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Bevitt T, Pereira RB, Bacon R, Isbel S. Exploring the concepts of consumer feedback systems for occupational therapy student learning during practice placements: A scoping review. Aust Occup Ther J 2024. [PMID: 39039970 DOI: 10.1111/1440-1630.12984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 06/27/2024] [Accepted: 07/04/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Consumer contribution to occupational therapy student learning is mandated for Australian educational programs. However, there is limited research about how consumers contribute to student learning during practice placements. A scoping review was completed to explore the concepts of existing feedback systems for consumers to authentically contribute to student learning during practice placements. METHODS Five databases were searched for all articles up to and including July 2023. All publications were included if they described and investigated authentic contribution to student learning during a practice placement experience. Data from the results and discussion sections of the papers were transformed into qualitative data and thematically analysed to develop a conceptual understanding of consumer feedback systems. RESULTS Forty-six papers met the eligibility criteria. Most articles originated from Medicine (30%) and Nursing (45%) education. Feedback systems were primarily designed to critique student communication and professional behaviours using a variety of standardised and non-standardised methods. Five interconnected themes were created that addressed the concepts of consumer feedback systems. The themes were (1) creating value specific for each stakeholder is essential, (2) preparation is required and nuanced; (3) consumers do engage and provide critical feedback when the system is supportive of all stakeholders; (4) gathering approaches need to be responsive to the diversity of practice and learning; (5) processing feedback with a trusted mentor is critical for learning. CONCLUSIONS Consumers, academics, practice educators, and students recognised that consumers have an important role in contributing to student learning during practice placements. Future consumer feedback systems need to be co-produced to create an optimal mode for consumers to authentically contribute to student learning constructively and safely. CONSUMER AND COMMUNITY INVOLVEMENT A consumer consultant was a member of the advisory panel for the larger research project that this review is part of and provided advice to the research team at all stages of the project. PLAIN LANGUAGE SUMMARY In Australia, occupational therapy training programs require input from consumers to help students learn. However, there is not much research on how consumers help occupational therapy students during their practical training. We did a review to see how existing feedback systems let consumers genuinely help students during their training. We searched five databases for research up to July 2023. We included research that talked about how consumers help all health students learn during practical training. We found 46 articles, mostly from Medicine and Nursing education. We analysed them to understand how consumer feedback systems work and found five main themes: (1) making sure everyone involved gets value out of it, (2) being prepared is important, (3) consumers give useful feedback when the system supports everyone involved, (4) different approaches are needed because practices and learning vary, and (5) discussing feedback with other people helps students learn. Current feedback systems mostly focused on how students communicate and behave professionally. Consumers, educators, and students all agree that consumers play a vital role in helping students learn during practical training. In the future, we need to work together to make feedback systems that let consumers help students in the best way possible, making sure it is constructive and safe for everyone.
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Affiliation(s)
- Thomas Bevitt
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Robert B Pereira
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Pear Tree Occupational Therapy, Geelong, Victoria, Australia
| | - Rachel Bacon
- Discipline of Nutrition and Dietetics, Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - Stephen Isbel
- Discipline of Occupational Therapy, Faculty of Health, University of Canberra, Bruce, ACT, Australia
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Eijkelboom MCL, de Kleijn RAM, Frenkel J, van der Schaaf MF. Medical Students' General Beliefs and Specific Perceptions about Patient Feedback Before and after Training in a Clinical Context. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:288-299. [PMID: 38737396 PMCID: PMC11086596 DOI: 10.5334/pme.1261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/04/2024] [Indexed: 05/14/2024]
Abstract
Introduction Despite its high potential, patient feedback does not always result in learning. For feedback to be effective students must engage with it, which partly depends on their perceptions of feedback. To better understand student engagement with patient feedback in a clinical context, this study explored the following research questions: 1) What are medical students' general beliefs about patient feedback and what are their specific perceptions of feedback messages? 2) What is the difference between these general beliefs and feedback message perceptions before and after patient feedback training? Methods The study context was a 12-week clerkship combining Pediatrics and Gynecology, which included feedback training for students and asking for patient feedback. Ninety 4th-year medical students completed pre- and post-clerkship questionnaires. The questionnaires (Beliefs about Patient Feedback Questionnaire, Feedback Perception Questionnaire) were adapted from validated peer-feedback questionnaires. Questionnaires were quantitatively analyzed. Results Both pre- and post-clerkship, students had positive general beliefs about patient feedback and positive perceptions of the feedback messages they received. However, paired t-tests showed that students' general beliefs and feedback message perceptions became less positive after feedback training and experience. Discussion Patient feedback is not an easy means to learn and students do not become feedback literate in terms of patient feedback overnight. We suggest that future researchers further explore reasons for the decline in positive perceptions of patient feedback. We suggest implementing longitudinal feedback training in medical curricula, where students are guided and supported in the complex task of learning from patients through feedback.
