How Do Surgery Students Use Written Language to Say What They See? A Framework to Understand Medical Students' Written Evaluations of Their Teachers

Background There remains debate regarding the value of the written comments that medical students are traditionally asked to provide to evaluate the teaching they receive. The purpose of this study was to examine written teaching evaluations to understand how medical students conceptualize teachers' behaviors and performance. Method All written comments collected from medical students about teachers in the two surgery clerkships at the University of Alberta in 2009-2010 and 2010-2011 were collated and anonymized. A grounded theory approach was used for analysis, with iterative reading and open coding to identify recurring themes. A framework capturing variations observed in the data was generated until data saturation was achieved. Domains and subdomains were named using an in situ coding approach. Results The conceptual framework contained three main domains: Physician as Teacher, Physician as Person, and Physician as Physician. Under Physician as Teacher, students commented on specific acts of teaching and subjective perceptions of an educator's teaching values. Under the Physician as Physician domain, students commented on elements of their educator's physicianship, including communication and collaborative skills, medical expertise, professionalism, and role modeling. Under Physician as Person, students commented on how both positive and negative personality traits impacted their learning. Conclusions This framework describes how medical students perceive their teachers and how they use written language to attach meaning to the behaviors they observe. Such a framework can be used to help students provide more constructive feedback to teachers and to assist in faculty development efforts aimed at improving teaching performance.