Limited Agreement Regarding Outpatient Preceptor Behaviors: Observer, Residents, Self.

Abstract

We developed the Mayo Outpatient Precepting Evaluation Tool (MOPET) to assess and improve clinical teaching for family medicine residents. Given the scheduling challenges of peer evaluation, we sought to improve the MOPET's usefulness by evaluating the reliability of self- and resident-reported teaching behaviors during clinical precepting compared to peer observation. Forty-eight half-day sessions in a family medicine residency clinic were assessed with parallel observer, preceptor, and resident MOPET forms. Interrater reliability was calculated using the κ (kappa) statistic. Residents reported that preceptors used 14 of 20 teaching behaviors more often than observers. Observers and preceptors significantly agreed on the use of five teaching behaviors, while residents agreed with observers on two teaching behaviors. Although self-assessment and resident-based feedback of preceptor teaching behavior may improve practicality, they are less reliable compared to direct peer observation with the validated MOPET.