A multi-level assessment of a program to teach medical students to teach.

Few longitudinal programs exist to teach senior students (MS4s) to be teachers, nor have there been any reports of comprehensive program evaluation in this area. The primary objectives of this study were to describe our ongoing faculty development effort and to develop a multi-level program evaluation, using Dixon's model. The TALKS (Teaching and Learning Communication Skills) program is a senior elective and open to all MS4s. We evaluated our program through assessment of its participants at three levels: level 1, opinion; level 2, competence; and level 3, performance; but not level 4, patient outcomes. The authors used a retrospective, pre-post questionnaire to assess MS4 attitudes about their educational experiences, a traditional instrument to assess their teaching, an interaction analysis technique using Bloom's taxonomy to assess MS4s' feedback skills, and a SP exam to assess MS4 communication skills. The authors hypothesized that MS4s participating in TALKS would view medical education more positively and informatively, would demonstrate important principles in giving feedback, would be assessed as excellent teachers, and would perform better than controls in an SP exam emphasizing communication skills. Results revealed that MS4s' ratings as teachers were very good to excellent, with the highest scores on the items "knowledgeable, supportive of me, and answering questions clearly." (Level 1, Opinion) MS4s' perceptions of their knowledge, attitudes and skills increased significantly from the pre to the post-questionnaire. (Level 2, Competence) MS4 feedback skills to MS2s revealed they did more talking than ideal, often at the lowest levels of Bloom's taxonomy. (Level 3, Performance) MS4s demonstrated better communication skills than controls on an evaluation by professional SPs. (Level 3, Performance).