Direct observation as a tool for needs assessment of resident teaching skills in the ambulatory setting

Objective This study was undertaken to develop and test a tool for direct observation of resident clinical teaching skills as a needs assessment before designing programs to improve teaching. Study design An 18-item checklist for a needs assessment of teaching skills was developed. Residents were observed teaching medical students while providing care in outpatient clinics. Teaching skills were documented by using the checklist, with each item assessed for performance only. Observations were compared across levels of resident education. Results Fifty-four encounters were observed and scored. There was no difference in frequency of skill performance with advancing level of training. Items relating to orientation and feedback were observed less frequently than other skills. Conclusion The combination of the needs assessment tool and direct observations was used to evaluate teaching skill deficiencies. This study confirmed the findings of the AAMC Medical Student Graduation Questionnaire (MSGQ) of the nationwide need to improve specific resident teaching skills.