Abstract
Introduction: In competency-based medical education, direct observation (DO) of residents’ skills
is scarce, notwithstanding its undisputed importance for credible feedback and assessment. A
growing body of research is investigating this discrepancy. Strikingly, in this research, DO as a concrete educational activity tends to remain vague. In this study, we concretised DO of technical
skills in postgraduate longitudinal training relationships.
Methods: Informed by constructivist grounded theory, we performed a focus group study among
general practice residents. We asked residents about their experiences with different manifestations of DO of technical skills. A framework describing different DO patterns with their varied
impact on learning and the training relationship was constructed and refined until theoretical sufficiency was reached.
Results: The dominant DO pattern was ad hoc, one-way DO. Importantly, in this pattern, various
unpredictable, and sometimes unwanted, scenarios could occur. Residents hesitated to discuss
unwanted scenarios with their supervisors, sometimes instead refraining from future requests for
DO or even for help. Planned bi-directional DO sessions, though seldom practiced, contributed
much to collaborative learning in a psychologically safe training relationship.
Discussion and conclusion: Patterns matter in DO. Residents and supervisors should be made
aware of this and educated in maintaining an open dialogue on how to use DO for the benefit of
learning and the training relationship.
is scarce, notwithstanding its undisputed importance for credible feedback and assessment. A
growing body of research is investigating this discrepancy. Strikingly, in this research, DO as a concrete educational activity tends to remain vague. In this study, we concretised DO of technical
skills in postgraduate longitudinal training relationships.
Methods: Informed by constructivist grounded theory, we performed a focus group study among
general practice residents. We asked residents about their experiences with different manifestations of DO of technical skills. A framework describing different DO patterns with their varied
impact on learning and the training relationship was constructed and refined until theoretical sufficiency was reached.
Results: The dominant DO pattern was ad hoc, one-way DO. Importantly, in this pattern, various
unpredictable, and sometimes unwanted, scenarios could occur. Residents hesitated to discuss
unwanted scenarios with their supervisors, sometimes instead refraining from future requests for
DO or even for help. Planned bi-directional DO sessions, though seldom practiced, contributed
much to collaborative learning in a psychologically safe training relationship.
Discussion and conclusion: Patterns matter in DO. Residents and supervisors should be made
aware of this and educated in maintaining an open dialogue on how to use DO for the benefit of
learning and the training relationship.
| Original language | English |
|---|---|
| Pages (from-to) | 937-944 |
| Number of pages | 8 |
| Journal | Medical Teacher |
| Volume | 43 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - 25 Mar 2021 |
