Characteristics of family physicians’ clinical teaching behaviors in the ambulatory setting: A descriptive study

Hekelman, Francine P.; Vanek, Eugenia P.; Kelly, Kathleen; Alemagno, Sonia A.

doi:10.1080/10401339309539582

Cited by 27 publications

(22 citation statements)

References 7 publications

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“…For further details on how the observational attributes were measured, please contact the authors. 'These attributes correlate with those defined by Mattern et al, 10 Hekelman, 19 and Hekelman et al 20 •These attributes correlate with those identified by the ABIM. 4 31 by the project team, the director of the PCC, and two senior faculty recognized for their teaching.…”

Section: Instrumentationsupporting

confidence: 60%

Humanistic teaching attributes of primary care physicians

Hekelman

Snyder

Alemagno

et al. 1995

Teaching and Learning in Medicine

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Section: Instrumentationsupporting

confidence: 60%

Humanistic teaching attributes of primary care physicians

Hekelman

Snyder

Alemagno

et al. 1995

Teaching and Learning in Medicine

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“…Feedback in ambulatory encounters is uncommon, ranging from 3.5% to 19% in various studies 1–4 . Furthermore, the scant feedback delivered is generally not specific and is rarely corrective 4–7 .…”

mentioning

confidence: 99%

Interactive faculty development seminars improve the quality of written feedback in ambulatory teaching

2003

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We performed a pre-post study of the impact of three 90-minute faculty development workshops on written feedback from encounters during an ambulatory internal medicine clerkship. We coded 47 encounters before and 43 after the workshops, involving 9 preceptors and 44 third-year students, using qualitative and semiquantitative methods. Postworkshop, the mean number of feedback statements increased from 2.8 to 3.6 statements ( P = .06); specific ( P = .04), formative ( P = .03), and student skills feedback ( P = .01) increased, but attitudinal ( P = .13) and corrective feedback did not ( P = .41). Brief, interactive, faculty development workshops may refine written feedback, resulting in more formative specific written feedback comments. While the amount and quality of verbal feedback improved and some aspects of preceptor self-perception improved, learner satisfaction remained unchanged. Building on that work, we performed the current study to characterize the content of written feedback in the outpatient clinic, and discern whether the amount and quality of written feedback also could be improved after our faculty development program. METHODSWe studied the effect of an ambulatory faculty development workshop on written feedback during a third-year outpatient medicine clerkship. Our intervention consisted of three 90-minute ambulatory faculty development seminars scheduled 1 week apart. The seminars were 30-minute minilectures, an interactive discussion about a videotaped simulated teaching encounter, and role-plays. The first session focused on the One-Minute Preceptor , and ambulatory teaching goals in general, the second on methods of evaluation in the ambulatory setting, and the third on the characteristics of quality feedback and how to provide it. During the third session, a specific 20-minute block of instruction covering effective written feedback was provided. We stressed the need to be specific and interactively discussed improving written feedback with suboptimal feedback examples.Routinely during this clerkship, preceptors fill out 3 ″ × 5 ″ cards rating student performance after each encounter. Written feedback for 3 months before and after faculty participation in an ambulatory teaching program was compared. After each encounter, teachers and learners were also asked several Likert-type questions on the amount and quality of feedback provided. Survey questions did not differentiate between verbal and written feedback. This study was performed in conjunction with assessment of verbal

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“…It is mainly specific feedback that will help to improve performance, as was demonstrated in a study on the positive effect of individual feedback given to physicians on specific aspects of their clinical behaviour 18. Other studies describing teaching interactions between faculty and residents/medical students reported varying rates of different types of feedback, with positive feedback being consistently higher than negative feedback (Glenn et al :19 35% positive and 0% critical feedback; Hekelman et al :20 16% positive and 11% negative feedback). However, these studies did not differentiate between specific and general feedback.…”

Section: Discussionmentioning

confidence: 99%