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Affiliation(s)
- M. Charlotte L. Eijkelboom
- Utrecht University, the Netherlands
- Department of Pediatrics, University Medical Center Utrecht, the Netherlands
| | - Renske A. M. de Kleijn
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, the Netherlands
| | - Joost Frenkel
- Department of Pediatrics, University Medical Center Utrecht, the Netherlands
| | - Marieke F. van der Schaaf
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, the Netherlands
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Rieffestahl AM, Mogensen HO, Morcke AM, Risør T. 'If you had taken the lead…' - a qualitative study of patients with chronic conditions and their perspective in clinical encounters with medical students. Chronic Illn 2023; 19:692-703. [PMID: 35918800 DOI: 10.1177/17423953221115437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To explore what patients with chronic conditions emphasize as important in the patient-medical student conversation, and how the patients' experiences relate to trust. METHODS Twenty-one video-recorded sessions of patients' feedback in simulation-based communication courses for medical students were observed, transcribed, analyzed inductively and organized into three themes. RESULTS In the patients' feedback, three aspects were emphasized as important relating to trust: a) when the medical student relates medical information to the patient's lifeworld, b) when the student leads the patient throughout the conversation, and c) when the patient gets emotional support from the student. The patients felt that being met this way by the students grows trust and allows them to lean into the uncertainties they experience while still feeling safe. DISCUSSION The patients emphasize three aspects of importance in conversations with the medical students that grow trust. We argue that these aspects cannot be found in the traditional authority-led practice but can be found in leadership, which imply empathy and willingness to learn from patients. We suggest that students should learn that to effectively communicate with patients infers such leadership. By doing so, medical students can walk alongside their patients to build a relationship and nurture trust.
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Affiliation(s)
- Anne Marie Rieffestahl
- Capital Region of Denmark, Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark
- Section of General Practice and The Research Unit for general Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Hanne O Mogensen
- Department of Anthropology, Faculty of Social Science, University of Copenhagen, Copenhagen, Denmark
| | - Anne Mette Morcke
- Centre for Educational Development, Aarhus University, Aarhus, Denmark
| | - Torsten Risør
- Section of General Practice and The Research Unit for general Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
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Tickle N, Creedy DK, Carter AG, Bass J, Gamble J. Impact of women's feedback on midwifery student learning: A thematic analysis of students' reflections. Women Birth 2023; 36:e591-e597. [PMID: 37246055 DOI: 10.1016/j.wombi.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 05/30/2023]
Abstract
PROBLEM Little is known about the educational impact of providing routine, online feedback from women on midwifery student learning and clinical practice. BACKGROUND Feedback on students' clinical performance has historically been provided by lecturers and clinical supervisors. Women's feedback is not routinely collected or evaluated for impact on student learning. AIM To evaluate the impact of women's feedback about continuity of care experiences with a midwifery student on learning and practice. DESIGN Descriptive, exploratory qualitative study. METHODS All second-and third-year Bachelor of Midwifery students undertaking clinical placement between February and June 2022 at one Australian university, submitted formative, guided written reflections on de-identified women's feedback they received through their ePortfolio. Data were analysed using reflexive thematic analysis. FINDINGS Forty-four of the 69 eligible students (64%) submitted reflections on feedback received. Three themes emerged: 1) Confidence boosting, 2) Deeply integrating Midwifery Metavalues, and 3) Enhancing commitment to continuity. Three subthemes: connection, future practice and advocacy were identified. Women's feedback positively impacts student learning and places the woman in the educational feedback loop. CONCLUSION This study is an international first evaluating the impact of feedback from women on midwifery students' learning. Students reported greater confidence in their clinical practice, a deeper understanding of their midwifery philosophy, and an intention to advocate for, and work in, midwifery continuity models after graduation. Routine feedback about women's experiences should be embedded into midwifery education programs.
