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Content and timing of feedback and reflection: A multi-center qualitative study of experienced bedside teachers

Gonzalo, JD and Heist, BS and Duffy, BL and Dyrbye, L and Fagan, MJ and Ferenchick, G and Harrell, H and Hemmer, PA and Kernan, WN and Kogan, JR and Rafferty, C and Wong, R and Elnicki, MD (2014) Content and timing of feedback and reflection: A multi-center qualitative study of experienced bedside teachers. BMC Medical Education, 14 (1).

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© 2014Gonzalo et al.; licensee BioMed Central Ltd. Background: Competency-based medical education increasingly recognizes the importance of observation, feedback, and reflection for trainee development. Although bedside rounds provide opportunities for authentic workplace-based implementation of feedback and team-based reflection strategies, this relationship has not been well described. The authors sought to understand the content and timing of feedback and team-based reflection provided by bedside teachers in the context of patient-centered bedside rounds.Methods. The authors conducted a thematic analysis qualitative study using transcripts from audio-recorded, semi-structured telephone interviews with internal medicine attending physicians (n= 34) identified as respected bedside teachers from 10 academic US institutions (2010-2011).Results: Half of the respondents (50%) were associate/full professors, with an average of 14 years of academic experience. In the context of bedside encounters, bedside teachers reported providing feedback on history-taking, physical-examination, and case-presentation skills, patient-centered communication, clinical decision-making, leadership, teaching skills, and professionalism. Positive feedback about physical-exam skills or clinical decision-making occurred during encounters, positive or constructive team-based feedback occurred immediately following encounters, and individualized constructive feedback occurred in one-on-one settings following rounding sessions. Compared to less frequent, emotionally-charged events, bedside teachers initiated team-based reflection on commonplace "teachable moments" related to patient characteristics or emotions, trainee actions and emotions, and attending physician role modeling.Conclusions: Bedside teachers use bedside rounds as a workplace-based method to provide assessment, feedback, and reflection, which are aligned with the goals of competency-based medical education. Embedded in patient-centered activities, clinical teachers should be encouraged to incorporate these content- and timing-related feedback and reflection strategies into their bedside teaching.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Gonzalo, JD
Heist, BSbrh60@pitt.eduBRH60
Duffy, BL
Dyrbye, L
Fagan, MJ
Ferenchick, G
Harrell, H
Hemmer, PA
Kernan, WN
Kogan, JR
Rafferty, C
Wong, R
Elnicki, MD
Date: 10 October 2014
Date Type: Publication
Journal or Publication Title: BMC Medical Education
Volume: 14
Number: 1
DOI or Unique Handle: 10.1186/1472-6920-14-212
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Date Deposited: 21 Dec 2016 20:44
Last Modified: 02 Feb 2019 13:58


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