An Exploration of Faculty Perspectives on the In-Training Evaluation of Residents

Watling, Christopher; Kenyon, Cynthia F.; Schulz, Valerie; Goldszmidt, Mark; Zibrowski, Elaine; Lingard, Lorelei

doi:10.1097/acm.0b013e3181e19722

Cited by 53 publications

(60 citation statements)

References 18 publications

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“…how they give feedback). A better understanding of how faculty staff think and feel about providing feedback after observing resident–patient interactions may also help elucidate why faculty staff are uncomfortable providing feedback 24 and why trainees are dissatisfied with it.…”

Section: Introductionmentioning

confidence: 99%

Faculty staff perceptions of feedback to residents after direct observation of clinical skills

Kogan¹,

Conforti²,

Bernabeo³

et al. 2012

Medical Education

143

122

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CONTEXT Performance-based workplace assessments are increasingly important in clinical training. Given the inaccuracy of self-assessment, the provision of external feedback to residents about their clinical skills is necessary for the development of expertise. However, little is known about the processes used by faculty members in giving feedback to residents after observing them with patients. This study explores the factors that underpin faculty members' decisions regarding the feedback they give to residents after directly observing them with patients and the factors that influence how feedback is delivered.METHODS In 2009, 44 general internal medicine faculty staff responsible for out-patient resident teaching from 16 internal medicine residency programmes watched four videotaped scenarios and two live scenarios of standardised residents (SRs) with standardised patients and rated the SRs using the mini-clinical evaluation exercise (mini-CEX) format. Faculty staff also provided feedback to the SRs after the live encounters. After each encounter, faculty staff were individually interviewed using a semi-structured interview. Interviews were videotaped, transcribed and analysed using grounded theory methods.RESULTS Two broad themes were identified in faculty members' descriptions of the feedback process: variability in feedback techniques, and the factors that influence how faculty staff think and feel about delivering feedback. Multiple approaches to feedback delivery were observed. Faculty members' tensions in balancing positive and negative feedback, their own perceived self-efficacy, their perceptions of the resident's insight, receptivity, skill and potential, the faculty member-resident relationship and contextual factors impacted the feedback process.CONCLUSIONS The provision of feedback by faculty staff to residents after observing resident-patient interactions is a complex and dynamic process and is influenced by many factors. Understanding these cognitive and affective factors may provide insight into potential new approaches to faculty development to improve faculty staff's feedback skills and the effectiveness of their feedback.

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Section: Introductionmentioning

confidence: 99%

Faculty staff perceptions of feedback to residents after direct observation of clinical skills

Kogan¹,

Conforti²,

Bernabeo³

et al. 2012

Medical Education

143

122

View full text Add to dashboard Cite

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“…The ability of supervisors to discuss the use of both poor and good communication skills in a constructive and interactive way when giving feedback to trainees is also another crucial element. However, supervisors often feel uncomfortable in providing residents negative feedback [22,23]. …”

Section: Introductionmentioning

confidence: 99%

Impact of postgraduate training on communication skills teaching: a controlled study

et al. 2014

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BackgroundObservation of performance followed by feedback is the key to good teaching of communication skills in clinical practice. The fact that it occurs rarely is probably due to clinical supervisors’ perceived lack of competence to identify communication skills and give effective feedback. We evaluated the impact of a faculty development programme on communication skills teaching on clinical supervisors’ ability to identify residents’ good and poor communication skills and to discuss them interactively during feedback.MethodsWe conducted a pre-post controlled study in which clinical supervisors took part to a faculty development program on teaching communication skills in clinical practice. Outcome measures were the number and type of residents’ communication skills identified by supervisors in three videotaped simulated resident-patient encounters and the number and type of communication skills discussed interactively with residents during three feedback sessions.Results48 clinical supervisors (28 intervention group; 20 control group) participated. After the intervention, the number and type of communication skills identified did not differ between both groups. There was substantial heterogeneity in the number and type of communication skills identified. However, trained participants engaged in interactive discussions with residents on a significantly higher number of communication items (effect sizes 0.53 to 1.77); communication skills items discussed interactively included both structural and patient-centered elements that were considered important to be observed by expert teachers.ConclusionsThe faculty development programme did not increase the number of communication skills recognised by supervisors but was effective in increasing the number of communication issues discussed interactively in feedback sessions. Further research should explore the respective impact of accurate identification of communication skills and effective teaching skills on achieving more effective communication skills teaching in clinical practice.

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“…Quite recently, data have started to emerge that, in order to increase the effectiveness of feedback and the subsequent impact on learning, trainees and supervisors need to engage in meaningful relationships over time, so that long-time follow up becomes a possibility (Carless 2006;Watling et al 2010). Scheduling postgraduate rotations of sufficient length with a dedicated supervisor, together with emphasising the importance of the supervisor-trainee relationship in discussions with trainees and supervisors, will increase the effectiveness and credibility of assessment for learning.…”

Section: Supportive Learning Environmentmentioning

confidence: 99%

“…Driving forces behind this shift are the fragmentation of postgraduate training that it is the result of reduced working hours, increase part-time staff and subspecialisation (Kennedy et al 2005;Watling et al 2010) together with increased pressures for certification and professional regulation (Sutherland & Leatherman 2006;Irvine 2007). These changes have led to an appeal for more efficient postgraduate training and for transparent, credible assessment.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study on trainees’ and supervisors’ perceptions of assessment for learning in postgraduate medical education

et al. 2013

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Introduction: Recent changes in postgraduate medical training curricula usually encompass a shift towards more formative assessment, or assessment for learning. However, though theoretically well suited to postgraduate training, evidence is emerging that engaging in formative assessment in daily clinical practice is complex. Aim: We aimed to explore trainees' and supervisors' perceptions of what factors determine active engagement in formative assessment. Methods: Focus group study with postgraduate trainees and supervisors in obstetrics and gynaecology. Results: Three higher order themes emerged: individual perspectives on feedback, supportiveness of the learning environment and the credibility of feedback and/or feedback giver. Conclusion: Engaging in formative assessment with a genuine impact on learning is complex and quite a challenge to both trainees and supervisors. Individual perspectives on feedback, a supportive learning environment and credibility of feedback are all important in this process. Every one of these should be taken into account when the utility of formative assessment in postgraduate medical training is evaluated.

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An Exploration of Faculty Perspectives on the In-Training Evaluation of Residents

Abstract: Faculty engagement in the ITER process may be compromised by both system and interpersonal challenges. These challenges may render ITERs less meaningful than faculty intend. Training programs must complement ITE with other tools to achieve robust systems of evaluation.

Cited by 53 publications

References 18 publications

Faculty staff perceptions of feedback to residents after direct observation of clinical skills

Faculty staff perceptions of feedback to residents after direct observation of clinical skills

Impact of postgraduate training on communication skills teaching: a controlled study

A qualitative study on trainees’ and supervisors’ perceptions of assessment for learning in postgraduate medical education

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