Direct observation in postgraduate training: making it happen and making it work

Renting, Nienke

doi:10.1111/medu.13755

Cited by 3 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Barriers to DO include resources, institutional culture, faculty time/remuneration, inadequate faculty development related to assessment, and lack of validated assessment tools. 2,3,4 Barriers to implementation were minimized due to our program having already transitioned to a competency-based assessment consistent with the 'Competence by Design' framework. 8 At Queen's University, our faculty do not work on a strictly fee-forservice model; therefore, the allocation of resources such as time and money minimally restricts our ability to schedule staff as dedicated assessors (DA) as much as has been reported in other research 3 in this area.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 Due to these barriers, substantial uncertainty remains on how best to practically implement or increase high-quality direct observation in the clinical setting in CBME residency training programs. 4 Resource implications of the successful program transformations required for CBME are considerable (e.g., curriculum reform, assessment culture change, human resources and management, educational technology implementation). Although the assessment system is not the only major change, it does require considerable time and resources to operationalize.…”

Section: Introductionmentioning

confidence: 99%

“…Being able to facilitate DO to allow for authentic workplace-based assessments is an essential part of implementing CBME as it is foundational to workplace-based assessment tools, allows for feedback provision as a powerful stimulus for learning, and strengthens the relationship and mutual trust between attendings and resident physicians. 4 This paper describes an educational innovation aimed at increasing DO by implementing a new role termed a Dedicated Assessor (DA) in an ambulatory clinic setting. It also explores assessor and resident perceptions of the project to inform best practices supporting DO as our residency training transitions fully to CBME.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dedicated Assessors: description of an innovative education intervention to facilitate direct observation in the clinical setting

et al. 2021

View full text Add to dashboard Cite

Background: The Department of Pediatrics at Queen’s University undertook a pilot project in July 2017 to increase the frequency of direct observations (DO) its residents received without affecting the patient flow in a busy hospital-based pediatric ambulatory care clinic. Facilitating DO for authentic workplace-based assessments is essential for assessing resident’s core competencies. The purpose of this study was to pilot an innovative education intervention to address the challenge of implementing DO in the clinical setting. Methods: The project allowed for staff physicians to act as “dedicated assessors” (DA), a faculty member who was scheduled to conduct direct observations of trainees’ clinical skills, while not acting as the attending physician on duty. At the end of the project, focus group interviews were conducted with faculty and residents, and thematic analysis was completed. Results: Participants reported an increase in the overall quality of feedback received during the observations performed by a DA, with more specific feedback and a broader focus of assessment. There seemed to be little disruption to patient care. Some residents described the observations as anxiety-provoking. Conclusions: Overall, this project provides insight into an educational approach that medical residency programs can apply to increase the frequency of workplace-based DO and boost the quality of feedback residents receive while maintaining the flow of already busy ambulatory care clinics.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dedicated Assessors: description of an innovative education intervention to facilitate direct observation in the clinical setting

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Direct supervisor observation of trainee practice is widely acknowledged to be an essential aspect of clinical learning, 1 entrustment 2 and workplace‐based assessment 3 . There have been many calls to systematically embed more direct observation into clinical training 4,5 .…”

Section: Introductionmentioning

confidence: 99%

The educational affordances of external clinician observation of GP trainee consultations

Sturman

Fitzmaurice

Waters³

et al. 2022

Medical Education

View full text Add to dashboard Cite

Aim There is widespread agreement about the importance of direct observation of trainee practice by clinical supervisors. Less is known about observation by observers external to the supervisory team. We explored the educational affordances of external observation of GP trainee consultations for educational and assessment purposes, from the perspectives of both observers and trainees. Method GP medical educators, who were scheduled to observe sessions of GP trainee consultations, were recruited as participant observers. They completed field notes, reflective memos and a focus group discussion, and conducted post‐observation interviews with trainees, focused on trainee experiences of accessing educational input from supervisors and observers during the sessions. Thematic analysis was guided by constructivist realism and socio‐cultural theory. Results A total of 23 observation sessions (131 observed patient consultations), 33 trainee interviews and 23 observer reflections were completed. External observers embraced teaching, coaching and pastoral opportunities, rather than being ‘flies on the wall’, despite also having research and assessment roles. They gained useful insights into the challenges of obtaining and providing in‐consultation supervisory assistance and provided some in‐consultation guidance themselves. Both trainees and observers experienced the sessions as valuable and collegial. Trainees appreciated post‐consultation feedback conversations: topics included consultation challenges, managing uncertainty and variation in clinical practice. Patient expectations and pre‐existing relationships influenced the distinctive interpersonal dynamic of the externally observed consultation. Conclusions The educational affordances and interpersonal dynamics of external observation differ from supervisor observation. We recommend wider use in clinical training of observers who cross between educator and clinician communities.

show abstract

Oncology residents’ experiences of decision-making in a clinical learning environment: a phenomenological study

Sanatani

Muir

2023

Adv in Health Sci Educ

View full text Add to dashboard Cite

Direct observation in postgraduate training: making it happen and making it work

Abstract: How does one successfully implement direct observation of residents’ competencies in postgraduate training programs? Renting offers insights into how to make it work.

Cited by 3 publications

References 10 publications

Dedicated Assessors: description of an innovative education intervention to facilitate direct observation in the clinical setting

Dedicated Assessors: description of an innovative education intervention to facilitate direct observation in the clinical setting

The educational affordances of external clinician observation of GP trainee consultations

Oncology residents’ experiences of decision-making in a clinical learning environment: a phenomenological study

Contact Info

Product

Resources

About