A Case for Caution: Chart-Stimulated Recall

Reddy, Shalini; Endo, Justin; Gupta, Shanu; Tekian, Ara; Park, Yoon Soo

doi:10.4300/jgme-d-15-00011.1

Cited by 8 publications

(9 citation statements)

References 32 publications

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“…Among clinicians who consented to study participation we conducted chart-stimulated recall (CSR) interviews, a methodology used to assess clinical decision-making processes [12, 13]. During CSR interviews, a clinician uses his or her own documentation to answer questions and explain the rationale for specific clinical decisions.…”

Section: Methodsmentioning

confidence: 99%

Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study

et al. 2017

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BackgroundEarly diagnosis and treatment of prediabetes and type 2 diabetes mellitus (T2DM) can prevent future health problems, yet many individuals with these conditions are undiagnosed. This could be due, in part, to primary care physicians’ (PCP) screening practices, about which little is known. The objectives of this study were to identify factors that influence PCPs’ decisions to screen patients for T2DM and to characterize their interpretation and communication of screening test results to patients.MethodsWe conducted semi-structured chart-stimulated recall interviews with 20 University of Michigan Health System (UMHS) primary care physicians. PCPs were asked about their recent decisions to screen or not screen 134 purposively sampled non-diabetic patients who met American Diabetes Association criteria for screening for T2DM. Interviews were audio-recorded, transcribed, and analyzed using qualitative directed content analysis. Data on patient demographic characteristics and comorbidities were abstracted from the electronic health record.ResultsThe most common reasons PCPs gave for not screening 63 patients for T2DM were knowledge of a previously normal screening test (49%) and a visit for reasons other than a health maintenance examination (48%). The most common reasons PCPs gave for screening 71 patients for T2DM were knowledge of a previously abnormal screening test (49%), and patients’ weight (42%) and age (38%). PCPs correctly interpreted 89% of screening test results and communicated 95% of test results to patients. Among 24 patients found to have prediabetes, PCPs usually (58%) recommended weight loss and increased physical activity but never recommended participation in a Diabetes Prevention Program or use of metformin.ConclusionsPrevious screening test results, visit types, and patients’ weight and age influenced PCPs’ decisions to screen for T2DM. When patients were screened, test results were generally correctly interpreted and consistently communicated. Recommendations to patients with prediabetes could better reflect evidence-based strategies to prevent T2DM.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-017-0623-3) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study

et al. 2017

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“…5 For physicians-in-training, clinical notes serve as medical education tools, 6 supporting information synthesis and faculty assessment and feedback. [7][8][9][10] Because clinical notes are more than just documentation for learners, sharing these notes with patients may have unanticipated effects on learners and their practice.…”

Section: Introductionmentioning

confidence: 99%

Open Notes in Teaching Clinics: A Multisite Survey of Residents to Identify Anticipated Attitudes and Guidance for Programs

Crotty

Anselmo

Clarke

et al. 2018

Journal of Graduate Medical Education

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Residents reported mixed feelings about the anticipated effects of sharing clinical notes with patients. They advocate for patient feedback on notes, yet worry about workload, supervision, and errors. Training site was correlated with many attitudes, suggesting local culture drives resident support for open notes. Strategies that address resident concerns and promote teaching and feedback related to notes may be helpful.

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“…Many primary care specialties use a teaching technique called "chart-stimulated recall," which is a hybrid teaching and assessment format that combines chart review and oral communication based on a documented patient encounter. 68 For example, a trainee independently interviews and examines a new patient. They do a preliminary writeup of the encounter and then present this to their instructor/ evaluator.…”

Section: Operative Note-stimulated Recallmentioning

confidence: 99%

“…Feedback is more than just information; rather, it is information whose explicit purpose is to promote improvement in learner performance. 21,68 Feedback provides the learner with insight into the consequences of specific actions with the opportunity to change any differences between intended and actual outcomes. There are 2 key influences on how and why feedback becomes meaningful.…”

Section: Neurosurgical Wardmentioning

confidence: 99%

“…The second is the learning culture within which feedback is exchanged. 68 For maximum benefit, the feedback should be specific, descriptive, formative (on-going), and limited to the aspect being examined. The learning culture is best when feedback is provided at a quiet time of the day, in a private setting, and when there is time to freely discuss the feedback.…”

Section: Neurosurgical Wardmentioning

confidence: 99%

See 1 more Smart Citation

Neurosurgeon as educator: a review of principles of adult education and assessment applied to neurosurgery

Jensen

Alzhrani

Kestle

et al. 2017

Journal of Neurosurgery

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A Case for Caution: Chart-Stimulated Recall

Cited by 8 publications

References 32 publications

Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study

Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study

Open Notes in Teaching Clinics: A Multisite Survey of Residents to Identify Anticipated Attitudes and Guidance for Programs

Neurosurgeon as educator: a review of principles of adult education and assessment applied to neurosurgery

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