title: How reliable are assessments of clinical teaching? A review of the published instruments.
abstract: BACKGROUND
  Learner feedback is the primary method for evaluating clinical faculty, despite few existing standards for measuring learner assessments.
  
  
  OBJECTIVE
  To review the published literature on instruments for evaluating clinical teachers and to summarize themes that will aid in developing universally appealing tools.
  
  
  METHODS
  Searching 5 electronic databases revealed over 330 articles. Excluded were reviews, editorials, and qualitative studies. Twenty-one articles describing instruments designed for evaluating clinical faculty by learners were found. Three investigators studied these papers and tabulated characteristics of the learning environments and validation methods. Salient themes among the evaluation studies were determined.
  
  
  RESULTS
  Many studies combined evaluations from both outpatient and inpatient settings and some authors combined evaluations from different learner levels. Wide ranges in numbers of teachers, evaluators, evaluations, and scale items were observed. The most frequently encountered statistical methods were factor analysis and determining internal consistency reliability with Cronbach's alpha. Less common methods were the use of test-retest reliability, interrater reliability, and convergent validity between validated instruments. Fourteen domains of teaching were identified and the most frequently studied domains were interpersonal and clinical-teaching skills.
  
  
  CONCLUSIONS
  Characteristics of teacher evaluations vary between educational settings and between different learner levels, indicating that future studies should utilize more narrowly defined study populations. A variety of validation methods including temporal stability, interrater reliability, and convergent validity should be considered. Finally, existing data support the validation of instruments comprised solely of interpersonal and clinical-teaching domains.
authors.affiliation: Department of Internal Medicine, Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic, Mayo Foundation, Rochester, MN, USA. Beckman.Thomas@mayo.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Beckman
authors.forename: Amit K
authors.initials: AK
authors.lastname: Ghosh
authors.forename: David A
authors.initials: DA
authors.lastname: Cook
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Erwin
authors.forename: Jayawant N
authors.initials: JN
authors.lastname: Mandrekar
mesh_terms: D000046:Academic Medical Centers; D005069:Evaluation Studies as Topic; D005163:Factor Analysis, Statistical; D005180:Faculty, Medical; D006801:Humans; D015203:Reproducibility of Results; D013663:Teaching