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Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers
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 re...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198734/ https://www.ncbi.nlm.nih.gov/pubmed/25304386 http://dx.doi.org/10.1186/1472-6920-14-212 |
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author | Gonzalo, Jed D Heist, Brian S Duffy, Briar L Dyrbye, Liselotte Fagan, Mark J Ferenchick, Gary Harrell, Heather Hemmer, Paul A Kernan, Walter N Kogan, Jennifer R Rafferty, Colleen Wong, Raymond Elnicki, Michael D |
author_facet | Gonzalo, Jed D Heist, Brian S Duffy, Briar L Dyrbye, Liselotte Fagan, Mark J Ferenchick, Gary Harrell, Heather Hemmer, Paul A Kernan, Walter N Kogan, Jennifer R Rafferty, Colleen Wong, Raymond Elnicki, Michael D |
author_sort | Gonzalo, Jed D |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4198734 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-41987342014-10-17 Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers Gonzalo, Jed D Heist, Brian S Duffy, Briar L Dyrbye, Liselotte Fagan, Mark J Ferenchick, Gary Harrell, Heather Hemmer, Paul A Kernan, Walter N Kogan, Jennifer R Rafferty, Colleen Wong, Raymond Elnicki, Michael D BMC Med Educ Research Article 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. BioMed Central 2014-10-10 /pmc/articles/PMC4198734/ /pubmed/25304386 http://dx.doi.org/10.1186/1472-6920-14-212 Text en © Gonzalo et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Gonzalo, Jed D Heist, Brian S Duffy, Briar L Dyrbye, Liselotte Fagan, Mark J Ferenchick, Gary Harrell, Heather Hemmer, Paul A Kernan, Walter N Kogan, Jennifer R Rafferty, Colleen Wong, Raymond Elnicki, Michael D Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers |
title | Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers |
title_full | Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers |
title_fullStr | Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers |
title_full_unstemmed | Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers |
title_short | Content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers |
title_sort | content and timing of feedback and reflection: a multi-center qualitative study of experienced bedside teachers |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4198734/ https://www.ncbi.nlm.nih.gov/pubmed/25304386 http://dx.doi.org/10.1186/1472-6920-14-212 |
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