Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers

BMC Medical Education

Michael D Elnicki⁶  Raymond Wong^1,12  Colleen Rafferty^1,10  Jennifer R Kogan¹  Walter N Kernan³  Paul A Hemmer⁵  Heather Harrell⁸  Gary Ferenchick^1,11  Mark J Fagan⁹  Liselotte Dyrbye⁴  Briar L Duffy²  Brian S Heist⁶  Jed D Gonzalo⁷ 

[1] Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA;Department of Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA;Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, USA;Department of Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA;Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA;Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA;Division of General Internal Medicine, Penn State Hershey Medical Center – HO34, 500 University Drive, Hershey, PA 17033, USA;Department of Medicine, University of Florida College of Medicine, Gainesville, Florida, USA;Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA;Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA;Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA;Department of Medicine, Loma Linda University School of Medicine, Loma Linda, California, USA

关键词: Patient centered care;    Medical education-faculty development;    Medical education;    Medical education-qualitative methods;   

Others  :  1090803
DOI  :  10.1186/1472-6920-14-212

 received in 2014-07-04, accepted in 2014-10-03,  发布年份 2014

【 摘 要 】

Background

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.

Methods

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).

Results

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.

Conclusions

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.

【 授权许可】

   
2014 Gonzalo et al.; licensee BioMed Central Ltd.

【 图 表 】

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