Review Article

Teaching to Teach: A Scoping Review of Teaching Skill–Development Programs across Medical Education

Authors: Alicia Darwin, MD, Ashley Mason, MD, Alyssa Faye Clare, BS, Sarah Nestler, BS, Antoinette Spoto-Cannons, MD

Abstract

Objectives: Teaching is an integral part of the day-to-day responsibilities of physicians and physicians-in-training. We provide an overview across the medical education continuum of who is being trained how to teach, the methods of delivery used, and the effectiveness of the program in improving teacher confidence and teaching skills to improve the execution of teaching training programs.

Methods: In October 2020, the authors conducted a scoping review, systematically searching six databases (PubMed, Embase, MEDLINE, Cochrane, Cumulative Index to Nursing and Allied Health Literature, and Web of Science) for literature dating back to 2010 describing interventions aimed at teaching physicians or physicians-in-training how to teach effectively. Four authors screened the articles for inclusion based on title and key words. Four authors reviewed all of the articles selected to identify key features, including manuscript citation, study design, study institution, demographic information, course description, and efficacy, and entered the data into a Qualtrics survey. Two authors then analyzed the data extracted.

Results: Of 23,409 potentially eligible studies, 163 were included. The populations studied included medical students (17%), residents (55%), fellows (13%), faculty/attendings (23%), and other (4%). The length of the training interventions ranged from half a day or less to longer than 1 year. Multiple instructional methods were used including lecture (71), observed teaching in action (71), case-based learning (34), learner feedback (24), modules (25), objective structured teaching exercises (19), essays/writing assignments (11), portfolio and/or personal teaching philosophy development (5), and tests/examinations (4). Evaluation methods varied, and efficacy was measured by an improvement in confidence in teaching abilities (61), in self-reported teaching abilities (59), objective structured teaching exercises scores (3), and an increased interest in academic medicine (33).

Conclusions: Current programs designed to teach medical students, residents, and physicians how to teach vary widely. We propose that future research is needed to advance the instruction of physicians and physicians-in-training on how to be effective clinical educators.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Cameron JL. William Stewart Halsted. Our surgical heritage. Ann Surg 1997;225:445.
 
2. Mason W, Strike P. See one, do one, teach one—is this still how it works? A comparison of the medical and nursing professions in the teaching of practical procedures. Med Teach 2003;25: 664–666.
 
3. Chokshi BD, Schumacher HK, Reese K, et al. A “resident-as-teacher” curriculum using a flipped classroom approach: can a model designed for efficiency also be effective? Acad Med 2017;92:511–514.
 
4. Dunnington GL, DaRosa D. A prospective randomized trial of a residents-as-teachers training program. Acad Med 1998;3:696–700. .
 
5. Gaba ND, Blatt B, Macri CJ, et al. Improving teaching skills in obstetrics and gynecology residents: evaluation of a residents-as-teachers program. Am J Obstet Gynecol 2007;196:87. e1–87.e7.
 
6. Ilgen JS, Takayesu JK, Bhatia K, et al. Back to the bedside: the 8-year evolution of a residentas-teacher rotation. J Emerg Med 2011;41:190–195.
 
7. Morrison EH, Hafler JP. Yesterday a learner, today a teacher too: residents as teachers in 2000. Pediatrics 2000;105(Suppl 2):238–241.
 
8. Ostapchuk M, Patel PD, Miller KH, et al. Improving residents’ teaching skills: a program evaluation of residents as teachers course. Med Teach 2010;32:e49–e56.
 
9. Wachtel J, Greenberg MR, Smith AB, et al. Residents as teachers: residents’ perceptions before and after receiving instruction in clinical teaching. J Am Osteopath Assoc 2013;113:23–33.
 
10. Zackoff M, Jerardi K, Unaka N, et al. An observed structured teaching evaluation demonstrates the impact of a resident-as-teacher curriculum on teaching competency. Hosp Pediatr 2015;5:342–347.
 
11. Zackoff M, Real FJ, DeBlasio D, et al. Objective assessment of resident teaching competency through a longitudinal, clinically integrated, resident-as-teacher curriculum. Acad Pediatr 2019;19:698–702.
 
12. Junod Perron N, Nendaz M, Louis-Simonet M, et al. Effectiveness of a training program in supervisors’ ability to provide feedback on residents’ communication skills. Adv Health Sci Educ 2013;18:901–915.
 
13. Lu WH, Mylona E, Lane S, et al. Faculty development on professionalism and medical ethics: the design, development and implementation of objective structured teaching exercises (OSTEs). Med Teach 2014;36:876–882.
 
14. Ottolini M, Wohlberg M, Lewis K, et al. Using observed structured teaching exercises (OSTE) to enhance hospitalist teaching during family centered rounds. J Hosp Med 2011;6:423–427.
 
15. Smith MA, Cherazard R, Fornari A, et al. A unique approach to faculty development using an observed structured teaching encounter (OSTE). Med Educ Online 2018;23:1527627.
 
16. Stone S, Mazor K, Devaney-O'Neill S, et al. Development and implementation of an objective structured teaching exercise (OSTE) to evaluate improvement in feedback skills following a faculty development workshop. Teach Learn Med 2003;15:7–13.
 