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Affiliation(s)
- Nikki Tickle
- School of Nursing and Midwifery, Griffith University Logan Campus, 68 University Drive, Meadowbrook, QLD 4131, Australia; Transforming Maternity Care Collaborative, MMid (Hons), Midwife, Australia.
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University Logan Campus, 68 University Drive, Meadowbrook, QLD 4131, Australia; Transforming Maternity Care Collaborative, MMid (Hons), Midwife, Australia
| | - Amanda G Carter
- School of Nursing and Midwifery, Griffith University Logan Campus, 68 University Drive, Meadowbrook, QLD 4131, Australia; Transforming Maternity Care Collaborative, MMid (Hons), Midwife, Australia
| | - Janice Bass
- School of Nursing and Midwifery, Griffith University Logan Campus, 68 University Drive, Meadowbrook, QLD 4131, Australia; Transforming Maternity Care Collaborative, MMid (Hons), Midwife, Australia
| | - Jenny Gamble
- School of Nursing and Midwifery, Griffith University Logan Campus, 68 University Drive, Meadowbrook, QLD 4131, Australia; Transforming Maternity Care Collaborative, Australia Coventry University, United Kingdom
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Eijkelboom MCL, de Kleijn RAM, van Diemen WJM, Maljaars CDN, van der Schaaf MF, Frenkel J. Patients as Feedback Providers: Exploring Medical Students' Credibility Judgments. PERSPECTIVES ON MEDICAL EDUCATION 2023; 12:129-140. [PMID: 37064270 PMCID: PMC10103723 DOI: 10.5334/pme.842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/07/2023] [Indexed: 05/05/2023]
Abstract
Introduction Patient feedback is becoming ever more important in medical education. Whether students engage with feedback is partly determined by how credible they think the feedback provider is. Despite its importance for feedback engagement, little is known about how medical students judge the credibility of patients. The purpose of this study was therefore to explore how medical students make credibility judgments regarding patients as feedback providers. Methods This qualitative study builds upon McCroskey's conceptualization of credibility as a three-dimensional construct comprising: competence, trustworthiness, and goodwill. Since credibility judgments are shaped by the context, we studied students' credibility judgments in both a clinical and non-clinical context. Medical students were interviewed after receiving feedback from patients. Interviews were analyzed through template and causal network analysis. Results Students based their credibility judgments of patients on multiple interacting arguments comprising all three dimensions of credibility. In estimating a patient's credibility, students reasoned about aspects of the patient's competence, trustworthiness, and goodwill. In both contexts students perceived elements of an educational alliance between themselves and patients, which could increase credibility. Yet, in the clinical context students reasoned that therapeutic goals of the relationship with patients might impede educational goals of the feedback interaction, which lowered credibility. Discussion Students' credibility judgments of patients were a weighing of multiple sometimes conflicting factors, within the context of relationships and their associated goals. Future research should explore how goals and roles can be discussed between students and patients to set the stage for open feedback conversations.
