The educational affordances of external clinician observation of GP trainee consultations.
Journal
Medical education
ISSN: 1365-2923
Titre abrégé: Med Educ
Pays: England
ID NLM: 7605655
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
07
05
2022
received:
14
03
2022
accepted:
13
05
2022
pubmed:
19
5
2022
medline:
5
8
2022
entrez:
18
5
2022
Statut:
ppublish
Résumé
There is widespread agreement about the importance of direct observation of trainee practice by clinical supervisors. Less is known about observation by observers external to the supervisory team. We explored the educational affordances of external observation of GP trainee consultations for educational and assessment purposes, from the perspectives of both observers and trainees. GP medical educators, who were scheduled to observe sessions of GP trainee consultations, were recruited as participant observers. They completed field notes, reflective memos and a focus group discussion, and conducted post-observation interviews with trainees, focused on trainee experiences of accessing educational input from supervisors and observers during the sessions. Thematic analysis was guided by constructivist realism and socio-cultural theory. A total of 23 observation sessions (131 observed patient consultations), 33 trainee interviews and 23 observer reflections were completed. External observers embraced teaching, coaching and pastoral opportunities, rather than being 'flies on the wall', despite also having research and assessment roles. They gained useful insights into the challenges of obtaining and providing in-consultation supervisory assistance and provided some in-consultation guidance themselves. Both trainees and observers experienced the sessions as valuable and collegial. Trainees appreciated post-consultation feedback conversations: topics included consultation challenges, managing uncertainty and variation in clinical practice. Patient expectations and pre-existing relationships influenced the distinctive interpersonal dynamic of the externally observed consultation. The educational affordances and interpersonal dynamics of external observation differ from supervisor observation. We recommend wider use in clinical training of observers who cross between educator and clinician communities.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
915-921Informations de copyright
© 2022 Association for the Study of Medical Education and John Wiley & Sons Ltd.
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