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 - 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.
UR - http://www.scopus.com/inward/record.url?scp=84907932170&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.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 -