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. 2022 Mar 22;13(1):29-54.
doi: 10.36834/cmej.72587. eCollection 2022 Mar.

[Feedback Guide for direct observation of family medicine residents in Canada: a francophone tool]

[Article in French]
Affiliations

[Feedback Guide for direct observation of family medicine residents in Canada: a francophone tool]

[Article in French]
Miriam Lacasse et al. Can Med Educ J. .

Abstract

Background: There is no CanMEDS-FM-based milestone tool to guide feedback during direct observation (DO). We have developed a guide to support documentation of feedback for direct observation (DO) in Canadian family medicine (FM) programs.

Methods: The Guide was designed in three phases with the collaboration of five Canadian FM programs with at least a French-speaking teaching site: 1) literature review and needs assessment; 2) development of the DO Feedback Guide; 3) testing the Guide in a video simulation context with qualitative content analysis.

Results: Phase 1 demonstrated the need for a narrative guide aimed at 1) specifying mutual expectations according to the resident's level of training and the clinical context, 2) providing the supervisor with tools and structure in his observations 3) to facilitate documentation of feedback. Phase 2 made it possible to develop the Guide, in paper and electronic formats, meeting the needs identified. In phase 3, 15 supervisors used the guide for three levels of residence. The Guide was adjusted following this testing to recall the phases of the clinical encounter that were often forgotten during feedback (before consultation, diagnosis and follow-up), and to suggest types of formulation to be favored (stimulating questions, questions of clarification, reflections).

Conclusion: Based on evidence and a collaborative approach, this Guide will equip French-speaking Canadian supervisors and residents performing DO in family medicine.

Contexte: Il n’existe aucun outil par jalons reposant sur les CanMEDS-MF pour guider la rétroaction en supervision par observation directe (SPOD). Nous avons développé un guide pour soutenir la documentation de la rétroaction en SPOD en médecine familiale (MF) au Canada.

Méthode: La conception du Guide a été effectuée en trois phases avec la collaboration de cinq programmes de MF canadiens ayant minimalement un site d’enseignement francophone : 1) recension des écrits et étude des besoins; 2) élaboration du Guide de rétroaction SPOD; 3) mise à l’essai du Guide en contexte de simulation vidéo avec analyse de contenu qualitative.

Résultats: La phase 1 a démontré le besoin d’un guide narratif ayant pour but 1) de préciser les attentes mutuelles selon le niveau de formation du résident et le contexte clinique, 2) d’outiller et structurer le superviseur dans ses observations 3) de faciliter la documentation de la rétroaction. La phase 2 a permis d’élaborer le Guide, en formats papier et électronique, répondant aux besoins identifiés. En phase 3, 15 superviseurs ont utilisé le guide pour trois niveaux de résidence. Le Guide a été ajusté à la suite de cette mise à l’essai pour rappeler les phases de la rencontre clinique souvent oubliées durant la rétroaction (avant la consultation, diagnostic et suivi), et y suggérer des types de formulation à favoriser (questions stimulantes, questions de clarification, réflexions).

Conclusion: Issu de données probantes et d’une démarche de concertation, ce Guide outillera les superviseurs et résidents francophones canadiens dans leurs activités de SPOD en médecine familiale.

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Conflict of interest statement

Les auteurs ne déclarent aucun conflit d’intérêt.

Figures

Figure 1
Figure 1
Étapes de développement du Guide de rétroaction pour la SPOD en médecine familiale *Types de besoins adaptés de Ratnapalan et Hilliard
Figure 2
Figure 2
Résultats de la recension des écrits * Pubmed: 393; ERIC: 21; Education source: 80; CINAHL: 157
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References

    1. Lorwald AC, Lahner FM, Nouns ZM, et al. . The educational impact of mini-clinical evaluation exercise (Mini-CEX) and direct observation of procedural skills (DOPS) and its association with implementation: a systematic review and meta-analysis. PloS one. 2018;13(6):e198009. 10.1371/journal.pone.0198009 - DOI - PMC - PubMed
    1. Kogan JR, Conforti LN, Yamazaki K, Iobst W, Holmboe ES. Commitment to change and challenges to implementing changes after workplace-based assessment rater training. Acad Med. 2017;92(3):394-402. 10.1097/acm.0000000000001319 - DOI - PubMed
    1. Holmboe E, Durning S, Hawkins R. Practical guide to the evaluation of clinical competence. 2nd ed2018. xii, 338 p.
    1. Fromme HB, Karani R, Downing SM. Direct observation in medical education: a review of the literature and evidence for validity. Mt. Sinai J. Med. New York. 2009;76(4):365-71. 10.1002/msj.20123 - DOI - PubMed
    1. Kogan JR, Holmboe ES, Hauer KE, Kogan JR, Holmboe ES, Hauer KE. Tools for direct observation and assessment of clinical skills of medical trainees: a systematic review. JAMA. 2009;302(12):1316-26. 10.1001/jama.2009.1365 - DOI - PubMed

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