In this study, we described the development of a new teaching quality evaluation questionnaire (TQEQ) of preclinical courses from the perceptive of medical students with the purpose of improving the effectiveness of preclinical courses in medical schools.
Reliability, validity efficiency and feasibility assessment of the evaluation program is necessary in order to provide an accurate, fair and reliable assessment of teaching quality [16]. We send the original questionnaire whose 47 items are in random to the participants, in order to reduce the impact of effects of subjective consciousness. The EFA of the TQEQ demonstrated seven factors consisting of 39 items: learning outcomes, teaching attitudes, student subjection, teaching abilities, teaching methods, teacher characteristics and teaching interactions, which included the four main aspects of teaching quality program: structure, process, teacher characteristics, and outcomes [17]. Besides, the value of Cronbach’s alpha was exceeded 0.70, indicating an acceptable and good internal consistency reliability of the instrument [18]. Thus, this new instrument may well be used to assess teaching quality for medical schools.
A good questionnaire not only contributes to measure the effectiveness of teaching, but also helps to provide a well informal feedback for the teachers and faculties. In this study, interestingly, we found that the common factor “learning outcomes’ weighted most heavily among the seven factors. Moreover, five of ten highest value items, “Teachers use heuristic teaching method to inspire students to think” (q3, 4.35 ± 0.82), which 86.8% agreed and only 2.9% disagreed; “Teachers are good at cultivating students’ ability of subject thinking rather than indoctrinating knowledge blindly " (q1, 4.49 ± 0.72), which 90.3% agreed and only 1.2% disagreed; “This course will train students to solve the problems” (q20, 4.29 ± 0.82), which 84.2% agreed and only 2.7% disagreed;“Students will have a good command of key points after the course” (q6, 4.4 ± 0.78), which 86.8% agreed and only 2.0% disagreed;“Teachers have excellent theoretical knowledge of their specialty, and appropriate application in teaching " (q21, 4.44 ± 0.71), which 89.7% agreed and only 1.4% disagreed, are in this common factor. In the other words, whether the course will improve students’ abilities, such as heuristic thinking, solving problems, is important for medical students. This is consistent with the previous studies that three types of outcomes need to take in consideration when determining the efficacy of medical education programs: education, clinical career, and environmental outcomes [19]. So, it is critical for teachers to focus on how to cultivate and elevate students’ comprehensive abilities rather than teaching literally.
In addition, the highest value items “Teachers are familiar with the teaching content and able to sort out the key points” (q42, 4.66 ± 0.63), 93.5% agreed and only 1.0% disagreed; “Teachers are well prepared for the course " (q4, 4.60 ± 0.65), 93.8% agreed and only 1.4% disagreed; “Teachers are good at organizing the process of class " (q32, 4.48 ± 0.69), 90.0% agreed and 10.0% disagreed, are in the common factor, “teaching abilities”, revealing that teacher’s performance is the most important for medical students. Thus, in the LBL model, it is essential for teachers to make good preparation and have a good charge of the course.
Moreover, the other two high value items “Teachers encourage students to discuss and ask questions " (q41, 4.57 ± 0.69), 91.7% agreed and only 1.0% disagreed; “Teachers are patient with students’ questions " (q40, 4.32 ± 0.84), 83.4% agreed and only 2.7% disagreed, are in the common factor, “teaching interactions”, indicating that students rely on teachers and hope teachers could give positive feedback to them.
Among the seven common factors, the common factor “teacher characteristics”, containing the four items “Teachers are young and nearly have no generation gap with students” (q43, 3.2 ± 1.07), 38.4% agreed and 22.0% disagreed; “Teachers are humorous” (q45, 3.39 ± 1.16), 47.9% agreed and 21.0% disagreed; “Teachers are good-looking and attractive” (q16, 3.35 ± 1.19), 46.4% agreed and 22.5% disagreed; “The evaluation of teacher related to the course difficulty” (q15, 3.64 ± 1.20), 60% agreed and 18.1% disagreed, seems not so essential to the medical student. This was further validated that teachers should exert their strong efforts to prepare their courses and improve their abilities, while they still need to pay attention to their words and actions.
However, this study still has some limitations. First, the course evaluation was administered at the middle of a curriculum; however, some studies suggested that continuous assessment during the courses brings up higher reliability ratings rather than the retrospective evaluation [1, 20]. Second, the questionnaire is collected from the view of students, but it should be also accessible to teachers. The teaching planning, teaching methods, and teaching skills may more suitable for teachers themselves to evaluate. Thus, both students and teachers are critical in the process of the assessment of preclinical courses. In addition, the data were collected in a single medical school; therefore, application of the questionnaire in other medical schools is needed to validate the effectiveness of the evaluation system.
In conclusion, TQEQ was demonstrated to be a valid and credible instrument for assessing teaching quality of medical school. Future studies needs to explore whether feedback acquired from this questionnaire contributes to facilitate teaching quality of preclinical courses and student learning outcome.