scholarly journals Building a doctor, one skill at a time: Rethinking clinical training through a new skills-based feedback modality

2021 ◽  
Author(s):  
Brandon Kappy ◽  
Lisa E. Herrmann ◽  
Daniel J. Schumacher ◽  
Angela M. Statile
Keyword(s):  
Clinical Training ◽  
Deliberate Practice ◽  
Hospital Medicine ◽  
Cognitive Schemas ◽  
Pediatric Resident ◽  
Theoretical Justification ◽  
Professional Activities ◽  
Worked Example ◽  
Trainee Development ◽  
Situational Contexts

AbstractThe Accreditation Council for Graduate Medical Education milestones and entrustable professional activities (EPAs) are important assessment approaches but may lack specificity for learners seeking improvement through daily feedback. As in other professions, clinicians grow best when they engage in deliberate practice of well-defined skills in familiar contexts. This growth is augmented by specific, actionable coaching from supervisors. This article proposes a new feedback modality called microskills, which are derived from the psychology, negotiation, and business literature, and are unique in their ability to elicit targeted feedback for trainee development. These microskills are grounded in both clinical and situational contexts, thereby mirroring learners’ cognitive schemas and allowing for more natural skill selection and adoption. When taken as a whole, microskills are granular actions that map to larger milestones, competencies, and EPAs. This article outlines the theoretical justification for this new skills-based feedback modality, the methodology behind the creation of clinical microskills, and provides a worked example of microskills for a pediatric resident on a hospital medicine rotation. Ultimately, microskills have the potential to complement milestones and EPAs and inform feedback that is specific, actionable, and relevant to medical learners.

scholarly journals Preparedness to practice paediatric hospital medicine

2019 ◽  
Vol 25 (7) ◽  
pp. 447-454
Author(s):  
Peter Vetere ◽  
Suzette Cooke
Keyword(s):  
Hospital Setting ◽  
Hospital Medicine ◽  
Paediatric Population ◽  
Fellowship Training ◽  
Medical Community ◽  
Independent Practice ◽  
New Paradigm ◽  
Paediatric Hospital ◽  
Professional Activities ◽  
The Usa

Abstract Background The field of paediatric hospital medicine (PHM) is evolving to meet the needs of an increasingly complex paediatric population, lead quality improvement initiatives, and conduct field-specific teaching and research. Over 50 subspecialty PHM fellowship programs exist in the USA and Canada and more are under active development to ensure trainees are prepared to perform competencies specific to the field following transition to independent practice. Objective The objective of this study was to assess the perceived preparedness of recently graduated general paediatric residents and recently certified staff paediatricians in Canada with respect to the practice of PHM. Methods A survey based on the ‘Objectives of Training in Pediatrics’ of the Royal College of Physicians and Surgeons of Canada (RCPSC) was distributed to graduating paediatric residents and recently graduated staff paediatricians (2013 to 2017) practicing in the hospital setting. Qualitative comments were also obtained. Results Fifty-five surveys were completed (50%). Respondents perceived that, at the on-set of starting practice, they would require assistance or consultation with the majority of representative PHM task competencies. Differences in perception between the two groups were minimal. Our study identified sub-sets of perceived areas of particular strengths (Professional) and deficiencies (Medical Expert, Manager, and Scholar). Conclusions Results may help inform future curricula for general paediatric residency programs and provide insight into competencies that may be better targeted for PHM fellowship training programs. This study may also stimulate discussion regarding entrustable professional activities for paediatric curricula as the medical community shifts to a new paradigm of outcome-based assessment.

scholarly journals Pedahohichni umovy formuvannia universalnoi kliuchovoi kompetentnosti v intensyvnii terapii na pershomu etapi pisliadyplomnoho navchannia zakladu vyshchoi medychnoi osvity [Pedagogical conditions of forming a universal key competence in intensive care during the first stage of postgraduate education in a medical school]

2021 ◽  
Vol 4 (2) ◽  
pp. 67-71
Author(s):  
O. Yu. Muryzina
Keyword(s):  
Intensive Care ◽  
Professional Education ◽  
Clinical Training ◽  
Life Support ◽  
Postgraduate Education ◽  
Self Organization ◽  
Critical Conditions ◽  
Educational Systems ◽  
Efficient Treatment ◽  
Professional Activities

