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Lockyer J, Lee-Krueger R, Armson H, Hanmore T, Koltz E, Könings K, Mahalik A, Ramani S, Roze des Ordons A, Trier J, Zetkulic M, Sargeant J. Application of the R2C2 Model to In-the-Moment Feedback and Coaching. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:1062-1068. [PMID: 37797303 DOI: 10.1097/acm.0000000000005237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE The R2C2 (relationship, reaction, content, coaching) model is an iterative, evidence-based, theory-informed approach to feedback and coaching that enables preceptors and learners to build relationships, explore reactions and reflections, confirm content, and coach for change and cocreate an action plan. This study explored application of the R2C2 model for in-the-moment feedback conversations between preceptors and learners and the factors that influence its use. METHOD A qualitative study using framework analysis through the lens of experiential learning was undertaken with 15 trained preceptor-learner dyads. Data were collected during feedback sessions and follow-up interviews between March 2021 and July 2022. The research team familiarized themselves with the data, used a coding template to document examples of the model's application, reviewed the initial framework and revised the coding template, indexed and summarized the data, created a summary document, examined the transcripts for alignment with each model phase, and identified illustrative quotations and overarching themes. RESULTS Fifteen dyads were recruited from 8 disciplines (11 preceptors were paired with a single resident [n = 9] or a single medical student [n = 2]; 2 preceptors each had 2 residents). All dyads were able to apply the R2C2 phases of building relationships, exploring reactions and reflections, and confirming content. Many struggled with the coaching components, specifically in creating an action plan and follow-up arrangements. Preceptor skill in applying the model, time available for feedback conversations, and the nature of the relationship impacted how the model was applied. CONCLUSIONS The R2C2 model can be adapted to contexts where in-the-moment feedback conversations occur shortly after a clinical encounter. Experiential learning approaches applying the R2C2 model are critical. Skillful application of the model requires that learners and preceptors go beyond confirming an area of change and deliberately engage in coaching and cocreating an action plan.
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Affiliation(s)
- Jocelyn Lockyer
- J. Lockyer is professor emerita and adjunct professor, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0002-3928-4827
| | - Rachelle Lee-Krueger
- R. Lee-Krueger is an education consultant, Office of Continuing Medical Education and Professional Development, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0001-6122-1868
| | - Heather Armson
- H. Armson is professor and assistant dean, Department of Family Medicine, Office of Continuing Medical Education and Professional Development, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0002-7147-6749
| | - Tessa Hanmore
- T. Hanmore is an educational consultant, Departments of Ophthalmology, Psychiatry, and Physical Medicine and Rehabilitation, Queen's University, Kingston, Ontario, Canada; ORCID: https://orcid.org/0000-0002-4654-9969
| | - Elizabeth Koltz
- E. Koltz is director of instructional and curricular design and assistant professor, Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, New Jersey; ORCID: https://orcid.org/0000-0002-0368-7413
| | - Karen Könings
- K. Könings is associate professor, School of Health Professions Education, Maastricht University, Maastricht, the Netherlands; ORCID: https://orcid.org/0000-0003-0063-8218
| | - Anne Mahalik
- A. Mahalik is an evaluation specialist, Continuing Professional Development & Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0003-3201-0871
| | - Subha Ramani
- S. Ramani is associate professor of medicine, Harvard Medical School, and adjunct professor, MGH Institute for Health Professions Education, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-8360-4031
| | - Amanda Roze des Ordons
- A. Roze des Ordons is clinical associate professor, Departments of Critical Care Medicine, Anesthesiology, and Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; ORCID: https://orcid.org/0000-0001-6480-4946
| | - Jessica Trier
- J. Trier is assistant professor, Department of Physical Medicine and Rehabilitation, Queen's University, Kingston, Ontario, Canada; ORCID: https://orcid.org//0000-0001-7478-8863
| | - Marygrace Zetkulic
- M. Zetkulic is associate professor of medicine and vice chair for medical education, Hackensack Meridian School of Medicine, Nutley, New Jersey; ORCID: https://orcid.org//0000-0002-2778-2124
| | - Joan Sargeant
- J. Sargeant is professor (postretirement), Continuing Professional Development and Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; ORCID: https://orcid.org/0000-0003-0451-3674
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Toews H, Pearce J, Tavares W. Recasting Assessment in Continuing Professional Development as a Person-Focused Activity. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:S35-S40. [PMID: 38054490 DOI: 10.1097/ceh.0000000000000538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
ABSTRACT In this article, we examine assessment as conceptualized and enacted in continuing professional development (CPD). Assessment is pervasive throughout the life of an individual health professional, serving many different purposes compounded by varied and unique contexts, each with their own drivers and consequences, usually casting the person as the object of assessment. Assessment is often assumed as an included part in CPD development conceptualization. Research on assessment in CPD is often focused on systems, utility, and quality instead of intentionally examining the link between assessment and the person. We present an alternative view of assessment in CPD as person-centered, practice-informed, situated and bound by capability, and enacted in social and material contexts. With this lens of assessment as an inherently personal experience, we introduce the concept of subjectification, as described by educationalist Gert Biesta. We propose that subjectification may be a fruitful way of examining assessment in a CPD context. Although the CPD community, researchers, and educators consider this further, we offer some early implications of adopting a subjectification lens on the design and enactment of assessment in CPD.
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Affiliation(s)
- Helen Toews
- Toews: Registered Dietitian, The Wilson Centre, University of Toronto, Toronto, Ontario, Canada. Dr. Pearce: Principal Research Fellow, Specialist and Professional Assessment, Tertiary Education, Australian Council for Educational, Research, Camberwell, Australia. Dr. Tavares: Scientist|Assistant Professor, Department of Health and Society, The Wilson Centre, Department of Medicine, University of Toronto, Scarborough, Ontario, Canada
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