OBJECTIVE: While several models of medical student instruction in the ambulatory setting exist, few have been formally studied. We wished to assess the impact of a faculty development workshop based on the One-Minute Preceptor model on the amount and quality of feedback in the outpatient setting.
DESIGN: Ambulatory teaching behaviors were studied during consecutive outpatient precepting sessions before and after 3 faculty development workshops. Student-teacher interactions were assessed using audiotapes of teaching encounters coded through qualitative techniques, and surveys of teacher, learner, and patient satisfaction.
SETTING: Ambulatory internal medicine clinic in a tertiary care medical center.
PATIENTS/PARTICIPANTS: Nine board-certified internist faculty preceptors and 44 third-year medical students.
INTERVENTIONS: Three 90-minute faculty development seminars based on the One-Minute Preceptor teaching model.
MEASUREMENTS AND MAIN RESULTS: Ninety-four encounters with 18,577 utterances were recorded, half before and half after the seminars. After the workshops, the proportion of utterances that contained feedback increased from 17% to 22% (P=.09) and was more likely to be specific (9% vs 15%; P=.02). After the workshops, teachers reported that the learning encounters were more successful (P=.03) and that they were better at letting the students reach their own conclusions (P=.001), at evaluating the learners (P=.03), and at creating plans for post-encounter learning (P=.02). The workshops had no effect on the duration of the student-teacher encounter or on student or patient satisfaction with the encounters.
CONCLUSIONS: Brief, interactive, faculty development workshops based on the One-Minute Preceptor model of clinical teaching resulted in modest improvements in the quality of feedback delivered in the ambulatory setting.
feedback ambulatory teaching faculty development
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