Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers
Identifieur interne : 003683 ( Main/Exploration ); précédent : 003682; suivant : 003684Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers
Auteurs : Jed D. Gonzalo [États-Unis] ; Brian S. Heist ; Briar L. Duffy ; Liselotte Dyrbye ; Mark J. Fagan ; Gary Ferenchick [États-Unis] ; Heather Harrell ; Paul A. Hemmer ; Walter N. Kernan ; Jennifer R. Kogan ; Colleen Rafferty ; Raymond Wong [États-Unis] ; Michael D. ElnickiSource :
- BMC Medical Education [ 1472-6920 ] ; 2014.
Abstract
Competency-based medical education increasingly recognizes the importance of observation, feedback, and reflection for trainee development. Although bedside rounds provide opportunities for authentic workplace-based implementation of feedback and team-based reflection strategies, this relationship has not been well described. The authors sought to understand the content and timing of feedback and team-based reflection provided by bedside teachers in the context of patient-centered bedside rounds.
The authors conducted a thematic analysis qualitative study using transcripts from audio-recorded, semi-structured telephone interviews with internal medicine attending physicians (n= 34) identified as respected bedside teachers from 10 academic US institutions (2010–2011).
Half of the respondents (50%) were associate/full professors, with an average of 14 years of academic experience. In the context of bedside encounters, bedside teachers reported providing feedback on history-taking, physical-examination, and case-presentation skills, patient-centered communication, clinical decision-making, leadership, teaching skills, and professionalism. Positive feedback about physical-exam skills or clinical decision-making occurred during encounters, positive or constructive team-based feedback occurred immediately following encounters, and individualized constructive feedback occurred in one-on-one settings following rounding sessions. Compared to less frequent, emotionally-charged events, bedside teachers initiated team-based reflection on commonplace “teachable moments” related to patient characteristics or emotions, trainee actions and emotions, and attending physician role modeling.
Bedside teachers use bedside rounds as a workplace-based method to provide assessment, feedback, and reflection, which are aligned with the goals of competency-based medical education. Embedded in patient-centered activities, clinical teachers should be encouraged to incorporate these content- and timing-related feedback and reflection strategies into their bedside teaching.
Url:
DOI: 10.1186/1472-6920-14-212
PubMed: 25304386
PubMed Central: 4198734
Affiliations:
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<author><name sortKey="Fagan, Mark J" sort="Fagan, Mark J" uniqKey="Fagan M" first="Mark J" last="Fagan">Mark J. Fagan</name>
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<author><name sortKey="Ferenchick, Gary" sort="Ferenchick, Gary" uniqKey="Ferenchick G" first="Gary" last="Ferenchick">Gary Ferenchick</name>
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<author><name sortKey="Kogan, Jennifer R" sort="Kogan, Jennifer R" uniqKey="Kogan J" first="Jennifer R" last="Kogan">Jennifer R. Kogan</name>
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<wicri:noCountry code="subfield">Pennsylvania USA</wicri:noCountry>
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<author><name sortKey="Elnicki, Michael D" sort="Elnicki, Michael D" uniqKey="Elnicki M" first="Michael D" last="Elnicki">Michael D. Elnicki</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Competency-based medical education increasingly recognizes the importance of observation, feedback, and reflection for trainee development. Although bedside rounds provide opportunities for authentic workplace-based implementation of feedback and team-based reflection strategies, this relationship has not been well described. The authors sought to understand the content and timing of feedback and team-based reflection provided by bedside teachers in the context of patient-centered bedside rounds.</p>
</sec>
<sec><title>Methods</title>
<p>The authors conducted a thematic analysis qualitative study using transcripts from audio-recorded, semi-structured telephone interviews with internal medicine attending physicians (n= 34) identified as respected bedside teachers from 10 academic US institutions (2010–2011).</p>
</sec>
<sec><title>Results</title>
<p>Half of the respondents (50%) were associate/full professors, with an average of 14 years of academic experience. In the context of bedside encounters, bedside teachers reported providing feedback on history-taking, physical-examination, and case-presentation skills, patient-centered communication, clinical decision-making, leadership, teaching skills, and professionalism. Positive feedback about physical-exam skills or clinical decision-making occurred during encounters, positive or constructive team-based feedback occurred immediately following encounters, and individualized constructive feedback occurred in one-on-one settings following rounding sessions. Compared to less frequent, emotionally-charged events, bedside teachers initiated team-based reflection on commonplace “teachable moments” related to patient characteristics or emotions, trainee actions and emotions, and attending physician role modeling.</p>
</sec>
<sec><title>Conclusions</title>
<p>Bedside teachers use bedside rounds as a workplace-based method to provide assessment, feedback, and reflection, which are aligned with the goals of competency-based medical education. Embedded in patient-centered activities, clinical teachers should be encouraged to incorporate these content- and timing-related feedback and reflection strategies into their bedside teaching.</p>
</sec>
</div>
</front>
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</TEI>
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</country>
<region><li>Californie</li>
<li>Michigan</li>
<li>Pennsylvanie</li>
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