실)
  • Received : 2020.12.02
  • Accepted : 2021.02.02
  • Published : 2021.02.28

Abstract

Residents serve as educators who teach patients, medical students, fellow residents, and other medical personnel while being trained as learners. The purpose of this study was to review the literature on the competencies, perceptions, and educational status of residents as teachers, and to suggest appropriate competencies and curricular components. A literature review was conducted and resident-related institutional homepages were searched. Many countries are developing the educational competencies of residents as teachers and implementing educational programs. Residents most often taught clinical knowledge and clinical skills to patients, medical students, fellow residents, and other medical professionals, and recognized the importance of education, the joy of teaching, and the role of teachers; however, the task of teaching was burdensome. Based on these findings, competencies and educational programs for the resident as teacher are proposed. The competencies consist of the five stages of ACCESS (active learner, clinical teacher, curriculum developer, educational scholar, social communicator, supervisor/leader), and specific teaching content, methods, and assessment methods are suggested to develop these competencies. Educating residents to develop their competencies as teachers is very important as a way to foster lifelong learning skills, help others, and assist in leadership roles.

Keywords

References

  1. Hill AG, Yu TC, Barrow M, Hattie J. A systematic review of resident-as-teacher programmes. Med Educ. 2009;43(12):1129-40. https://doi.org/10.1111/j.1365-2923.2009.03523.x
  2. Michael SH, Rougas S, Zhang XC, Clyne B. A content analysis of the ACGME specialty milestones to identify performance indicators pertaining to the development of residents as educators. Teach Learn Med. 2019;31(4):424-33. https://doi.org/10.1080/10401334.2018.1560298
  3. Ahn D. Korean doctor's role. J Korean Med Assoc. 2014;57(1):3-7. https://doi.org/10.5124/jkma.2014.57.1.3
  4. Act on the Improvement of Training Conditions and Status of Medical Residents [Internet]. Sejong: Korea Ministry of Government Legislation; 2019 [cited 2020 Nov 30]. Available from: https://www.law.go.kr/LSW/eng/engLsSc.do?menuld=2§ion=lawNm&query=ACT+ON+THE+IMPROVEMENT+OF+TRAINING+CONDITIONS+AND+STATUS+OF+MEDICAL+RESIDENTS&x=38&y=27#liBgcolor1.
  5. Smith CC, Newman LR, Huang GC. Those who teach, can do: characterizing the relationship between teaching and clinical skills in a residency program. J Grad Med Educ. 2018;10(4):459-63. https://doi.org/10.4300/jgme-d-18-00039.1
  6. Good medical practice [Internet]. London: General Medical Council; 2013 [cited 2020 Nov 30]. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/good-medical-practice.
  7. Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system: rationale and benefits. N Engl J Med. 2012;366(11):1051-6. https://doi.org/10.1056/NEJMsr1200117
  8. Ahn D, Kwon B, Kwon S, Kim B, Lee Y, Jeon Y. Development of generic curriculum for graduate medical education. Seoul: Korean Institute of Medical Education and Evaluation; 2009.
  9. Lee S, Park J, Kim W, Kim J, Park S, Lee S. Residents' experiences, perceptions, and competencies of Resident-as-Learner and Teacher (RALT) in postgraduate medical education. Seoul: Korea Institute of Medical Education and Evaluation; 2014.
  10. The Korean Association of Internal Medicine. Resident's annual training curriculum [Internet]. Seoul: The Korean Association of Internal Medicine; 2020 [cited 2020 Nov 30]. Available from: https://www.kaim.or.kr/major/?sn=1.
  11. ASK2019 (Accreditation Standards of KIMEE 2019): Basic Medical Education Accreditation Standards [Internet]. Seoul: The Korean Institute of Medical Education and Evaluation; 2020 [cited 2020 Nov 30]. Available from: https://kimee.or.kr/en/standards/the-new-standards-for-accredication.
  12. Milestones guidebook for residents and fellows [Internet]. Chicago (IL): Accreditation Council for Graduate Medical Education; 2020 [cited 2020 Nov 30]. Available from: https://www.acgme.org/Portals/0/PDFs/Milestones/MilestonesGuidebookforResidentsFellows.pdf.
  13. ACGME core competencies: general competencies [Internet]. Chicago (IL): Accreditation Council for Graduate Medical Education; 2020 [cited 2020 Nov 30]. Available from: https://health.usf.edu/medicine/surgery/general/residency/acgme.
  14. Frank JR, Snell L, Sherbino J. CanMEDS 2015 physician competency framework [Internet]. Ottawa: Royal College of Physician and Surgeons of Canada; 2015 [cited 2020 Nov 30]. Available from: https://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e.
  15. CanMEDS scholar [Internet]. Ottawa: Royal College of Physician and Surgeons of Canada; 2015 [cited 2020 Nov 30]. Available from: https://www.royalcollege.ca/rcsite/canmeds/framework/canmeds-role-scholar-e.
