Engaged at the extremes:  residents' perspectives on clinical teaching assessment.
OBJECTIVE
Although academic centers rely on assessments from medical trainees regarding the effectiveness of their faculty as teachers, little is known about how trainees conceptualize and approach their role as assessors of their clinical supervisors.


METHODS
In 2010, using a constructivist grounded theory approach, five focus group interviews were conducted with 19 residents from an internal medicine residency program. A constant comparative analysis of emergent themes was conducted.


RESULTS
Residents viewed clinical teaching assessment (CTA) as a time-consuming task with little reward. They reported struggling throughout the academic year to meet their CTA obligations and described several shortcut strategies they used to reduce their burden. Rather than conceptualizing their assessments as a conduit for both formative and summative feedback, residents perceived CTA as useful for the surveillance of clinical supervisors at the extremes of the spectrum of teaching effectiveness. They put the most effort, including the crafting of written comments, into the CTAs of these outliers. Trainees desired greater transparency in the CTA process and were skeptical regarding the anonymity and perceived validity of their faculty appraisals.


CONCLUSIONS
Individual and system-based factors conspire to influence postgraduate medical trainees' motivation for generating high-quality appraisals of clinical teaching. Academic centers need to address these factors if they want to maximize the usefulness of these assessments.
Division of General Internal Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada. Kathryn.myers@sjhc.london.on.ca
Kathryn
K
Myers
Elaine M
EM
Zibrowski
Lorelei
L
Lingard
D001291:Attitude of Health Personnel; D004650:Employee Performance Appraisal / Q000379:methods*; D005180:Faculty, Medical / Q000458:organization & administration*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007388:Internal Medicine / Q000193:education* / Q000458:organization & administration; D007396:Internship and Residency; D008297:Male; D009042:Motivation; D009864:Ontario; D013663:Teaching / Q000458:organization & administration*