is Professor Emeritus, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, USA, and Associate Editor, Journal of Graduate Medical Education, Chicago, Illinois, USA.
is Associate Professor Emerita, Department of Internal Medicine, and Former Director, Office of Evaluation, University of Colorado School of Medicine, Aurora, Colorado, USA.
J Grad Med Educ. 2024 Oct;16(5):607-610. doi: 10.4300/JGME-D-24-00247.1. Epub 2024 Oct 15.
The medical workplace presents challenges for workplace-based learning. Structured debriefing of shared clinical experiences has been proposed as a way to take advantage of workplace-based learning in a setting that facilitates deep learning conversations. To investigate faculty and learner acceptance of private, face-to-face, structured debriefing of performance of entrustable professional activities (EPAs). During the 2020-2021 academic year, faculty at the University of Colorado (CU) and the University of Utah (UU) debriefed fellow performance of jointly selected EPAs in neonatal-perinatal medicine pertinent to shared 1- to 3-week clinical rotations. Private face-to-face debriefing was structured by a comprehensive EPA-specific list of behavioral anchors describing 3 levels of entrustment/accomplishment. Sessions ended with joint decisions as to level of entrustment/accomplishment and goals for improvement. We used thematic analysis of semistructured fellow interviews and faculty focus groups to identify themes illustrated with representative quotations. We interviewed 17 fellows and 18 faculty. CU participants debriefed after clinical rotations; UU usually debriefed during rotations. Debriefing sessions for 1 to 2 EPAs lasted 20 to 40 minutes. Themes represented in fellow interviews and faculty focus groups suggested that debriefing facilitated formative feedback along with shared understanding of clinical performance and assessment criteria. The standardized format and private conversations supported assessment of aspects of performance for which review might otherwise have been overlooked or avoided. The conversations also provided valuable opportunities for formative discussion of other matters of importance to fellows. Structured debriefing of recently shared clinical experiences fostered formative assessment viewed positively by teachers and learners.
医疗工作场所给基于工作场所的学习带来了挑战。已经提出了对共享临床经验进行结构化讨论，以便在促进深度学习对话的环境中利用基于工作场所的学习。 调查教师和学习者对可委托专业活动（EPAs）绩效的私下、面对面、结构化讨论的接受程度。 在 2020-2021 学年，科罗拉多大学（CU）和犹他大学（UU）的教师对新生儿围产期医学中共同选择的与共同 1-3 周临床轮转相关的 EPAs 进行了同行绩效的私下面对面讨论。私人面对面讨论是通过一份全面的 EPA 特定行为锚描述 3 级委托/完成的行为锚进行结构化的。会议结束时，根据委托/完成程度以及改进目标做出共同决定。我们使用半结构化同行访谈和教师焦点小组的主题分析来识别主题，并以有代表性的引语说明主题。 我们采访了 17 名学员和 18 名教师。CU 的参与者在临床轮转后进行讨论；UU 通常在轮转期间进行讨论。1 到 2 个 EPA 的讨论时间为 20 到 40 分钟。学员访谈和教师焦点小组中体现的主题表明，讨论促进了形成性反馈，以及对临床表现和评估标准的共同理解。标准化格式和私下对话支持评估可能被忽视或避免的表现的各个方面。这些对话还为学员重要事项的形成性讨论提供了宝贵的机会。 对最近共享的临床经验进行结构化讨论促进了教师和学习者积极看待的形成性评估。
