What motivates residents to teach? The Attitudes in Clinical Teaching study.
BACKGROUND
Graduate medical trainees have a critical role in the teaching of other trainees. Improving their teaching requires an understanding of their attitudes towards teaching and their motivation to teach. Both have been incompletely explored in this population. We aimed to better understand graduate medical trainees' attitudes towards teaching and motivation to teach in the clinical setting in order to inform modifications to resident-as-teacher (RAT) programmes and enhance teaching practices.


METHODS
We applied Q methodology, an established sorting method, to identify and quantify the factors that have an impact on trainees' engagement in teaching. We invited house officers at our institution to rank-order 47 statements regarding their attitudes to and motivation for teaching. Respondents explained their Q-sort rankings in writing and completed a demographic questionnaire. By-person factor analysis yielded groups of individuals with similar attitudes.


RESULTS
One hundred and seven trainees completed the Q-sort. We found three primary groups of attitudes towards teaching in the clinical setting: enthusiasm, reluctance and rewarded. Enthusiastic teachers are committed and make time to teach. Teaching increases their job satisfaction. Reluctant teachers have enthusiasm but are earlier in training and feel limited by clinical workload and unprepared. Rewarded teachers feel teaching is worthwhile and derive satisfaction from the rewards and recognition they receive for teaching.


CONCLUSIONS
This improved understanding of common attitudes shared by groups of residents will help curriculum designers create RAT programmes to further reinforce and encourage attitudes that promote teaching as well as improve trainees' motivation to teach. Designing RAT programmes that acknowledge the attitudes to and motivations for teaching should help develop effective teachers to improve educational outcomes. Directed efforts to enhance motivation for reluctant teachers and encourage more positive attitudes in rewarded teachers may lead to improved teaching behaviours among residents.
Division of Maternal Fetal Medicine, University of North Carolina, Chapel Hill, North Carolina, USA.
Sarah
S
Dotters-Katz
Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Charles W
CW
Hargett
Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina, USA.
Aimee K
AK
Zaas
Division of Rheumatology and Immunology, Duke University Medical Center, Durham, North Carolina, USA.
Lisa G
LG
Criscione-Schreiber
D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D009042:Motivation; D009657:North Carolina; D010549:Personal Satisfaction; D013337:Students, Medical / Q000523:psychology*; D013663:Teaching / Q000523:psychology*