Successful Implementation of a Direct Observation Program in an Ambulatory Block Rotation

Abstract

Background Direct observation of clinical skills is a cornerstone of competency-based education and training. Ensuring direct observation in a consistent fashion has been a significant challenge for residency programs.

Coaching Residents in the Ambulatory Setting: Faculty Direct Observation and Resident Reflection

“…11 Previous studies examining direct observation in the outpatient setting have shown acceptability among faculty and changes in practice. 12,13 A longitudinal coaching program in pediatrics was associated with an increase in integration of resident self-assessment into feedback sessions and improved resident confidence in faculty feedback, 18 and other models of direct observation, such as videotaping, have shown promise in improving the quality of feedback. 19 We found differences between resident self-evaluation and faculty-observed performance, consistent with previous literature showing poor rates of physician self-assessment of clinical skills.…”

“…Ambulatory practice is a crucial aspect of internal medicine residency training in which direct observation is often limited because of encounters occurring behind closed doors with several residents supervised by 1 attending physician. Data suggested that structured episodes of direct observation in ambulatory settings might be valuable for educational assessment and resident skills development, 12,13 although no published studies, to our knowledge, have examined the benefits of adding structured coaching in this clinical setting.…”

The Enhanced Brief Structured Observation Model: Efficiently Assess Trainee Competence and Provide Feedback

“…Direct observation represents the major way to assess the professional competence of trainees. [1][2][3][4][5][6] With few models in the literature on which to base one's observations, the enhanced BSO model we have presented gave faculty a tool they can use to observe trainees more frequently and provided an opportunity to give more specific and effective feedback.…”

Longitudinal resident coaching in the outpatient setting: A novel intervention to improve ambulatory consultation skills

“…Previous direct observation and coaching interventions in the outpatient setting have demonstrated acceptability among residents and faculty, improved resident confidence in faculty feedback, and better identification of blind spots in resident self-assessment [11,13,14]. This paper adds to this sparse literature by describing how this is grounded in a conceptual framework and providing some evidence for its educational value in changing behaviors.…”