Background: Intensive care is a universal professional key competence for doctors of all specializations. Preventive care, early detection and timely correction of precursors, life-threatening symptoms and complications, are its structural components that must ensure capabilities and readiness to diagnose acute pathologies and to provide efficient treatment for patients in critical conditions. It requires complex professional skills, know-hows, attitude and working experience which must be created by professional educational systems, focused on both near- and long-term outcomes for patients. Purpose: To increase effectiveness of medical education by improving related technologies and methodologies. Materials and Methods: Contemporary interactive education in cardio-respiratory resuscitation and intensive care for medical interns of all specializations which was improved in line with recent development of intensive care technologies and devices for patients’ monitoring and life support. Results: Our adaptive educational environment allowed to implement pedagogical process as a complex professional adult education system. Competency-oriented approach was used for structured accumulation of know-hows, increased complexity of systematic assignments for theoretical, simulated, and practical clinical training, thereby providing for comprehensive adoption of the invariant content. Systematic approach to assignments of variable complexity helped to overcome educational difficulties and adequately evaluate the results and perspectives of individual activities. It strengthened motivation for professional self-organization and developed related competencies and value-based attitude to professional activities. Conclusions: Adult professional education during early post-graduate stage is implemented as pedagogical process targeting comprehensive improvements of personal actionable self-organization while acquiring new know-hows, technological and perceptive actions and providing new levels of self-development and professional competencies.

scholarly journals ‘Whatever you cut, I can fix it’: clinical supervisors’ interview accounts of allowing trainee failure while guarding patient safety

2019 ◽  
Vol 29 (9) ◽  
pp. 727-734 ◽  
Author(s):  
Jennifer M Klasen ◽  
Erik Driessen ◽  
Pim W Teunissen ◽  
Lorelei A Lingard
Keyword(s):  
Patient Safety ◽  
Clinical Training ◽  
Diagnostic Procedures ◽  
Educational Value ◽  
Educational Benefits ◽  
Clinical Supervisors ◽  
Individual Interviews ◽  
Trainee Development ◽  
Communication Events ◽  
Critical Resource

BackgroundLearning is in delicate balance with safety, as faculty supervisors try to foster trainee development while safeguarding patients. This balance is particularly challenging if trainees are allowed to experience the educational benefits of failure, acknowledged as a critical resource for developing competence and resilience. While other educational domains allow failure in service of learning, however, we do not know whether or not this strategy applies to clinical training.MethodsWe conducted individual interviews of clinical supervisors, asking them whether they allowed failure for educational purposes in clinical training and eliciting their experiences of this phenomenon. Participants’ accounts were descriptively analysed for recurring themes.ResultsTwelve women and seven men reported 48 specific examples of allowing trainee failure based on their judgement that educational value outweighed patient risk. Various kinds of failures were allowed: both during operations and technical procedures, in medication dosing, communication events, diagnostic procedures and patient management. Most participants perceived minimal consequences for patients, and many described their rescue strategies to prevent an allowed failure. Allowing failure under supervision was perceived to be important for supporting trainee development.ConclusionClinical supervisors allow trainees to fail for educational benefit. In doing so, they attempt to balance patient safety and trainee learning. The educational strategy of allowing failure may appear alarming in the zero-error tolerant culture of healthcare with its commitment to patient safety. However, supervisors perceived this strategy to be invaluable. Viewing failure as inevitable, they wanted trainees to experience it in protected situations and to develop effective technical and emotional responses. More empirical research is required to excavate this tacit supervisory practice and support its appropriate use in workplace learning to ensure both learning and safety.

scholarly journals The Case for Writing Critical Thinking Reports as a Teaching Strategy on Today’s Hospital Wards

2020 ◽  
Vol 7 ◽  
pp. 238212052094887
Author(s):  
Farrin A Manian
Keyword(s):  
Critical Thinking ◽  
Medical Students ◽  
Learning Experience ◽  
Teaching Strategy ◽  
Hospital Medicine ◽  
Directed Search ◽  
Extensive Literature ◽  
Professional Activities ◽  
Work Related ◽  
College Classes

