Purpose
Feedback is important for medical students’ development. Recent conceptualizations of feedback as a dialogue between feedback provider and recipient point to longitudinal relationships as a facilitator of effective feedback discussions. This study illuminates how medical students experience feedback within a longitudinal relationship with a physician coach.
Method
In this qualitative study, second-year medical students from the University of California, San Francisco, School of Medicine participated in semistructured interviews that explored their experiences discussing feedback within longitudinal, nonevaluative coaching relationships. Interviews occurred between May and October 2018. Interview questions addressed students’ experiences receiving feedback from their coach, how and when they used this feedback, and how their relationship with their coach influenced engagement in feedback discussions. Interviews were analyzed using constructivist grounded theory.
Results
Seventeen students participated. The authors identified 3 major themes. First, students’ development of a feedback mindset: Over time, students came to view feedback as an invaluable component of their training. Second, setting the stage for feedback: Establishing feedback routines and a low-stakes environment for developing clinical skills were important facilitators of effective feedback discussions. Third, interpreting and acting upon feedback: Students described identifying, receiving, and implementing tailored and individualized feedback in an iterative fashion. As students gained comfort and trust in their coaches’ feedback, they reported increasingly engaging in feedback conversations for learning.
Conclusions
Through recurring feedback opportunities and iterative feedback discussions with coaches, students came to view feedback as essential for growth and learning. Longitudinal coaching relationships can positively influence how students conceptualize and engage in feedback discussions.
BackgroundRecruitment of a diverse participant pool to cancer clinical trials is an essential component of clinical research as it improves the generalizability of findings. Investigating and piloting novel recruitment strategies that take advantage of ubiquitous digital technologies has become an important component of facilitating broad recruitment and addressing inequities in clinical trial participation. Equitable and inclusive recruitment improves generalizability of clinical trial outcomes, benefiting patients, clinicians, and the research community. The increasing prevalence of online connectivity in the USA and use of the Internet as a resource for medical information provides an opportunity for digital recruitment strategies in cancer clinical trials. This study aims to measure the acceptability, preliminary estimates of efficacy, and feasibility of the Trial Library intervention, an Internet-based cancer clinical trial matching tool. This study will also examine the extent to which the Trial Library website, designed to address the linguistic and literacy needs of broader patient populations, influences patient-initiated conversations with physicians about clinical trial participation.MethodsThis is a study protocol for a non-randomized, single-arm pilot study. This is a mixed methods study design that utilizes the statistical analysis of quantitative survey data and the qualitative analysis of interview data to assess the participant experience with the Trial Library intervention. This study will examine (1) acceptability as a measure of participant satisfaction with this intervention, (2) preliminary measure of efficacy as a measure of proportion of participants with documented clinical trial discussion in the electronic medical record, and (3) feasibility of the intervention as a measure of duration of clinical visit.DiscussionThe principles that informed the design of the Trial Library intervention aim to be generalizable to clinical trials across many disease contexts. From the ground up, this intervention is built to be inclusive of the linguistic, literacy, and technological needs of underrepresented patient populations. This study will collect essential preliminary data prior to a multi-site randomized clinical trial of the Trial Library intervention.Trial registrationThis study has received institutional approval from the Committee of Human Subjects Research at the University of California, San Francisco.
Background: The ability of clinical trials to effectively translate into therapeutic interventions for the general population can be limited by a lack of representative participants in these trials. There is an acute need to develop informational resources regarding cancer clinical trials that meet the linguistic and literary needs of under-represented and vulnerable populations. Current practices utilize a one-size-fits-all approach that may be inaccessible to a diverse audience. Given the increased utilization of online resources for health information among a diverse patient population and across age groups, we developed a website, called Trial Library, which may serve as a prostate cancer clinical trial matching tool. We hypothesize that use of the Internet-based clinical trial matching tool in clinic will increase the number of patient-initiated conversations with physicians about clinical trial options, and by extension, improve enrollment to therapeutic cancer clinical trials among a diverse participant pool.
Procedures/Design/Aims: This is a nonrandomized, nontherapeutic interventional pilot study. The study will be performed in genitourinary medical oncology clinic at UCSF Helen Diller Family Comprehensive Cancer Center. We will measure the feasibility and acceptability of a clinical trial matching tool that includes two unique features: user-validated clinical trial content and navigation schema. We will measure preliminary estimates of efficacy of the online clinical trial matching tool in triggering patient-promoted conversations regarding clinical trials and ultimately clinical trial enrollment.
Discussion: Trial Library is designed to be an accessible informational resource for patients from diverse levels of health literacy and English proficiency. This pilot study will provide important preliminary results to inform the design of the website and subsequent testing outside of clinic. Additionally, this website will ultimately serve as a model for clinical trial information that can be translated across tumor types.
Note: This abstract was not presented at the conference.
Citation Format: Hala T. Borno, Brian Bakke, Anke Hebig Prophet, Yoon-Ji Kim, Jan Yaeger, Jessica Chao, Pelin Cinar, Celia Kaplan, Eric Small, Christy Boscardin, Ralph Gonzales. Trial Library: A pilot study to examine feasibility, acceptability, and preliminary estimates of efficacy for an online clinical trial matching website on patient-prompted conversations for prostate cancer clinical trials [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A081.
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