The power of questions: a discourse analysis about doctor-student interaction

Zwet, Jonne van der; Croix, Anne de la; Jonge, Laury P. J. W. M. de; Stalmeijer, Renée E.; Scherpbier, Albert J.J.A.; Teunissen, Pim W.

doi:10.1111/medu.12493

Cited by 17 publications

(9 citation statements)

References 26 publications

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“…Our results suggest that pedagogic practices that encourage an open dialogue could be the key to achieving an optimal level of intersubjectivity. 25 In addition to confirming how difficult it can be to give trainees the desired amount of autonomy and opportunities to participate, [11][12][13]26 our findings expand our understanding of how residents take advantage of such imbalance. Even when the clinical supervisor did not provide the expected amount of autonomy or opportunities to participate, residents struck back and forced them to engage in productive pedagogic practices that benefited them, restoring the balance and easing the tension.…”

Section: Become a Passive Observersupporting

confidence: 53%

Dealing with the tension: how residents seek autonomy and participation in the workplace

et al. 2017

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Section: Become a Passive Observersupporting

confidence: 53%

Dealing with the tension: how residents seek autonomy and participation in the workplace

et al. 2017

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“…Hence, our findings are consistent with socio-constructivist views on assessment that explicitly acknowledge the role of assessment users' views, beliefs, values and attitudes in shaping assessment behaviours [44,45]. Supervisor-resident dyads must be aware of the ways they communicate about the use of performance observations in residency training, of factors that are known to affect communication and decision-making -including power differences and gender communication differences-, and their potential impact on the creation of a shared working repertoire [46,47]. To unlock the full potential of observations, working towards an effective educational alliance requires awareness of and transparency about the individual goals and preferential approaches of both supervisor and resident, in equal partnerships [48,49].…”

Section: Implications For Educational Practice and Researchsupporting

confidence: 70%

Supervisory dyads’ communication and alignment regarding the use of workplace-based observations: a qualitative study in general practice residency

et al. 2022

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Background In medical residency, performance observations are considered an important strategy to monitor competence development, provide feedback and warrant patient safety. The aim of this study was to gain insight into whether and how supervisor-resident dyads build a working repertoire regarding the use of observations, and how they discuss and align goals and approaches to observation in particular. Methods We used a qualitative, social constructivist approach to explore if and how supervisory dyads work towards alignment of goals and preferred approaches to performance observations. We conducted semi-structured interviews with supervisor-resident dyads, performing a template analysis of the data thus obtained. Results The supervisory dyads did not frequently communicate about the use of observations, except at the start of training and unless they were triggered by internal or external factors. Their working repertoire regarding the use of observations seemed to be primarily driven by patient safety goals and institutional assessment requirements rather than by providing developmental feedback. Although intended as formative, the institutional test was perceived as summative by supervisors and residents, and led to teaching to the test rather than educating for purposes of competence development. Conclusions To unlock the full educational potential of performance observations, and to foster the development of an educational alliance, it is essential that supervisory dyads and the training institute communicate clearly about these observations and the role of assessment practices of- and for learning, in order to align their goals and respective approaches.

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“…Therefore, rating questioning as positive may have been influenced by the image students felt able to portray. The role of questioning in medicine also has a long tradition and the nuances attached to its value are complex [50].…”

Section: Positive Affectmentioning

confidence: 99%

Relationships among perceived learning, challenge and affect in a clinical context

et al. 2021

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Background Challenge, sometimes perceived as stress, may be beneficial or detrimental to learning but the circumstances when it may be beneficial are not clear. This study looks at the association of challenge with perceived learning and how this might be influenced by affect, context or the type of learning. Method The participants, medical students in their first years of experiential clinical exposure, rated specified learning episodes (LEs) on the perceived learning (low to high), challenge (low to high) and affect (feeling positive to negative). Such learning episodes were self-identified or identified by course organisers. Correlations, using Kendall’s tau-b test, were conducted to explore the associations among learning, challenge and affect. In the second stage the types of LEs were then thematically classified in order to determine those that were positive for learning and challenging and/or associated with positive affect. Result There were positive correlations between perceived learning and challenge, and between perceived learning and affect for both types of LEs. The circumstances in which challenge (stress) promoted learning were authentic environments, authentic tasks and simulated clinical activities; most requiring a degree of social interaction. Conclusion Challenge and positive affect are beneficial in the perception of discrete learning, but are two separate constructs. Ideally both challenge and affect need to operate alongside authentic supportive clinical activities, that by their nature involve others, to maximise perceived learning.

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The power of questions: a discourse analysis about doctor-student interaction

Cited by 17 publications

References 26 publications

Dealing with the tension: how residents seek autonomy and participation in the workplace

Dealing with the tension: how residents seek autonomy and participation in the workplace

Supervisory dyads’ communication and alignment regarding the use of workplace-based observations: a qualitative study in general practice residency

Relationships among perceived learning, challenge and affect in a clinical context

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