Wilfahrt Robert P, Oberhelman Sara S, Merten Zachary T, Angstman Kurt B
Department of Family Medicine, Mayo Clinic, Rochester, MN.
Department of Family Medicine, Mayo Clinic, Eau Claire, WI.
PRiMER. 2019 Nov 20;3:26. doi: 10.22454/PRiMER.2019.469608. eCollection 2019.
Medical schools have an enduring need to provide ongoing faculty development and to foster educational alliances between teachers and learners, so that feedback provided to learners is both frequent and of high quality. We hypothesized that medical students trained as academic detailers with a mission to increase the emphasis on feedback could serve in this role during our clerkship, while still being evaluated as students in our clerkship rotation.
The family medicine clerkship at Mayo Clinic School of Medicine launched a revised curriculum in 2016 in which students were taught how they might build an educational alliance with preceptors, were taught characteristics of high-quality feedback, and practiced requesting more useful feedback when initial quality was poor. After utilizing a clerkship-specific curriculum with small group sessions on receiving feedback, and training students and preceptors on the SNAPPs model, students were then directed to request feedback from their preceptors and model successful feedback conversations for preceptors. The study evaluated the medical students' summative evaluations to compare the rate from the preintervention year (2015-2016) and the intervention year (2016-2017) at which preceptors added comments on students' use of feedback.
Preceptors' written comments about students seeking feedback increased at about a four-fold rate (74.4% vs 18.8%, <.001) after implementing a suite of changes to our clerkship curriculum.
Using medical students to change preceptor behaviors was an important part of our suite of interventions. This intervention directed preceptor attention toward our instructional goal of increased medical student feedback.
医学院校长期需要提供持续的教师发展机会,并促进教师与学习者之间的教育联盟,以便为学习者提供频繁且高质量的反馈。我们假设,接受学术推广员培训、肩负增强反馈重要性使命的医学生,在我们的临床实习期间可以发挥这一作用,同时在临床实习轮转中仍作为学生接受评估。
梅奥诊所医学院的家庭医学临床实习于2016年推出了修订后的课程,教导学生如何与带教老师建立教育联盟,传授高质量反馈的特点,并在初始反馈质量较差时练习请求更有用的反馈。在使用针对临床实习的课程并开展关于接受反馈的小组讨论,以及对学生和带教老师进行SNAPPs模型培训后,学生们被要求向带教老师请求反馈,并为带教老师示范成功的反馈对话。该研究评估了医学生的总结性评价,以比较干预前一年(2015 - 2016年)和干预年(2016 - 2017年)带教老师对学生反馈使用情况添加评论的比例。
在对我们的临床实习课程实施一系列变革后,带教老师关于学生寻求反馈的书面评论增加了约四倍(74.4%对18.8%,<.001)。
利用医学生来改变带教老师的行为是我们一系列干预措施的重要组成部分。这种干预将带教老师的注意力导向了我们提高医学生反馈的教学目标。