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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

Medical Education
|November 23, 2006
PubMed

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.
Abstract

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