1. Exploring typologies of consultation performance using authentic clinical experiences to support learning and assessment in postgraduate medical training
- Author
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Teresa Pawlikowska, Paul Ram, Marjolein Oerlemans, Angelique A. Timmerman, Jean W M Muris, Cees P. M. van der Vleuten, RS: CAPHRI other, RS: CAPHRI - R6 - Promoting Health & Personalised Care, Family Medicine, RS: SHE - R1 - Research (OvO), Onderwijsontw & Onderwijsresearch, and RS: CAPHRI - R5 - Optimising Patient Care
- Subjects
Typology ,education ,General Practice ,Specialty ,Graduate medical education ,COMMUNICATION-SKILLS ,Assessment ,BEHAVIORS ,Patient centredness ,Humans ,Contextual adaptation ,Road map ,Dimension (data warehouse) ,Adaptation (computer science) ,Competence (human resources) ,Referral and Consultation ,Medical education ,Physician-patient communication ,General Medicine ,Narrative profiles ,Consultation performance ,ENCOUNTERS ,Education, Medical, Graduate ,Clinical Competence ,Psychology ,Family Practice ,Qualitative research - Abstract
OBJECTIVE: To validate and refine typologies of consultation performance from previous research to identify learning needs associated with each typology.METHODS: We performed a qualitative study in a General Practice Specialty Training programme, using a two-stage design. First, we selected four exemplars from 80 videotaped consultations of 7 first-year and 6 third-year trainees that reflected the four typologies. We subsequently held individual interviews with clinical supervisors (N = 20) who observed these consultations to identify recurrent trainee behaviours.RESULTS: The 'doctor-patient interaction' dimension from previous research was specified to encompass relationship-building, exploring, structuring, and shared decision-making competencies. Medical expertise was a moderating factor. The attitude and consultation behaviours included in the typologies were validated and we formulated directions for learning based on learning needs identified per typology.CONCLUSION: Supervisors have a shared frame of reference for the behaviours reflecting proficient consultation performance. Serving as a developmental road map, all learning needs emphasised contextual adaptation, calling for an improved balance between patient-centred relationship building and application of medical expertise.PRACTICE IMPLICATIONS: By providing rich and tailored feedback on consultation performance, the refined typologies - albeit subject to additional refinement in future research - may promote the monitoring of individual competence development over time.
- Published
- 2022