An assessment of rheumatology fellows' skills as clinical teachers through self-assessment and direct observation.

Objective: The purpose of this study is to assess rheumatology fellows' teaching skills through an Observed Structured Teaching Exercise (OSTE), self-assessment, and a survey of fellows' teaching experiences.

Methods: Rheumatology fellows from 5 institutions participated in an in-person OSTE, involving a simulated teaching encounter with a standardized learner. Trained faculty observers rated each OSTE encounter to assess the fellows' proficiency as a clinical teacher in the following domains: learning environment, learner assessment, presenting material, feedback, and overall teaching ability. Prior to the OSTE, fellows completed a self-assessment of their teaching skills according to those same five domains. In addition, they completed a post-OSTE survey assessing their experience with teaching during rheumatology fellowship training and their experience with the OSTE station itself.

Results: A total of 25 fellows completed the OSTE and self-assessment. According to preceptor ratings on the OSTE, the domain with the highest average proficiency was presenting material (4.16, SD 0.46) and the lowest was learner assessment (3.06, SD 1.56). There was no significant correlation between OSTE ratings and fellow self-assessment in any domain. Of the 23 (92%) fellows who completed the post-OSTE survey, only 57% agreed they had received high-quality feedback on their teaching skills during fellowship training, and 100% agreed they received effective feedback during the OSTE.

Conclusion: Fellows' self-assessed teaching ability does not correlate with direct observation. Interventions such as this OSTE are useful for providing high-quality feedback on fellows' teaching skills.