Abstract
BACKGROUND: The importance of effective clinical teaching skills is well established in the literature. However, reliable tools with validity evidence that are able to measure the development of these skills and can effectively be used by nonphysician raters do not exist. OBJECTIVE: Our initiative had 2 aims: (1) to develop a teaching development assessment tool (TDAT) that allows skill assessment along a continuum, and (2) to determine if trained nonphysicians can assess clinical teachers with this tool. METHODS: We describe the development of the TDAT, including identification of 6 global teaching domains and observable teaching behaviors along a 3-level continuum (novice/beginner, competent/proficient, expert) and an iterative revision process involving local and national content experts. The TDAT was studied with attending physicians during inpatient rounds with trained physician and nonphysician observers over 6 months. RESULTS: The TDAT showed emerging evidence of content, construct, and viable validity (the degree to which an assessment tool is practical, affordable, suitable, evaluable, and helpful in the real world) for the evaluation of attending physicians on inpatient rounds. Moderate to near perfect interrater reliability was seen between physician and nonphysician raters for the domains of promotion of clinical reasoning, control of the learning environment, ability to teach to multiple levels of learners, and provision of feedback. CONCLUSIONS: The TDAT holds potential as a valid and reliable assessment tool for clinical teachers to track the development of each individual's teaching skills along the continuum from early development to mastery.