Tomiak Anna, Braund Heather, Egan Rylan, Dalgarno Nancy, Emack Jeffrey, Reid Mary-Anne, Hammad Nazik
Department of Oncology, Cancer Centre of Southeastern Ontario, Burr 2, Kingston General Hospital, Queen's University, 25 King Street W, Kingston, Ontario, K7L 5P9, Canada.
Faculty of Education, Office of Professional Development and Educational Scholarship, Botterell Hall, Queen's University, Room 217, 18 Stuart Street, Kingston, Ontario, K7L 3N6, Canada.
J Cancer Educ. 2020 Feb;35(1):165-177. doi: 10.1007/s13187-018-1456-z.
The post-graduate medical programs at Queen's University transitioned to a competency-based medical education framework on July 1, 2017. In advance of this transition, the Medical Oncology program participated in a pilot of six Entrustable Professional Activities (EPAs) focused workplace-based assessment (WBA) tools with faculty and residents. The purpose of this sequential explanatory mixed method study was to determine the extent to which these WBAs provided quality feedback for residents. The WBAs were introduced into daily clinical practice and, once completed, were collected by the research team. A resident focus group (n = 4) and faculty interviews (n = 5) were also conducted. Focus group and interview data were analyzed using an emergent thematic analysis. Data from the completed assessment tools were analyzed using both descriptive statistics and a literature-informed framework developed to assess the quality of feedback. Six main findings emerged: Verbal feedback is preferred over written; providing both written and verbal feedback is important; effective feedback was seen as timely, specific, and actionable; the process was conceptualized as coaching rather than high stakes; there were logistical concerns about the WBAs, and additional clarification about the WBA tools is needed. This study provides insight into faculty and resident perceptions of quality feedback and the potential for WBA tools to assist in providing effective feedback to residents as we shift to competency-based medical education in Canada. Our results suggest the need for additional faculty development around the use of the tools, and their intended role, and the elements of quality feedback.
女王大学的研究生医学项目于2017年7月1日过渡到基于能力的医学教育框架。在这一过渡之前,肿瘤内科项目与教员和住院医师一起参与了一项试点,该试点采用了六种基于工作场所评估(WBA)工具的可托付专业活动(EPA)。这项序列解释性混合方法研究的目的是确定这些WBA在多大程度上为住院医师提供了高质量的反馈。WBA被引入日常临床实践,完成后由研究团队收集。还进行了一次住院医师焦点小组访谈(n = 4)和教员访谈(n = 5)。焦点小组和访谈数据采用新兴主题分析法进行分析。已完成的评估工具的数据使用描述性统计和为评估反馈质量而开发的文献参考框架进行分析。出现了六个主要发现:口头反馈比书面反馈更受青睐;同时提供书面和口头反馈很重要;有效的反馈被视为及时、具体且可操作;该过程被概念化为指导而非高风险评估;对WBA存在后勤方面的担忧,并且需要对WBA工具进行更多说明。这项研究深入了解了教员和住院医师对高质量反馈的看法,以及在加拿大向基于能力的医学教育转变过程中,WBA工具在为住院医师提供有效反馈方面的潜力。我们的结果表明,需要围绕工具的使用、其预期作用以及高质量反馈的要素开展更多教员培训。