Outpatient case presentations in the conference room versus examination room: results from two randomized controlled trials

Anderson, Robert J.; Cyran, Elizabeth M.; Schilling, Lisa M.; Chen, Lin; Albertson, Gail; Ware, Lindsay; Steiner, John F.

doi:10.1016/s0002-9343(02)01320-7

Cited by 27 publications

(18 citation statements)

References 17 publications

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“…Several patients stated that they felt more comfortable knowing a preceptor was observing the visit. This is in line with findings from prior studies showing that patients appreciate interaction with faculty members when seeing a resident doctor . Only one patient declined to have their clinical encounter observed.…”

Section: Discussionsupporting

confidence: 90%

Observing trainee encounters using a one-way mirror

2014

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Summary Background Direct observation of patient encounters is a key component of evaluating residents during training, but there are scarce data on the various methods of observation. Aim To implement a novel method for direct observation of out‐patient encounters via a one‐way mirror in an internal medicine resident practice, and to assess the feasibility and acceptance of this method. Methods Each selected resident–patient encounter was directly observed by a preceptor through a one‐way mirror. The preceptor provided feedback to the resident at the conclusion of each encounter. A post‐visit survey assessed resident satisfaction and comfort with this method of observation. Results Using a one‐way mirror was a feasible method of observation. Fifty residents had a clinic visit that was directly observed, and 42 (84%) completed the post‐visit survey. Residents reported that they preferred direct observation through a one‐way mirror compared with other methods, including videotaped encounters or having a preceptor physically present in the room. They also felt that having a preceptor observing through the one‐way mirror had no negative effect on the clinic visit. Conclusions Direct observation through a one‐way mirror is a viable method in the out‐patient setting, and might be preferable for evaluating certain skills.

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Section: Discussionsupporting

confidence: 90%

Observing trainee encounters using a one-way mirror

2014

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“…Finally, 1 study supported prior findings that patients continue to express preference for bedside discussions of their cases, although patient satisfaction did not differ by location of case discussions 61 . A small minority of residents felt loss of autonomy and some felt awkward.…”

Section: Resultssupporting

confidence: 78%

Changing habits of practice

et al. 2005

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This updated review continues to identify key deficiencies in ambulatory training curriculum and faculty skills. The authors make several recommendations: (1) Make training in the ambulatory setting a priority. (2) Address systems problems in practice environments. (3) Create learning experiences appropriate to the resident's level of development. (4) Teach and evaluate in the examination room. (5) Expand subspecialty-based training to the ambulatory setting. (6) Make faculty development a priority. (7) Create and fund multiinstitutional educational research consortia.

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“…1,2 Procedure services have the potential to affect patient satisfaction, a key indicator in quality of care measurment. 3 Having senior physicians present increases patient comfort during outpatient case presentations 4 and improves patient satisfaction with explanations of tests and medications. 5 However, we had concerns that teaching during a procedure may heighten patient anxiety.…”

mentioning

confidence: 99%

Patient satisfaction with a hospitalist procedure service: Is bedside procedure teaching reassuring to patients?

Mourad

Auerbach

Maselli

et al. 2011

Journal of Hospital Medicine

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BACKGROUND:In recent years, hospital medicine programs have adopted “procedure teams” that supervise residents in performing invasive bedside procedures. The effect of procedure teams on patient satisfaction is unknown.OBJECTIVE:We sought to measure patient satisfaction with procedures performed by a hospitalist‐supervised, intern‐based procedure service (HPS) with a focus on patient perception of bedside communication.DESIGN:This was a prospective survey.METHODS:We surveyed all patients referred to the HPS for bedside thoracentesis, paracentesis, lumbar puncture, and arthrocentesis at a single academic medical center. Following each procedure, surveys were administered to English‐speaking patients who could provide informed consent. Survey questions focused on patients' satisfaction with specific aspects of procedure performance as well as the quality and impact of communication with the patient and between members of the team.RESULTS:Of 95 eligible patients, 65 (68%) completed the survey. Nearly all patients were satisfied or very satisfied with the overall experience (100%), explanation of informed consent (98%), pain control (92%), and expertise (95%) of physicians. The majority of patients were satisfied with procedure duration (88%) and in those with therapeutic procedures most (89%) were satisfied with improvement in symptoms. Hearing physicians discuss the procedure at the bedside was reassuring to most patients (84%), who felt this to be a normal part of doing a procedure (94%).CONCLUSIONS:Patients are highly satisfied with procedure performance by supervised trainees, and many patients were reassured by physician communication during the procedure. These results suggest that patient experience and teaching can be preserved with a hospitalist‐supervised procedure service. Journal of Hospital Medicine 2011. © 2011 Society of Hospital Medicine.

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Outpatient case presentations in the conference room versus examination room: results from two randomized controlled trials

Cited by 27 publications

References 17 publications

Observing trainee encounters using a one-way mirror

Observing trainee encounters using a one-way mirror

Changing habits of practice

Patient satisfaction with a hospitalist procedure service: Is bedside procedure teaching reassuring to patients?

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