I review some of the challenges in teaching medical students and housestaff on today’s hospital medicine wards, including increasingly limited time for dedicated teaching. Tapping into the extensive literature of “writing to learn” or “writing-across-the curriculum” in non-medical educational settings ranging from elementary school to college classes, I urge consideration of writing concise critical thinking reports (CTRs) by medical students and housestaff in response to questions raised during patient rounds as a means of enhancing their ward-based learning experience. Several potential reasons for writing CTRs are offered: (1) Nurtures curiosity; (2) Demands self-directed search for and encoding of new knowledge; (3) Emphasizes metacognition and conceptualization crucial to meaningful learning; (4) Provides opportunity for learners to teach and share newly-assimilated material with a broader web-based audience; (5) Encourages the concept of narrow but more in-depth learning related to a specific clinically relevant subject matter; (6) Nudges learners toward clear and succinct writing as an important general skill to develop in their everyday professional activities, including electronic medical record documentation; and (7) Reduces work-related burnout. Barriers to writing CTRs, including lack of general appreciation for explanatory writing as a potential teaching strategy in medical education and allowing sufficient time for medical students and housestaff to engage in this activity among other competing demands, are discussed. Writing CTRs is a potentially powerful pedagogical tool in ward-based learning that deserves consideration and formal evaluation by properly designed studies.

An Analysis of Pastoral Counseling Supervisors: Their Identities, Roles and Resources

1983 ◽  
Vol 37 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Craig A. Everett ◽  
Anthony Wayland-Seaton-Johnson
Keyword(s):  
Professional Identity ◽  
Pastoral Counseling ◽  
Clinical Training ◽  
Demographic Variables ◽  
Female Representation ◽  
Research Project ◽  
Professional Activities ◽  
Personal Psychotherapy ◽  
Counseling Supervisors

Reports on a research project on a population of 900 persons identified as Diplomates and Fellows of AAPC and ACPE Supervisors. Analyzes demographic variables, issues of supervision, professional activities, and supervisor attitudes. Discusses data implications for AAPC and ACPE noting especially the lack of female representation in the organizations, ambivalences in regard to professional identity, and the disparities related to personal psychotherapy as an adjunct to clinical training.

The Impact of a 9-Month Booster Training Using Rapid Cycle Deliberate Practice on Pediatric Resident PALS Skills

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sai Surapa Raju ◽  
Nancy M. Tofil ◽  
Stacy L. Gaither ◽  
Carrie Norwood ◽  
J. Lynn Zinkan ◽  
...  
Keyword(s):  
Deliberate Practice ◽  
Pediatric Resident ◽  
The Impact

scholarly journals Entrustable Professional Activities for Undergraduate Nutrition Student Clinical Training: Development and Implementation

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 485-485
Author(s):  
Weining Wang ◽  
Ya Ling Wang ◽  
Chao Hsiu Chen ◽  
Yi Jui Chan ◽  
Hui Min Hsieh
Keyword(s):  
Clinical Training ◽  
Credit Rating ◽  
Medical Training ◽  
Medical Center ◽  
Complete Information ◽  
Multisource Feedback ◽  
Entrustable Professional Activities ◽  
Diabetic Patients ◽  
Professional Activities ◽  
Nutrition Care

Abstract Objectives Entrustable professional activities (EPAs) have been applied to postgraduate and undergraduate medical training, but the application of nutrition intern students is rare. The clinical training of nutrition intern students must be connected with the nutrition care ability after graduation. Outpatient diabetes nutrition care is an important job of hospital dietitian. Therefore, this is the good point for the development of EPAs evaluation. The objective of this study was to describe the development of EPAs for nutrition intern training in the nutrition department of a medical center. Methods We chose the topic “Diet and health education for diabetic patients in outpatient clinics” and set the EPAs framework. EPAs was developed through an iterative consensus process involving the advanced dietitians. The content includes task description, capabilities (knowledge, skills, attitudes and behaviors), evaluation information, setting the trust level and validity period. The evaluation was established through expert validity. Final EPAs revisions followed from the multisource feedback. The Clinical Competency Committees (CCC) was established for final evaluation and approval. Results The EPAs was piloted for intern students in the Nutrition Department of the Medical Center from 2019. The assessment methods include test, mini-CEX, ad-hoc EPA, OSCE. The assessment content includes the knowledge of diabetes medical, diet, drug, clinical consultation, education, empathy and attitude, etc. Students were evaluated during each period of training. Finally, all the evaluation results were summarized and the CCC gave each student a credit rating. Conclusions Through multiple evaluations and timely feedback, the ability of intern students was defined in more precision. It allowed clinical teachers to achieve a teaching consensus. Combine competence with actual work, and integrate evaluation with authorization. We need to construct a complete information system to make evaluation more efficient in the future. Funding Sources None.

Sign in / Sign up

Export Citation Format

Share Document