'Sometimes the work just needs to be done': socio-cultural influences on direct observation in medical training.
Context Direct observation promises to strengthen both coaching and assessment, and calls for its increased use in medical training abound. Despite its apparent potential, the uptake of direct observation in medical training remains surprisingly limited outside the formal assessment setting. The lim...
| Publicado en: | Medical Education Vol. 50; no. 10; pp. 1054 - 1065 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=118093295&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 118093295 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03080110 ESF jtl: Medical Education issn: 03080110 maglogo: Y pubinfo: dt: Oct2016 vid: 50 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 118093295 118093295 118093295 10.1111/medu.13062 118093295 ppf: 1054 ppct: 11 formats: fmt: @attributes: type: P tig: atl: 'Sometimes the work just needs to be done': socio-cultural influences on direct observation in medical training. aug: au: Watling, Christopher LaDonna, Kori A Lingard, Lorelei Voyer, Stephane Hatala, Rose affil: Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London Ontario, Canada sug: subj: Education, Medical Teaching Methods Student Placement Learning Task Performance and Analysis Human Grounded Theory Semi-Structured Interview Male Female Interns and Residents Training Support, Financial Organizational Culture Comparative Studies Specialization Education Cultural Values Autonomy Ontario Organizational Efficiency Funding Source Male Female ab: Context Direct observation promises to strengthen both coaching and assessment, and calls for its increased use in medical training abound. Despite its apparent potential, the uptake of direct observation in medical training remains surprisingly limited outside the formal assessment setting. The limited uptake of observation raises questions about cultural barriers to its use. In this study, we explore the influence of professional culture on the use of direct observation within medical training. Methods Using a constructivist grounded theory approach, we interviewed 22 residents or fellows (10 male, 12 female) about their experiences of being observed during training. Participants represented a range of specialties and training levels. Data collection and analysis were conducted iteratively. Themes were identified using constant comparative analysis. Results Observation was used selectively; specialties tended to observe the clinical acts that they valued most. Despite these differences, we found two cultural values that consistently challenged the ready implementation of direct observation across specialties: (i) autonomy in learning and (ii) efficiency in health care provision. Furthermore, we found that direct observation was a primarily learner-driven activity, which left learners caught in the middle, wanting observation but also wanting to appear independent and efficient. Conclusions The cultural values of autonomy in learning and practice and efficiency in health care provision challenge the integration of direct observation into clinical training. Medical learners are often expected to ask for observation, but such requests are socially and culturally fraught, and likely to constrain the wider uptake of direct observation. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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