TY - JOUR
T1 - Content and timing of feedback and reflection
T2 - A multi-center qualitative study of experienced bedside teachers
AU - Gonzalo, Jed D.
AU - Heist, Brian S.
AU - Duffy, Briar L.
AU - Dyrbye, Liselotte
AU - Fagan, Mark J.
AU - Ferenchick, Gary
AU - Harrell, Heather
AU - Hemmer, Paul A.
AU - Kernan, Walter N.
AU - Kogan, Jennifer R.
AU - Rafferty, Colleen
AU - Wong, Raymond
AU - Elnicki, Michael D.
N1 - Funding Information:
The authors would like to thank all participants for volunteering their time to be interviewed and the University of Pittsburgh Medical Center’s Shadyside Thomas H. Nimick, Jr. Research Fund and the Shadyside Hospital Foundation for funding this project.
Publisher Copyright:
© 2014Gonzalo et al.; licensee BioMed Central Ltd.
PY - 2014/10/10
Y1 - 2014/10/10
N2 - 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.
AB - 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.
KW - Medical education
KW - Medical education-faculty development
KW - Medical education-qualitative methods
KW - Patient centered care
UR - http://www.scopus.com/inward/record.url?scp=84907932170&partnerID=8YFLogxK
U2 - 10.1186/1472-6920-14-212
DO - 10.1186/1472-6920-14-212
M3 - Article
C2 - 25304386
AN - SCOPUS:84907932170
SN - 1472-6920
VL - 14
JO - BMC Medical Education
JF - BMC Medical Education
IS - 1
M1 - 212
ER -