Coaching Residents in the Ambulatory Setting: Faculty Direct Observation and Resident Reflection

Journal of Graduate Medical Education
Ryan GraddyScott M Wright

Abstract

Direct observation can be valuable for learners' skill development in graduate medical education, but it is done infrequently. Information on how to optimize trainee learning from, and best practices of, direct observation interventions in the ambulatory setting is limited. We explored the impact of a focused outpatient direct observation and coaching intervention on internal medicine residents. Using a behavior checklist based on tenets of clinical excellence, 2 faculty preceptors observed outpatient primary care visits with 96% (46 of 48) of the internal medicine residents in 2017. Residents self-assessed their performance after the visit using the same checklist. Next, a focused coaching feedback session, emphasizing reflection, was structured to highlight areas of discrepancy between resident self-assessment and coach observation (blind spots), and residents were asked to identify goals for practice improvement. Common blind spots in resident self-assessment related to collaborating with patients while using the electronic health record (48%, 21 of 44), hand washing (43%, 20 of 46), and asking thoughtful questions (40%, 18 of 45). At 1-month follow-up, 93% (43 of 46) of responding residents reported change in practice towar...Continue Reading

References

Nov 11, 1992·Annals of Internal Medicine·G L NoelJ Harvey
Mar 18, 2003·Annals of Internal Medicine·John J NorciniGregory S Fortna
Apr 27, 2004·Academic Medicine : Journal of the Association of American Medical Colleges·Karan A ColeDavid E Kern
Sep 7, 2006·JAMA : the Journal of the American Medical Association·David A DavisLaure Perrier
Sep 9, 2008·Mayo Clinic Proceedings·Colleen ChristmasScott M Wright
Sep 10, 2008·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·K Anders Ericsson
Nov 16, 2010·CJEM·Constance Leblanc, Jonathan Sherbino
Oct 14, 2011·Academic Medicine : Journal of the Association of American Medical Colleges·Kathleen M MazorPeter J Katsufrakis
Oct 28, 2011·Academic Medicine : Journal of the Association of American Medical Colleges·Melissa NothnagleShmuel Reis
Apr 7, 2012·Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie·Robert MadanLeslie Wiesenfeld
Feb 14, 2013·BMC Medical Education·Fatima Taleb Abadel, Abdulla Saeed Hattab
Jul 26, 2014·Medical Education Online·Kathleen HanleyColleen Gillespie
Oct 9, 2014·Academic Medicine : Journal of the Association of American Medical Colleges·Eric S Holmboe
Apr 22, 2015·Issues in Mental Health Nursing·Michelle Cleary, Jan Horsfall
Nov 12, 2016·Medical Education Online·Noëlle Junod PerronMathieu Nendaz
Dec 28, 2016·Medical Teacher·Deepa RangachariMichael T Melia
Mar 7, 2017·Journal of Graduate Medical Education·Jeremy SmithDavid Feldstein
Jul 13, 2017·Academic Medicine : Journal of the Association of American Medical Colleges·Caroline E Rassbach, Rebecca Blankenburg

❮ Previous
Next ❯

Citations

Sep 10, 2020·Perspectives on Medical Education·Paul L P BrandCees P M van der Vleuten
Feb 25, 2020·Journal of Graduate Medical Education·Jocelyn LockyerJoan Sargeant
Apr 20, 2021·Medical Teacher·Alexander A LoganGinger Evans
Jun 8, 2021·Journal of Surgical Education·Andrew D ZaleJessica L Bienstock

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

JAMA : the Journal of the American Medical Association
L D Fenninger
Bulletin of the New York Academy of Medicine
J I Boufford
Academic Medicine : Journal of the Association of American Medical Colleges
I B HarrisS R Ytterberg
© 2022 Meta ULC. All rights reserved