17. Trowbridge RL, Snydman LK, Skolfield J, et al. A systematic review of the use and effectiveness of the objective structured teaching encounter. Med Teach 2011;33:893–903.
 
18. Pasquinelli LM, Greenberg LW. A review of medical school programs that train medical students as teachers (MED-SATS). Teach Learn Med 2008;20:73–81.
 
19. Soriano RP, Blatt B, Coplit L, et al. Teaching medical students how to teach: a national survey of students-as-teachers programs in U.S. medical schools. Acad Med 2010;85:1725–1731.
 
20. Hill AG, Yu T, Barrow M, et al. A systematic review of resident-as-teacher programmes. Med Educ 2009;43:1129–1140.
 
21. Post RE, Quattlebaum RG, Benich JJ, 3rd. Residents-as-teachers curricula: a critical review. Acad Med 2009;84:374–380.
 
22. Clark JM, Houston TK, Kolodner K, et al. Teaching the Teachers National Survey of Faculty Development in departments of medicine of U.S. teaching hospitals. J Gen Intern Med 2004; 19:205–214.
 
23. Steinert Y, Mann K, Centeno A, et al. A systematic review of faculty development initiatives designed to improve teaching effectiveness in medical education. Med Teach 2006;28:497–526.
 
24. Arksey H, O’Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005;8:19–32.
 
25. Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J 2009;26:91–108.
 
26. Levac D, Colquhoun H, O’Brien KK. Scoping studies: advancing the methodology. Implement Sci 2010;5:69.
 
27. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med 2018;169:467–473.
 
28. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Int J Surg 2021;88:105906.
 
29. Wamsley MA, Julian KA, Wipf JE. A literature review of “resident-as-teacher” curricula. J Gen Intern Med 2004;19(5 Part 2):574–581.
 
30. Bree KK, Whicker SA, Fromme HB, et al. Residents-as-teachers publications: what can programs learn from the literature when starting a new or refining an established curriculum? J Grad Med Educ 2014;6:237–248.
 
31. Meyer HS, Larsen K, Samuel A, et al. Teaching medical students how to teach: a scoping review. Teach Learn Med 2021;34:379–391.
 
32. Alexandraki I, Rosasco RE, Mooradian AD. An evaluation of faculty development programs for clinician–educators: a scoping review. Acad Med 2021;96:599–606.
 
33. Friedman K, Lester J, Young JQ. Clinician–educator tracks for trainees in graduate medical education: a scoping review. Acad Med 2019;94:1599–1609.
 
34. Steinert Y, Mann K, Anderson B, et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: a 10-year update: BEME guide no. 40. Med Teach 2016;38:769–786.
 
35. Marton GE, McCullough B, Ramnanan CJ. A review of teaching skills development programmes for medical students. Med Educ 2015;49:149–160.
 
36. Morrison EH, Friedland JA, Boker J, et al. Residents-as-teachers training in U.S. residency programs and offices of graduate medical education. Acad Med 2001;76(10 Suppl):S1–S4.
 
37. Accreditation Council for Graduate Medical Education. Institutional requirements. https://www.acgme.org/globalassets/pfassets/programrequirements/800_institutionalrequirements2022.pdf. Published September 26, 2021. Accessed February 18, 2022.
 
38. Liaison Committee on Medical Education. Functions and structure of a medical school. Standards for the accreditation of medical education programs leading to the M.D. degree. https://lcme.org/publications/#Standards. Accessed February 18, 2022.
 
39. Rodriguez-Linares Y, Keser Z, Ansoanuur G, et al. Empowering residents to enhance medical students’ education during their neurology clerkship (P2. 9-030). https://www.neurology.org/doi/10.1212/WNL.92.15_supplement.P2.9-030. Published April 9, 2019. Accessed February 18, 2022.
 
40. Bing-You RG, Sproul MS. Medical students’ perceptions of themselves and residents as teachers. Med Teach 1992;14(2-3):133–138. .
 
41. Chaalan T, Landis-Lewis D, O'Connor K, et al. Too many learners? Do students belong in resident continuity clinics? Obstet Gynecol 2019;134:52S.
 
42. Masters K. Edgar Dale’s pyramid of learning in medical education: a literature review. Med Teach 2013;35:e1584–e1593.
 
43. Davis DA, Thomson MA, Oxman AD, et al. Changing physician performance: a systematic review of the effect of continuing medical education strategies. JAMA 1995;274:700–705.
 
44. Palis AG, Quiros PA. Adult learning principles and presentation pearls. Middle East Afr J Ophthalmol 2014;21:114–122.
 
45. Cooper AZ, Richards JB. Lectures for adult learners: breaking old habits in graduate medical education. Am J Med 2017;130:376–381.
 
46. Pernar LI, Beleniski F, Rosen H, et al. Spaced education faculty development may not improve faculty teaching performance ratings in a surgery department. J Surg Educ 2012;69: 52–57.
 
47. Pernar LI, Corso K, Lipsitz SR, et al. Using spaced education to teach interns about teaching skills. Am J Surg 2013;206:120–127.
 
48. Matthiesen MI, Hiserodt J, Li CN, et al. Going virtual: objective structured teaching exercises as an innovative method for formative resident education. Acad Pediatr 2022;22:12–16.