Resident physicians' perspectives on effective outpatient teaching: A qualitative study

Learning theories, which suggest that experienced faculty use collaborative teaching styles, are reflected in qualitative studies of learners in hospital settings. However, little research has used resident focus groups to explore characteristics of successful teachers in outpatient clinics. Therefore, focus group discussions with first through third-year internal medicine residents at a large academic medical center were conducted to better understand residents' perspectives on effective outpatient teaching. A group facilitator solicited residents' reflections, based on their lived experiences, on teaching domains from previous factor analytic studies: interpersonal, clinical-teaching, and efficiency. Researchers coded focus group transcripts and identified themes within the domains. Final themes were determined by consensus. Leading themes were "kindness" and "teacher-learner relationships." Junior residents were sensitive to faculty who were brusque, harsh, and degrading. Senior residents respected faculty who were humble, collaborative, and allowed residents to co-manage teaching encounters. Seniors emphasized the importance of faculty role-modelling and preferentially staffed with experts to "gain wisdom from experience." Overall, residents expressed that effective learning requires grounded teacher-learner relationships. These findings support learning theories and previous factor analytic studies. However, this qualitative study provided insights that could not be gleaned from assessment scores alone.