Creating Middle Stage: Finding a New Space for Reflection within a Residency Program

ABSTRACT

While communication is essential to effective clinical outcomes, training programs that employ synchronous feedback systems are expensive and time consuming. Using a secure web blog as an asynchronous alternative for enhancing communication skills, we created a unique middle stage learning opportunity within a residency training program. Each resident was recorded interacting with a patient and that digital record was posted to a secure blog. By the end of year three, the residents (N = 6) interacted with 20 patients and wrote a blog post discussing each interaction. The other residents watched these interactions and responded to their peers’ digitized interactions in the form of a blog post (N = 95). Transcripts were created and analyzed using the constant comparative method and yielded five categories of resident message types. They were: Narrative of the visit, visit issues, communication strategies, social support, and reflections on the experience and provided a unique opportunity to examine interaction among the residents.

Disclosure of potential conflicts of interest

The content of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the Health Resources and Services Administration or the U.S. Department of Health and Human Services.

Additional information

Funding

This publication was made possible by Grant Number T0BHP29994 from the Health Resources and Services Administration, an operating division of the U.S. Department of Health and Human Services.