Assessing the quality of clinical teachers: a systematic review of content and quality of questionnaires for assessing clinical teachers.
BACKGROUND
Learning in a clinical environment differs from formal educational settings and provides specific challenges for clinicians who are teachers. Instruments that reflect these challenges are needed to identify the strengths and weaknesses of clinical teachers.


OBJECTIVE
To systematically review the content, validity, and aims of questionnaires used to assess clinical teachers.


METHODS
MEDLINE, EMBASE, PsycINFO and ERIC from 1976 up to March 2010.


METHODS
The searches revealed 54 papers on 32 instruments. Data from these papers were documented by independent researchers, using a structured format that included content of the instrument, validation methods, aims of the instrument, and its setting.


RESULTS
Aspects covered by the instruments predominantly concerned the use of teaching strategies (included in 30 instruments), supporter role (29), role modeling (27), and feedback (26). Providing opportunities for clinical learning activities was included in 13 instruments. Most studies referred to literature on good clinical teaching, although they failed to provide a clear description of what constitutes a good clinical teacher. Instrument length varied from 1 to 58 items. Except for two instruments, all had to be completed by clerks/residents. Instruments served to provide formative feedback ( instruments) but were also used for resource allocation, promotion, and annual performance review (14 instruments). All but two studies reported on internal consistency and/or reliability; other aspects of validity were examined less frequently.


CONCLUSIONS
No instrument covered all relevant aspects of clinical teaching comprehensively. Validation of the instruments was often limited to assessment of internal consistency and reliability. Available instruments for assessing clinical teachers should be used carefully, especially for consequential decisions. There is a need for more valid comprehensive instruments.
Fluit
Cornelia R M G
CR
Department for Evaluation, Quality and Development of Medical Education, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. C.Fluit@owi.umcn.nl
Bolhuis
Sanneke
S
Grol
Richard
R
Laan
Roland
R
Wensing
Michel
M
D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement / Q000379:methods / Q000592:standards*; D005180:Faculty, Medical / Q000592:standards*; D006801:Humans; D011795:Surveys and Questionnaires / Q000592:standards*; D013663:Teaching / Q000379:methods / Q000592:standards*