EVALUATION OF CLINICAL TEACHING BY GENERAL INTERNAL-MEDICINE FACULTY IN OUTPATIENT AND INPATIENT SETTINGS

Purpose. To determine the measurement characteristics of a form used t o evaluate teaching in outpatient settings, and to compare ratings rec eived by general internists in outpatient and inpatient settings. Meth od. The physicians evaluated were 29 faculty who taught in both outpat ient and inpatient settings affiliated with the Department of Medicine , University of Washington School of Medicine, over a five-year period (from 1985 - 86 through 1989-90). Residents completed 639 evaluations , using a six-point Likert-type scale (from 1, very poor, to 6, excell ent) to rate instructors in eight categories and to provide an overall assessment of each instructor's teaching effectiveness. In addition, each evaluation contained an indication of the resident's perceived de gree of involvement with the instructor. Statistical analysis involved two-tailed t-tests, analysis of variance and covariance, intraclass c orrelation coefficients, and the Spearman Brown prophecy formula. Resu lts. When more than ten raters of teaching in outpatient settings were available, the reliabilities ranged from.58 to.81. The outpatient-set ting ratings were significantly lower than the inpatient-setting ratin gs for seven categories, overall teaching effectiveness (5.01 versus 5 .35, p < .05), and perceived degree of involvement of the instructor w ith the resident. When controlled for perceived degree of involvement, differences remained in only two categories: demonstration of clinica l skills, rated higher for outpatient settings, and instructor accessi bility, rated lower. Conclusion. The evaluation form provides reliable ratings of teaching in outpatient settings when more than ten raters are available. The differences found in the ratings between the inpati ent and outpatient settings may be explained by the factor of the resi dent's perceived degree of involvement with the instructor.