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The teacher and learner interactive assessment system (TeLIAS): a new tool to assess teaching behaviors in the
Jeffrey L Jackson1, Patrick G O'Malley, Stephen M Salerno
1Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA. jejackson@usuhs.mil
Background:
There are no objective tools to assess ambulatory teaching, an increasingly important component of medical education.
Purpose:
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.