Medical Student Self-Efficacy With Family-Centered Care During Bedside Rounds

Abstract

Purpose Factors that support self-efficacy must be understood in order to foster family-centered care (FCC) during rounds. Based on social cognitive theory, this study examined (1) how 3 supportive experiences (observing role models, having mastery experiences, and receiving feedback) influence self-efficacy with FCC during rounds and (2) whether the influence of these supportive experiences was mediated by self-efficacy with 3 key FCC tasks (relationship building, exchanging information, and decision making). Method Researchers surveyed 184 students during pediatric clerkship rotations during the 2008–2011 academic years. Surveys assessed supportive experiences and students’ self-efficacy with FCC during rounds and with key FCC tasks. Measurement models were constructed via exploratory and confirmatory factor analyses. Composite indicator structural equation (CISE) models evaluated whether supportive experiences influenced self-efficacy with FCC during rounds and whether self-efficacy with key FCC tasks mediated any such influences. Results Researchers obtained surveys from 172 eligible students who were 76% (130) White and 53% (91) female. Observing role models and having mastery experiences supported self-efficacy with FCC during rounds (each p<0.01), while receiving feedback did not. Self-efficacy with two specific FCC tasks, relationship building and decision making (each p < 0.05), mediated the effects of these two supportive experiences on self-efficacy with FCC during rounds. Conclusions Observing role models and having mastery experiences foster students’ self-efficacy with FCC during rounds, operating through self-efficacy with key FCC tasks. Results suggest the importance of helping students gain self-efficacy in key FCC tasks before the rounds experience and helping educators implement supportive experiences during rounds.

Teaching in a Family-Centered Care Model: The Exam Room as the Classroom

“…Having role models who teach, and learn, in front of patients assists students in developing their own communication skills and bedside manner. 4 …”

Interrogating patient-centredness in undergraduate medical education using an integrated behaviour model

“…When proper role modelling and feedback on learning are combined with sufficient opportunities for practical experiences, students may be assisted in developing their sense of self-efficacy and thus the patient-centred behaviour that they intend to perform. 25 Crucial aspects that therefore need to part of a patient-centred curriculum are several opportunities where students can observe and practice patient-centredness both in simulation and in the clinical areas. This should be followed by feedback and reflection opportunities.…”

Using Evidence to Overcome Obstacles to Family Presence

“…36 Also, clinicians need to be instructed to involve the patient and family instead of just allowing presence, focus on the goals of care instead of just the interesting aspects of the case, and humanize the patient when conducting rounds with FP. 43 In a study of 36 parents, 19% reported feeling anxious during rounds, yet 83% reported improved satisfaction and 89% felt that they had improved information about their child's condition when allowed to be present on rounds. 11,[37][38][39][40] Furthermore, hallway rounds that do not include family members have been reported to increase anxiety and suspicion and also cause concerns about confidentiality, as evidenced by direct feedback from families to those testing models of FPR.…”