Quality improvement in clinical teaching through student evaluations of rotations and feedback to departments

Background: Clinical teaching at medical schools needs continual improvement. We used a new evaluation instrument to gather student ratings on a departmental level across all clinical rotations. The ratings were used to enable cross comparison of departmental clinical teaching quality, official ranking and feedback as a method to improve teaching quality. This study was designed to evaluate whether these interventions increased the quality of clinical teaching. Methods: A web-based questionnaire consisting of 10 questions (Likert scale 1-6) was introduced into all hospital departments at Uppsala University Hospital, Sweden. Specific feedback was given to participating departments based on the assessments collected. Action plans were created in order to address areas for departmental improvement. Questionnaire scores were used as a measure of clinical teaching quality. Results: Mean follow-up time was 2.5 semesters. The student response rate was 70% (n=1981). The departments' median ratings (25th-75th percentile) for the baseline were 4.05 (3.80-4.30). At follow-up, the median rating had increased to 4.56 (4.29-4.72) (p<0.001). Conclusion: The introduction of a uniform clinical teaching evaluation instrument enabled cross comparison between clinical departments. Specific feedback enabled the development of action plans in the departments. This caused a rapid and substantial increase in the quality of clinical teaching.