  16. Geary A, Hess DT, Pernar LIM. Resident-as-teacher programs in general surgery residency: a review of published curricula. Am J Surg. 2019;217(2):209-13. https://doi.org/10.1016/j.amjsurg.2018.09.003
  17. Al Achkar M, Hanauer M, Morrison EH, Davies MK, Oh RC. Changing trends in residents-as-teachers across graduate medical education. Adv Med Educ Pract. 2017;8:299-306. https://doi.org/10.2147/AMEP.S127007
  18. Mann KV, Sutton E, Frank B. Twelve tips for preparing residents as teachers. Med Teach. 2007;29(4):301-6. https://doi.org/10.1080/01421590701477431
  19. Ko SM, Choi SH. Residents who work 130 hours a week, "keep at least 80 hours a week". The Chosunilbo [Internet]. 2019 Feb 14 [cited 2020 Nov 30]. Available from: https://www.chosun.com/site/data/html_dir/2019/02/14/2019021402032.html.
  20. Morrison EH, Rucker L, Boker JR, Gabbert CC, Hubbell FA, Hitchcock MA, et al. The effect of a 13-hour curriculum to improve residents' teaching skills: a randomized trial. Ann Intern Med. 2004;141(4):257-63. https://doi.org/10.7326/0003-4819-141-4-200408170-00005
  21. McKeon BA, Ricciotti HA, Sandora TJ, Ramani S, Pels R, Miloslavsky EM, et al. A consensus guideline to support resident-as-teacher programs and enhance the culture of teaching and learning. J Grad Med Educ. 2019;11(3):313-8. https://doi.org/10.4300/JGME-D-18-00612.1
  22. Messman A, Kryzaniak SM, Alden S, Pasirstein MJ, Chan TM. Recommendations for the development and implementation of a residents as teachers curriculum. Cureus. 2018;10(7):e3053.
  23. Smith CC, McCormick I, Huang GC. The clinician-educator track: training internal medicine residents as clinician-educators. Acad Med. 2014; 89(6):888-91. https://doi.org/10.1097/ACM.0000000000000242
  24. Barth RJ Jr, Rowland-Morin PA, Mott LA, Burchard KW. Communication effectiveness training improves surgical resident teaching ability. J Am Coll Surg. 1997;185(6):516-9. https://doi.org/10.1016/S1072-7515(97)00112-9
  25. Rivera V, Yukawa M, Aronson L, Widera E. Teaching geriatric fellows how to teach: a needs assessment targeting geriatrics fellowship program directors. J Am Geriatr Soc. 2014;62(12):2377-82. https://doi.org/10.1111/jgs.13187
  26. Liaison Committee on Medical Education. Functions and structure of a medical school: standards for accreditation of medical education programs leading to the MD degree. Washington (DC): Liaison Committee on Medical Education; 2007.
  27. Dunnington GL, DaRosa D. A prospective randomized trial of a residents-as-teachers training program. Acad Med. 1998;73(6):696-700. https://doi.org/10.1097/00001888-199806000-00017
  28. Sturpe DA, Schaivone KA. A primer for objective structured teaching exercises. Am J Pharm Educ. 2014;78(5):104. https://doi.org/10.5688/ajpe785104
  29. Geary AD, Hess DT, Pernar LIM. Resident-as-teacher programs in general surgery residency: context and characterization. J Surg Educ. 2019;76(5):1205-10. https://doi.org/10.1016/j.jsurg.2019.03.004
  30. Pernar LI, Corso K, Lipsitz SR, Breen E. Using spaced education to teach interns about teaching skills. Am J Surg. 2013;206(1):120-7. https://doi.org/10.1016/j.amjsurg.2012.05.034
  31. Watkins AA, Gondek SP, Lagisetty KH, Castillo-Angeles M, Gangadharan SP, Cahalane MJ, et al. Weekly e-mailed teaching tips and reading material influence teaching among general surgery residents. Am J Surg. 2017;213(1):195-201. https://doi.org/10.1016/j.amjsurg.2016.05.004
  32. Jochemsen-van der Leeuw HG, van Dijk N, van Etten-Jamaludin FS, Wieringa-de Waard M. The attributes of the clinical trainer as a role model: a systematic review. Acad Med. 2013;88(1):26-34. https://doi.org/10.1097/ACM.0b013e318276d070
  33. ACGME milestones guidebook for residents and fellows [Internet]. Chicago (IL): Accreditation Council for Graduate Medical Education; 2020 [cited 2020 Nov 30]. Available from: https://www.acgme.org/Portals/0/PDFs/Milestones/MilestonesGuidebookforResidentsFellows.pdf.
  34. Burke AE, Benson B, Englander R, Carraccio C, Hicks PJ. Domain of competence: practice-based learning and improvement. Acad Pediatr. 2014;14(2 Suppl):S38-54.
  35. Sawatsky AP, Ratelle JT, Bonnes SL, Egginton JS, Beckman TJ. Faculty support for self-directed learning in internal medicine residency: a qualitative study using grounded theory. Acad Med. 2018;93(6):943-51. https://doi.org/10.1097/acm.0000000000002077
  36. Li ST, Paterniti DA, Co JP, West DC. Successful self-directed lifelong learning in medicine: a conceptual model derived from qualitative analysis of a national survey of pediatric residents. Acad Med. 2010;85(7):1229-36. https://doi.org/10.1097/ACM.0b013e3181e1931c
  37. Kwon HJ, Lee YM, Chang HJ, Kim AR. Needs assessment of a core curriculum for residency training. Korean J Med Educ. 2015;27(3):201-12. https://doi.org/10.3946/kjme.2015.27.3.201