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Affiliation(s)
- M. C. L. Eijkelboom
- Faculty of Medicine, Utrecht University, the Netherlands
- Department of Pediatrics, University Medical Center Utrecht, the Netherlands
| | - R. A. M. de Kleijn
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, the Netherlands
| | - W. J. M. van Diemen
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, the Netherlands
| | | | - M. F. van der Schaaf
- Utrecht Center for Research and Development of Health Professions Education, University Medical Center Utrecht, the Netherlands
| | - J. Frenkel
- Department of Pediatrics, University Medical Center Utrecht, the Netherlands
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Björklund K, Stenfors T, Nilsson GH, Leanderson C. Multisource feedback in medical students' workplace learning in primary health care. BMC MEDICAL EDUCATION 2022; 22:401. [PMID: 35614484 PMCID: PMC9134659 DOI: 10.1186/s12909-022-03468-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND In medical students' workplace learning, feedback is important for effective learning regarding communication and clinical skills. The provision of multisource feedback (MSF) in clinical practice with focus on the patient's perspective is rarely addressed in the literature. The overall objective was to explore the experience of MSF in medical students' clinical learning in primary healthcare (PHC). METHODS In the study, patients provided feedback by use of the Patient Feedback in Clinical Practice (PFCP) questionnaire. By use of adapted PFCP questionnaire versions peers and clinical supervisors provided feedback and students performed a self-evaluation. The MSF learning activity was evaluated using surveys (4-point Likert scale/open-ended questions), (students (n = 26), peers (n = 9) and clinical supervisors (n = 7)). Data were analysed using descriptive and qualitative content analysis. RESULTS Results (mean 4-point Likert scale) from participants evaluation of the MSF learning activity visualises the value of feedback in terms of patient-centred communication (students 3.50, peers 2.44 and clinical supervisors 3.57), guidance for further training (students 3.14, peers 2.89 and clinical supervisors 3.00) and clarification of pedagogical assignment (students 3.14, peers 2.89 and clinical supervisors 3.00). Thematic analysis of participants' free-text answers in the evaluation surveys resulted in three themes: (1) applicability of the MSF, (2) MSF - collaborative learning process and (3) MSF as a facilitator in students' clinical skills development. The participants experienced that the written MSF provided multi-facetted perspectives, which contributed to students' and peers' clinical and communication learning. MSF experience also enhanced clinical supervisors' feedback regarding communication skills, targeting the supervisors' pedagogical assignment. CONCLUSION Our findings indicate that MSF provided directly after a patient encounter, using the PFCP questionnaire as feedback provider, could be an adequate learning activity for medical students' workplace learning. The MSF, provided through the PFCP questionnaire, was experienced to neutralise and operationalise the provision of concrete feedback, facilitating peers' learning and clinical supervisors' tuition. The results visualise the importance of patients in MSF, as a valuable resource in students' workplace learning. Our study implies that this learning activity could be an applicable tool to facilitate learning and pedagogic development in clinical education in PHC.
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Affiliation(s)
- Karin Björklund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar H Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Leanderson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Björklund K, Stenfors T, Nilsson G, Leanderson C. Learning from patients' written feedback: medical students' experiences. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2022; 13:19-27. [PMID: 35108219 PMCID: PMC9017500 DOI: 10.5116/ijme.61d5.8706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
METHODS Fifty-nine medical students evaluated their learning experience of receiving patients' written feedback obtained from the PFCP questionnaire. Students (N = 57) evaluated their experiences by applying a nine-question evaluation survey (Likert scale N = 3 and free-text questions N = 6) and/or participated in a semi-structured interview (N = 6 students). Data were analyzed using descriptive statistics and qualitative content analysis. RESULTS The analysis of data from the students' evaluation survey was performed using 4-point Likert scale questions presented in mean, SD and range; ability to apply patient-centred communication (3.3, 0.74, 2-4), guidance for further clinical training of clinical skills (3.2, 1.31, 1-4) and visualization of the pedagogical assignment during an encounter (3.0, 1.68, 1-4). A content analysis of the free-text questions from the students' evaluation surveys and interviews resulted in three themes: (1) confidence in clinical practice, (2) application of patient-centred communication and (3) identification of learning needs. CONCLUSIONS The results indicate that patients' feedback facilitated a reflective self-directed learning process with the identification of learning needs and increased awareness of the patient as a collaborative partner during the encounter. Patients' written feedback adjacent to a patient encounter is identified as a valuable additional learning tool in medical students' workplace learning. Further studies are required to explore how patients' written feedback can be operationalized in different clinical contexts, for example, in in-patient care.
