Department of General Practice, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
Department of Educational Research and Development, Maastricht University, Maastricht, The Netherlands.
BMC Med Educ. 2022 Apr 28;22(1):330. doi: 10.1186/s12909-022-03395-7.
In medical residency, performance observations are considered an important strategy to monitor competence development, provide feedback and warrant patient safety. The aim of this study was to gain insight into whether and how supervisor-resident dyads build a working repertoire regarding the use of observations, and how they discuss and align goals and approaches to observation in particular.
We used a qualitative, social constructivist approach to explore if and how supervisory dyads work towards alignment of goals and preferred approaches to performance observations. We conducted semi-structured interviews with supervisor-resident dyads, performing a template analysis of the data thus obtained.
The supervisory dyads did not frequently communicate about the use of observations, except at the start of training and unless they were triggered by internal or external factors. Their working repertoire regarding the use of observations seemed to be primarily driven by patient safety goals and institutional assessment requirements rather than by providing developmental feedback. Although intended as formative, the institutional test was perceived as summative by supervisors and residents, and led to teaching to the test rather than educating for purposes of competence development.
To unlock the full educational potential of performance observations, and to foster the development of an educational alliance, it is essential that supervisory dyads and the training institute communicate clearly about these observations and the role of assessment practices of- and for learning, in order to align their goals and respective approaches.
在住院医师培训中，绩效观察被认为是监测能力发展、提供反馈和保障患者安全的重要策略。本研究旨在深入了解主管-住院医师二人组是否以及如何建立关于使用观察的工作方案，以及他们如何特别讨论和协调目标和观察方法。
我们采用定性的社会建构主义方法，探讨监督对子是否以及如何努力实现目标和对绩效观察的首选方法的一致性。我们对主管-住院医师二人组进行了半结构化访谈，对由此获得的数据进行了模板分析。
监督对子除了在培训开始时以及内部或外部因素触发时，并不经常就观察的使用进行沟通。他们关于使用观察的工作方案似乎主要由患者安全目标和机构评估要求驱动，而不是提供发展反馈。尽管旨在形成性，但监管人员和住院医师都将机构测试视为总结性的，导致为了测试而教学，而不是为了能力发展而教育。
为了充分发挥绩效观察的教育潜力，并促进教育联盟的发展，监督对子和培训机构必须就这些观察以及评估实践在学习中的作用进行清晰的沟通，以协调他们的目标和各自的方法。
