Teaching is a core component of being a physician. Physicians are responsible for teaching medical students, residents, and peers in addition to teaching patients and families. It has been demonstrated that resident physicians provide substantial medical student teaching, particularly in clinical settings (1). Therefore, a residents-as-teachers’ curriculum which incorporates learning objectives that address knowledge, skills, attitudes and values related to teaching is an essential component of residency education.

There has been limited work with regard to psychiatric resident-as-teacher program development (2, 3). The “Psychiatry Residents as Teachers” guide created by the APA Committee on Graduate Medical Education provides basic information on teaching and feedback along with a list of resources and references (4). The Association of American Medical Colleges (AAMC) Group on Resident Affairs (GRA) has also created web-based materials on developing teaching skills for residents from all medical specialties (5). The utilization of the APA guide or the AAMC-GRA program is unknown. The primary goals of this pilot study were to investigate whether participation in a brief psychiatric residents-as-teachers course improved junior psychiatric residents’ knowledge of the medical student curriculum and their perceived core teaching skills.

This interactive course is comprised of two 2-hour long sessions held in July of the PGY-2 year. Course learning objectives are describe the background and components of the medical student curriculum; describe key learning theories; identify practical teaching skills; distinguish feedback, evaluation, and assessment; and demonstrate how to give effective feedback.

An overview of the medical school curriculum at University of Rochester School of Medicine and Dentistry and a discussion of the important roles that residents have in medical student teaching comprise the initial hour of the workshop. The second hour is devoted to review of small- and large-group teaching and adult learning principles. A description of the one-minute preceptor clinical teaching method (6) and key feedback principles and methods, such as “RIME—Reporter, Interpreter, Manager, and Educator” (7), comprise the third hour of the workshop. The final hour is a detailed overview of the psychiatry clerkship. It includes the clerkship learning objectives as well as the resident roles and responsibilities for medical student teaching and evaluation. The workshop ends with the opportunities for residents to practice feedback using paper-based trigger cases.

Twelve PGY-2 general psychiatric residents participated in this 4-hour workshop over the course of three academic years (July 2002–July 2005). Ten residents completed a written precourse self-assessment survey, and all 12 residents completed a postcourse self-assessment survey. Completion of the survey demonstrated resident consent to participate in this educational study. As an educational pilot study it was exempt from institutional review board approval.

The 12-item Likert-type self-assessment instrument was modeled on one from the Department of Pediatrics (personal communication, Robert Swantz, M.D., 2002). A question regarding the resident’s understanding of the undergraduate medical school curriculum was added to the original survey. Residents anonymously responded to the statements about teaching shown in Table 1.

Descriptive summary statistics were obtained on pre- and postcourse survey data. These data were analyzed using t tests assuming unequal variance to ascertain if there was significant difference in residents’ self-assessment of their knowledge, attitudes, values, or skills about teaching after completion of the course (Table 1).

Nearly all residents agreed or strongly agreed that the development of teaching skills is important to professional development. Teaching as a core value was demonstrated by a precourse mean of 4.5 (SD=0.71) and a postcourse mean of 4.8 (SD=0.39) (p>0.05).

Statistically significant improvement following course participation was noted in specific domains of knowledge and perceived skills. Residents’ reported knowledge of the undergraduate medical school curriculum was markedly improved (p<0.001). Several items related to residents’ self-assessment of their teaching skills were improved following participation in the course: I can apply two different teaching methods (p<0.001); I can describe and evaluate my teaching techniques (p<0.002); and I have a plan for improving my teaching skills (p=0.016).

Resident attitudes regarding their level of comfort teaching students and peers and their perception of how others would evaluate their teaching skills also changed following course participation. There was significant improvement in residents’ assessment of their comfort level teaching medical students (p<0.04) and their perception of how interns or residents would evaluate their teaching (p<0.03).

Our findings suggest that residents’ knowledge, attitudes, and perceived skills about teaching, including their perceived knowledge of the undergraduate medical student curriculum, may improve after a brief workshop. It is possible that residents’ improved understanding of the medical student curriculum will enhance medical students’ experience since residents should be able to teach students at a more appropriate level. However, this requires further evaluation.

Additionally, our findings suggest that residents’ self-assessment of their teaching skills improved after course participation. This is consistent with a recent study examining the role of a 1-day residents-as-teachers workshop for first-year residents across multiple specialties (8). An examination of their actual ability to apply different teaching methods and to describe and evaluate teaching techniques is the necessary next step. Moreover, formal evaluation of the residents’ assessment of their increased ability to create a plan for improving teaching skills is necessary to know that participating residents will utilize course experiences for lifelong learning.

There are several limitations of this pilot study. Our findings are from a single institution in a small residency program (maximum of 16 residents across the 4 years). Moreover, the evaluation tool is a pre- and postcourse self-assessment and is not a validated instrument. There are no other correlations to verify that participation in the workshop led to the change in resident self-assessment of their teaching skills or knowledge. Plus, the study does not have benefit of a control group for comparison purposes.

Another significant limitation of this study is the absence of medical student feedback on resident teaching skills. Postclerkship surveys did not include specific questions regarding psychiatric resident teaching skills or knowledge. Thus, we do not have evidence that resident teaching practices changed after the intervention.

Direct observation of resident teaching by peers and/or faculty would enhance our findings. Objective standardized teaching examinations (OSTEs) to assess resident physician teaching skills would provide better outcome data on the effectiveness of this brief curriculum (1).

These preliminary findings are encouraging with regard to the apparent improvement of psychiatric residents’ self-assessment of their knowledge, attitudes, and skills about teaching following a brief didactic course. The development of more specific outcome measures such as including specific questions on resident teaching skills on postclerkship evaluations as well as direct observation and rating of clinical teaching is needed for future courses. Improved resident knowledge, skills, and attitudes about teaching can only improve the quality of psychiatric education for medical students and residents.

At the time of submission, the authors reported no competing interests.