A PROSPECTIVE RANDOMIZED TRIAL OF A RESIDENTS-AS-TEACHERS TRAINING-PROGRAM

Purpose. To develop, implement, and evaluate a course for improving th e teaching skills of surgery residents. Method. Responses from residen ts at four general surgery training programs to a needs assessment sur vey were used to develop a two-day course for improving teaching skill s. Residents at two surgical training programs were randomly assigned to experimental and control groups, and experimental residents partici pated in and evaluated the newly devised course. Six to seven months l ater, experimental and control residents' teaching performances were e valuated using a five-station objective structured teaching evaluation (OSTE). Differences between the residents' performances were calculat ed using Mann-Whitney U, chi-square analysis, or Fisher's exact test. Results. Participating residents rated the course highly. They conside red the interactive nature of the course its greatest strength. As mea sured by the OSTE, the performances of the residents differed least si gnificantly in the feedback station, where the residents in the experi mental groups showed significant improvement on only one of seven item s at one institution, and only one of nine items at the other, The gre atest differences occurred in the microskills teaching station, where the residents at one institution performed significantly better than d id their control counterparts on four of five items and in overall per formance. Conclusion. This study demonstrates the value of a needs ass essment in developing a course to improve residents' teaching skills. Such courses must provide active learning with opportunities for pract icing skills and, following the course, ongoing feedback to maintain c hanges in teaching behaviors. The curriculum developed in this study h as been put into a transportable form that includes an instructor's ma nual providing guidelines and suggestions for implementation.