The teacher and learner interactive assessment system (TeLIAS): a new tool to assess teaching behaviors in the ambulatory setting.
BACKGROUND
There are no objective tools to assess ambulatory teaching, an increasingly important component of medical education.


OBJECTIVE
To develop and describe an objective ambulatory teaching tool.


METHODS
Exactly 30 consecutive ambulatory teaching encounters were audio taped. Audio tapes were transcribed and teacher-learner utterances were qualitatively analyzed by 3 coders using a grounded theory approach.


RESULTS
A total of 4,560 utterances were coded: 1/3 were devoted to case presentations, and the remainder to case discussion. Most learner utterances conveyed factual patient information; only 7% conveyed learner thoughts on diagnosis or management. Attending utterances were equally divided between questions, statements of fact, and management statements. Most attending questions (75%) asked patient or medical facts; few were of a higher-level asking learners to analyze, synthesize, or apply content. Feedback, although common (10%), consisted of mostly minimal statements such as "right" or "I agree." At the bedside, 80% of utterances were by the teacher.


CONCLUSIONS
This is a feasible tool that reliably documents ambulatory teacher and learner behaviors and may be useful for educational research and faculty development.
Jackson
Jeffrey L
JL
Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA. jejackson@usuhs.mil
O'Malley
Patrick G
PG
Salerno
Stephen M
SM
Kroenke
Kurt
K
D000553:Ambulatory Care / Q000458:organization & administration*; D004501:Education, Medical / Q000379:methods* / Q000592:standards; D005069:Evaluation Studies as Topic; D006801:Humans; D007400:Interprofessional Relations; D013637:Tape Recording; D013663:Teaching / Q000379:methods* / Q000592:standards