Twelve tips for implementing tools for direct observation of medical trainees’ clinical skills during patient encounters

Karen E. Hauer University of California San Francisco, USA; KAREN E. HAUER, MD is professor of Medicine and Gold Headed Cane Endowed Education Chair in the Department of Medicine at the University of California, San Francisco. She is director of Internal Medicine Clerkships and director of Student Assessment for the School of Medicine.Correspondence[email protected]

Eric S. Holmboe American Board of Internal Medicine, USA; ERIC S. HOLMBOE, MD is senior vice president and chief medical officer at the American Board of Internal Medicine and American Board of Internal Medicine Foundation. He is also adjunct professor of Medicine at Yale University, and adjunct professor at the Uniformed Services University of the Health Sciences.

Jennifer R. Kogan Penn Medicine, University of Pennsylvania School of Medicine, USA; JENNIFER R. KOGAN, MD is assistant professor of Medicine and director of Undergraduate Education for the Department of Medicine at the University of Pennsylvania School of Medicine. She is clerkship director of the Internal Medicine Core Clerkship and course director of the Internal Medicine Sub-Internship.

Abstract

Background: Direct observation of medical trainees by their supervisors with actual patients is essential for trainees to develop clinical skills competence. Despite the many available tools for direct observation of trainees by supervisors, it is unclear how educators should identify an appropriate tool for a particular clinical setting and implement the tool to maximize educational benefits for trainees in a manner that is feasible for faculty.

Aims and methods: Based on our previous systematic review of the literature, we provide 12 tips for selecting and incorporating a tool for direct observation into a medical training program. We focus specifically on direct observation that occurs in clinical settings with actual patients.

Results: Educators should focus on the existing tools for direct observation that have evidence of validity. Tool implementation must be a component of an educational program that includes faculty development about rating performance, providing meaningful feedback, and developing action plans collaboratively with learners.

Conclusions: Educators can enhance clinical skills education with strategic incorporation of tools for direct observation into medical training programs. Identification of a psychometrically sound instrument and attention to faculty development and the feedback process are critical to the success of a program of direct observation.

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Twelve tips for implementing tools for direct observation of medical trainees’ clinical skills during patient encounters

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Twelve tips for implementing tools for direct observation of medical trainees’ clinical skills during patient encounters

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