Council on Medical Student Education in Pediatrics

COMSEP Logo

Search This Site

Journal Club

Quirk M., Stone S., Chuman A., Devaney-O'Neil S, Mazor K., Starr S., and Lasser D. Using Differences between Perceptions of Importance and Competence to Identify Teaching Needs of Primary Care Preceptors. Teaching and Learning in Medicine, 2002;14(3),157-163. Reviewed by Lindsay Lane, Philadelphia Pa


Quirk M., Stone S., Chuman A., Devaney-O'Neil S, Mazor K., Starr S., and Lasser D. Using Differences between Perceptions of Importance and Competence to Identify Teaching Needs of Primary Care Preceptors. Teaching and Learning in Medicine, 2002;14(3),157-163.

Reviewed by Lindsay Lane, Philadelphia Pa

This study describes a novel method to tailor the offerings in a faculty development program to the needs of participants. The authors' starting point is that faculty development needs assessments do not usually distinguish between content importance (how the preceptor rates the importance of the topic) and content performance (how well the faculty member perceives that they already perform the content) instead they focus only on one dimension. This study looked at how, by taking into account both the "importance" and "performance" dimensions, the priority given to faculty development topics is changed.

The study population was 105 primary care preceptors in Family Medicine (n=59), Internal medicine (n=30) and Pediatrics (n=39) from 13 different medical schools. Surveys were sent that asked the preceptors to assess the importance of and their perceived competence in, 27 areas of clinical teaching grouped into three categories: environment of teaching, content of teaching, and general teaching skills. From the survey data the authors created a faculty development content "hierarchy". Topics that had a high importance rating and large discrepancy between importance and current preceptor performance made the "first tier", topics with mid -level importance but high discrepancy the "second tier" and topics with low importance and low discrepancy (however high the importance rating) made the "bottom tier".

The results indicate that a "2 dimensional" survey yields different priorities for topics than a "one dimensional" needs assessment. Although topics in the "content of teaching" domain were rated as very important they mainly fell into the bottom tier because they were already felt to be performed well. Of the six topics that were in the top tier using this method, five were in the general teaching skills domain. They were: 1.Understand how each learner learns best, 2. Use the most effective teaching behaviors to meet learner needs, 3. Talk to the learner about how well she or he has performed, 4. Choose teaching methods specifically based on what the student needs, 5. Assess what the learner needs to know, do, feel. One topic, falling second on the list, was in the environment of teaching domain: 1. Make time for teaching.

Comment: The distinction between importance and performance seems such a simple one to make but I guess I had not made it myself before reading this article! Because I regularly run faculty development programs for my clinical preceptors I've been wondering if my needs assessment, which only asks for a high/low rating of whether a topic should be included in the next faculty development session, includes the dimensions of performance and importance.

I feel better about having not explicitly addressed the "performance/importance" factor when I reflect that this article was published by the group from the University of Massachusetts which has been doing extensive, region wide community faculty development for a long time, and it's still taken them a while to figure this out!

The discussion at the end of this article mentions the problem of discrepancies between topics that clerkship directors may perceive as important but preceptors perceive as unimportant and vice-versa and the negative effect this may have on attendance at faculty development sessions. I'm sure we can all think of examples when we perceived a topic to be educationally important but the preceptors did not and we have had to do more than the usual faculty development to overcome this barrier. The reasons these authors suggest for discrepancies include preceptors not being aware of clerkship goals and not having access to the resources of the medical school. No surprises there and the solutions are obvious!

Just a quick FYI - There is going to be a 3 hour workshop at the APA meeting in May showcasing different faculty development programs from around the country. Many of you should find this of interest so make a note to "put it on your dance card"!

(Using another method, What are your top 3 needs in faculty development - for you as a clerkship director? Steve Miller)

Return to Journal Club