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Affiliation(s)
- Karin Björklund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics (LIME), Division for learning, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Gunnar Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Charlotte Leanderson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Björklund K, Stenfors T, Nilsson GH, Alinaghizadeh H, Leanderson C. Let's ask the patient - composition and validation of a questionnaire for patients' feedback to medical students. BMC MEDICAL EDUCATION 2021; 21:269. [PMID: 33971866 PMCID: PMC8111976 DOI: 10.1186/s12909-021-02683-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 04/22/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Adequate communication and maintaining a patient-centered approach throughout patient encounters are important skills for medical students to develop. Feedback is often provided by clinical teachers. Patients are seldom asked to provide feedback to students that systematically addresses knowledge and skills regarding communication and patient-centeredness during an encounter. One way for patients to provide feedback to students is through a questionnaire; there is, however, a lack of such validated feedback questionnaires. This study aimed to compose and validate a feedback questionnaire for patients' feedback to medical students regarding students' ability to communicate and apply patient-centeredness in clinical practice. METHOD This study comprises (a) composition of the questionnaire and (b) validation of the questionnaire. The composition included (1) literature review, (2) selection and composition of items and construction of an item pool, (3) test of items' content, and (4) test of the applicability of the questionnaire. The items originated from the Calgary-Cambridge Guide (Kurtz S, Silverman J, Benson J and Draper J, Acad Med 78:802-809, 2003), the 'Swedish National Patient Survey' (National Patient Survey, Primary Health Care, 2020), patient evaluation form by Braend et al. (Tidsskr Nor Laegeforen 126:2122-5, 2006), and additional developed items. The items were further developed after feedback from 65 patients, 22 students, eight clinical supervisors, and six clinical teachers. The validation process included 246 patients who provided feedback to 80 students. Qualitative content analysis and psychometric methods were used and exploratory factor analysis assessed internal validity. Cronbach's alpha was used to test the reliability of the items. RESULTS The process resulted in the 19-item 'Patient Feedback in Clinical Practice' (PFCP) questionnaire. Construct validity revealed two dimensions: consultational approach and transfer of information. Internal consistency was high. Thematic analysis resulted in three themes: ability to capture the personal agenda of the consultation, alignment with the consultation, and constructs and characteristics. Students reported that the PFCP questionnaire provided useful feedback that could facilitate their learning in clinical practice. CONCLUSIONS The results of this study indicate that the questionnaire is a valid, reliable, and internally consistent instrument for patients' feedback to medical students. The participants found the questionnaire to be useful for the provision of feedback in clinical practice. However, further studies are required regarding the PFCP questionnaire applicability as a feedback tool in workplace learning.
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Affiliation(s)
- Karin Björklund
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Gunnar H Nilsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | | | - Charlotte Leanderson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
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Barr J, Ogden K, Robertson I, Martin J. Exploring how differently patients and clinical tutors see the same consultation: building evidence for inclusion of real patient feedback in medical education. BMC MEDICAL EDUCATION 2021; 21:246. [PMID: 33926426 PMCID: PMC8082899 DOI: 10.1186/s12909-021-02654-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 04/07/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Undergraduate medical education recognises that patient feedback is potentially valuable for student learning and development as a component of multi-source feedback. However greater exploration of how patient feedback perspectives differ to clinical educators is required for curriculum development and improving student feedback literacy. This study aimed to determine how two sources of feedback, patients and clinical tutors, compare on the same patient-centred, interpersonal criteria. METHODS A patient feedback instrument designed for the undergraduate medical education setting was used to compare patients' feedback with clinical tutors' feedback following a student-patient consultation in the learning context. Assessments from 222 learning consultations involving 40 medical students were collected. Descriptive statistics for tutors and patients for each question were calculated and correlations between patient and tutor were explored using Spearman's rank-order correlation. Mixed effects ordered logistic regression was used to compare each question with an overall rating for tutor and patients in addition to comparing patient with tutor ratings. RESULTS Clinical tutor and patient assessments had a weak but significant positive correlation in all areas except questions related to respect and concern. When making judgements compared with overall assessment, patients' ratings of respect, concern, communication and being understood in the consultation have a greater effect. After eliminating the effect of generally higher ratings by patients compared with tutors using comparative ordered logistic regression, patients rated students relatively less competent in areas of personal interaction. CONCLUSION This study provides insight about patient feedback, which is required to continue improving the use and acceptability of this multisource feedback to students as a valuable component of their social learning environment. We have revealed the different perspective-specific judgement that patients bring to feedback. This finding contributes to building respect for patient feedback through greater understanding of the elements of consultations for which patients can discriminate performance.
