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Appraising my Teaching Skills using MSF

Appraising my Teaching Skills using MSF






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    Appraising my Teaching Skills using MSF Appraising my Teaching Skills using MSF Presentation Transcript

    • Appraising my ‘IMPROMPTU WARD-BASED Teaching’
      Dr Colin Mitchell
      MSc Geriatric Medicine
      June 2009
    • Choosing a Topic
      I know some of my strengths as a teacher:
      Can explain complex concepts
      Keen to teach
      And I’m aware of my weaknesses
      Prone to long-windedness
      Can over-elaborate
      I already know to concentrate on the known weaknesses
      But are there any issues that I’m not fully aware of?
    • Is this right?
      Previous 360o feedback
      ‘Can be intimidating’
      Jars with my self-image
      Could interfere with a conducive learning environment
    • The MSF - Keeping it simple
      Aim to focus on the learning environment
      Is the environment conducive to learning?
      Relaxed / Intimidating
      Is some pressure a good thing?
      Further focus on one skill: ward-based teaching (WBT)
      Multiple exposures, multiple sources of feedback
      Just F1s
    • Assessing Educational Environment
      DREEM - Dundee Ready Educational Environment Measure*
      50 Questions – agree / disagree
      Based on instruments in use for 40 years
      Designed by 80+ experts using the Delphi process
      Statistically validated to focus on reliable / discriminatory elements
      Used worldwide to assess medical school teaching
      *Roff et al, 1997. “Development and validation of the DREEM. Medical Teacher 19:4, 205-209
    • Refining the Quantitative
      Principles of choosing the items*:
      Clear, concise, focused and simple
      Some balance of +ve and –ve (DREEM 82% +ve)
      Chose 7 from DREEM (slightly adapted)
      Added 4 of my own
      Some concordance, not repetition
      8 +ve, 3 -ve
      *Adapted from Berk (2006), 13 Strategies to Measure College Teaching. Stylus: Virginia
    • Choosing the scale
      DREEM uses 5-point bipolar ‘intensity’ anchors:
      Strongly Agree
      Strongly disagree
      Simple but allows a breadth of response
      Still sufficiently granular & simple
      Balanced (✔) and has a midpoint (?✔)
    • Defining the Qualitative
      Opportunity to explore particular issues more fully
      Correlate with quantitative themes
    • Defining the Qualitative
      Opportunity to explore particular issues more fully
      Correlate with quantitative themes
    • Making it anonymous - online
      MSF in UK training – anonymous. In industry – 97% anonymous
      “Maintaining the anonymity of the rater’s feedback is key to the process. Just as a tie to compensation can lead raters to soften their ratings, so can a lack of anonymity”*
      “…when peer assessment is used in a high stakes setting, it results in inflated estimates of performance... There is no way to completely avoid this issue but it may help to ensure the anonymity of evaluators”**
      Online forms preserve anonymity - This can be made clear in the MSF
      Rogers E et al, 2002. “Improving the Payoff from 360-Degree Feedback”. Human Resource Development. 25: 44-54
      **Norcini J, 2003. “Peer assessment of competence”. Medical Education. 37(6): 539-543
    • Validation
      Cannot empirically validate without significant resources
      Using 7 items from the DREEM – pre-validated
      My own questions must be logically validated
      Representative pilot
      Sent to 5 SHOs. 4 replied with comments (unstructured)
      Minor adjustments made to wording, stressing anonymity
    • Results
    • Rater Scores (% of Maximum)
    • Question Scores (Fractions of 100%)
    • Scoring
      For negative aspects the score is reversed
      Therefore: Higher score is a good thing
    • Academic Perceptions
    • Perception of the Teacher
    • Teaching Atmosphere
    • Free Responses (1)
      What are the strengths of my ward-based teaching?
      When a situation arises you take time to discuss the case (23/44*)
      Enthusiastic and approachable… make[s] the learner think the problem through in a logical manner (30/40)
      …instead of just giving an answer, you get us to think through the problem and help us work out the solution ourselves (24/44)
      *Commenter’s overall score for quantitative elements shown in parentheses
    • Free Responses (2)
      What do you like LEAST about my style of ward-based teaching? (Only 5/11 replied)
      Sometimes assume too much which can be uncomfortable (20/40)
      Sometimes can go into a lot of depth for too long (26/44)
      … on some occasions it would be easier to get an answer, especially when it gets busy, but I would not learn as well… (24/44)
      Sometimes it becomes a little didactic (25/44)
    • Free Responses (3)
      How does the pressure of on-the-spot quizzing affect your learning (+vely or –vely)?
      (In the US, “Pimping”generally viewed positively*)
      8/11 were generally positive, 2 didn’t answer
      Only negative response:
      Too pressurizing and can be intimidating and lead to not wanting to ask for teaching (29/44)
      *Wear D et al, 2005. “Pimping: perspectives of 4th year medical students”. Teaching and Learning in Medicine. 17(2) 184-191
    • Free Responses (4)
      Every teacher can improve his skills – how would you suggest I improve my ward-based teaching?
      Be a bit more aware of when people have got lost in your explanations (20/40)
      You are a good teacher and have a lot of knowledge, but could improve by talking more succinctly and not rambling (26/44)
      There is very little to improve on, your teaching is excellent (25/44)
      I think sometimes you loose [sic] the balance and focus too much on teaching rather than seeing the patients… and thus even though your teaching is good, you are not setting a good example for juniors (28/40)
    • Analysis
    • Robust?
      Some basic statistical analysis of average total score:
      Median = average (59%, around a 2.5)
      95% CI: ±19%
      Some observations can be made:
      Lower scorers more likely to give a critique in the weaknesses question
      Poor correlation between ridicule / intimidating / relaxed questions.
      The lowest scorer commented: “the relaxed manner of teaching is definitely a good approach”
      He/she also disagreed with the ‘relaxed atmosphere’ item (?)
    • Findings – My Teaching
      Quantitative results
      Overall positive (59% compares with DREEM results)
      I can be intimidating
      Yet the atmosphere is generally relaxed (=3rd highest scoring item)
      3 comments specifically mentioned friendly / approachable
      Themes emerging from qualitative results
      Rambling / long-windedness
      Correlates with ‘teacher-centred’
      Few negative comments about atmosphere
      Only one comment directly mentioned ‘intimidating’ or synonyms.
      Also note comment about assuming too much = ‘uncomfortable’
      This rater also agreed with both the intimidate and ridicule questions
    • Findings – The Process
      Getting good feedback is more difficult than it seems
      Limiting scope
      Using validated questions
      Anonymous data entry
      The results didn’t tell me much I didn’t already know
      Partially corroborated ‘intimidating’ problem
      Confirmed ‘long-winded’ problem
    • assimilation
      Borg Cube by Martin Teufel - http://www.infosun.fim.uni-passau.de/br/lehrstuhl/Sommercamp/virtualworld/2005/galerie/
    • How I see myself
      Image from http://www.theinsider.com/photos/1079058_TOM_CRUISE_FOR_TOP_GUN_2. Top Gun - Paramount Pictures.
    • How I see myself
    • YOU BOY!
      What I need to avoid:
      Val-de ha ha ha ha ha ha!
    • Further Actions
      I may not be intimidating to most…
      But clearly a few may find me so
      How do I know who they are?
      What do I do about it?
      Design my own feedback forms for my teaching sessions
      Add demographics
      Push for free-text responses
      Don’t be afraid of constructive criticism
      Criticism is worst when I don’t know how to fix the problem
    • Questions?
      Email: drcolinmitchell@gmail.com
      Twitter: @drcolinmitchell