Becoming a Clinician Educator: Developmental Trajectories of Resident Large-Group Teaching Skills

Large-group teaching skill remains a hallmark of medical education, and teaching skill remains an educational imperative of modern competency-based medical education. Like other skills that must be honed during the course of medical education, teaching skill is neither innate nor produced solely by one’s presence within graduate medical education. Teaching, like other skills required of physicians, represents a developmental phenomenon, one that must be deliberately practiced and coached. Rigorous assessment of educator skill across graduate medical education (GME) training levels could lead to understanding of such skill development. A tool with accumulating validity evidence for large group teaching, the Resident-led Large Group Teaching Assessment Instrument (ReLaTe AI), was ideally suited to assess large group teaching of residents but has not been used to study growth across the developmental trajectory. To investigate large group teaching skill development over time, we conducted a retrospective cohort analysis of resident’s annual teaching experiences at Mayo Clinic using a modified ReLaTe AI and rigorously trained local raters, then developed and analyzed individual and group-level learning curves. We studied large group teaching in an authentic context, the “Baldwin Talk”, across all years of pediatric training from 2012 - 2018. In this reflective practice environment, learner skills increased with moderate effect sizes over training time. Between-learner differences were larger than mean within-learner growth. Importantly, not all teaching skills grew to the same degree. Evaluation of local contexts and the developmental curves that develop within them may provide important insight into program strengths and opportunities for improvement.