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Affiliation(s)
- Jennifer Barr
- Tasmanian School of Medicine, University of Tasmania, Hobart, Australia.
| | - Kathryn Ogden
- Tasmanian School of Medicine, University of Tasmania, Hobart, Australia
| | | | - Jenepher Martin
- Eastern Health Clinical School, Monash University, Melbourne, Australia
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Chua IS, Bogetz AL, Bhansali P, Long M, Holbreich R, Kind T, Ottolini M, Park YS, Lineberry M, Hirshfield LE. The Patient Experience Debrief Interview: How Conversations With Hospitalized Families Influence Medical Student Learning and Reflection. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:S86-S94. [PMID: 31365398 DOI: 10.1097/acm.0000000000002914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE To determine the effect of patient debrief interviews on pediatric clerkship student depth of reflection and learning. METHOD The authors conducted a multi-institutional, mixed-methods, cluster randomized trial among pediatric clerkship students from May 2016 to February 2017. Intervention students completed a debrief interview with a patient-caregiver, followed by a written reflection on the experience. Control students completed a written reflection on a memorable patient encounter. Three blinded authors scored written reflections according to the 4-level REFLECT rubric to determine depth of reflection. Interrater reliability was examined using kappa. REFLECT scores were analyzed using a chi-square test; essays were analyzed using content analysis. RESULTS Eighty percent of eligible students participated. One hundred eighty-nine essays (89 control, 100 intervention) were scored. Thirty-seven percent of the control group attained reflection and critical reflection, the 2 highest levels of reflection, compared with 71% of the intervention group; 2% of the control group attained critical reflection, the highest level, compared with 31% of the intervention group (χ(3, N = 189) = 33.9, P < .001). Seven themes were seen across both groups, 3 focused on physician practice and 4 focused on patients. Patient-centered themes were more common in the intervention group, whereas physician-focused themes were more common in the control group. CONCLUSIONS Patient debrief interviews offer a unique approach to deepen self-reflection through direct dialogue and exploration of patient-caregiver experiences during hospitalization.
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Affiliation(s)
- Ian S Chua
- I.S. Chua is assistant professor, Department of Pediatrics, Children's National Medical Center, Washington, DC, and clinical instructor, Department of Pediatrics, Stanford School of Medicine, Stanford, California. A.L. Bogetz is associate program director, Department of Pediatrics, Stanford School of Medicine, Stanford, California. P. Bhansali is associate professor, Department of Pediatrics, Children's National Medical Center, Washington, DC. M. Long is associate professor, Department of Pediatrics, University of California, San Francisco, San Francisco, California. R. Holbreich is a medical student, George Washington University School of Medicine and Health Sciences, Washington, DC. T. Kind is professor of pediatrics and associate dean of clinical education, George Washington University School of Medicine and Health Sciences, Washington, DC. M. Ottolini is vice chair of education and professor, Children's National Medical Center, Washington, DC. Y.S. Park is associate professor, Department of Medical Education, University of Illinois, Chicago, Chicago, Illinois. M. Lineberry is assistant professor and director of simulation research, assessment, and outcomes, University of Kansas City Medical Center, Kansas City, Kansas. L.E. Hirshfield is assistant professor, Department of Medical Education, University of Illinois, Chicago, Chicago, Illinois
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