Related Experiment Videos
Factor instability of clinical teaching assessment scores among general internists and cardiologists
Thomas J Beckman1, David A Cook, Jayawant N Mandrekar
1Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA. Beckman.Thomas@mayo.edu
Insights
Teaching assessment scores show instability across medical specialties. The interpersonal and clinical teaching domains collapsed into one for cardiologists, unlike general internists, highlighting the need for context-specific validation.
Area of Science:
- Medical Education Research
- Assessment Validation
- Specialty-Specific Pedagogy
Background:
- Limited research exists on the stability of teaching assessment scores across diverse medical specialties.
- Previous studies identified three domains (interpersonal, clinical teaching, efficiency) in general internal medicine assessments.
- The current study investigates the applicability of this model in cardiology.
Purpose of the Study:
- To determine the factor stability of a three-dimensional clinical teaching assessment model in cardiology.
- To compare domain-specific teaching assessment scores between general internists and cardiologists.
Main Methods:
- Principal factor analysis of 2000 hospital teaching assessments (general internal medicine and cardiology) from 2000-2004.
- Calculation of internal consistency (Cronbach's alpha) and inter-rater reliability.
- Comparison of mean item scores between the two specialties.
Main Results:
- The interpersonal and clinical teaching domains merged into a single domain for cardiologists, while the efficiency domain remained stable.
- Both specialties demonstrated good to excellent internal consistency (Cronbach's alpha 0.89-0.93) and inter-rater reliability (0.65-0.87).
- General internists generally scored higher than cardiologists, except on items specific to the cardiology teaching environment.
Conclusions:
- Significant factor instability was observed in clinical teaching assessment scores when using the same instrument for general internists and cardiologists.
- Differences in educational environments between specialties likely account for the observed instability.
- Assessment instruments require validation within specific educational contexts to ensure accurate measurement.
Context:
We are unaware of studies examining the stability of teaching assessment scores across different medical specialties. A recent study showed that clinical teaching assessments of general internists reduced to interpersonal, clinical teaching and efficiency domains. We sought to determine the factor stability of this 3-dimensional model among cardiologists and to compare domain-specific scores between general internists and cardiologists.
Methods:
A total of 2000 general internal medicine and cardiology hospital teaching assessments carried out from January 2000 to March 2004 were analysed using principal factor analysis. Internal consistency and inter-rater reliability were calculated. Mean item scores were compared between general internists and cardiologists.
Results:
The interpersonal and clinical teaching domains previously demonstrated among general internists collapsed into 1 domain among cardiologists, whereas the efficiency domain remained stable. Internal consistency of domains (Cronbach's alpha range 0.89-0.93) and inter-rater reliability of items (range 0.65-0.87) were good to excellent for both specialties. General internists scored significantly higher (P<0.05) than cardiologists on most items except for 4 items that more accurately assessed the cardiology teaching environment.
Conclusions:
We observed factor instability of clinical teaching assessment scores from the same instrument administered to general internists and cardiologists. This finding was attributed to salient differences between these specialties' educational environments and highlights the importance of validating assessments for the specific contexts in which they are to be used. Future research should determine whether interpersonal domain scores identify superior teachers and study the reasons why interpersonal and clinical teaching domains are unstable across different educational settings.
Related Concept Videos
Regression Toward the Mean
Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
Errors occurring during blood pressure monitoring
Several factors...
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Fundamental Attribution Error