Teacher Effectiveness in Clinical Teaching: Structural Equation Modeling

Abstract

Clinical teaching of medical students is vital to prepare them for effective patient management and future practice. In turn, it is important for teachers to recognize the factors that influence learning (i.e., principles) along with the processes that underlie them (i.e., theories). This is expected to promote student learning and facilitate student achievement, future practice and lifelong learning.
 
 This study focuses on the effectiveness of the clinical teacher in a clinical teaching setting, through the statistical and empirical investigation of a model representing the relationship between teacher characteristics, student perceptions and student outcomes. This study was carried out in clinical settings in one medical school in Saudi Arabia. 
 
 The study focused on two research questions: First, if there is there a relationship between teacher characteristics (input), student perceptions (process) and student assessment (outcome) factors in clinical teaching. Second, if a latent variable path model can be developed to demonstrate the relationship between teacher characteristic, student perception and student outcome.
 
 This study developed and tested a theory-based model using structural equation modeling. It evaluated clinical teaching by taking into consideration three levels: (1) input factors including teacher characteristics, (2) process factors focusing on student perceptions, and (3) outcome factors addressing student achievement. Data were gathered from clinical teachers as well as medical students.
 The results showed a significant relationship between teacher characteristics, student perceptions and student outcomes in clinical teaching. A latent variable path analysis showed a good fit to the data with a comparative fit index of .93, which converged in 7 iterations, with a standardized residual mean error of 0.05 and RMSEA of 0.08, SRMR = 0.05. 
 
 To our knowledge this is the first study in the medical education literature that analyzed and demonstrated a perfect fit of the tested three level theoretical model (teacher characteristics, teaching and coaching skills and student outcomes) and empirical data using Structural Equation Modelling. It is proposed that future research studies identify and test additional factors that may influence student outcomes in a clinical setting.