Learning how to learn using simulation: Unpacking disguised feedback using a qualitative analysis of doctors’ telephone talk

Abstract

Introduction: Telephone talk between clinicians represents a substantial workplace activity in postgraduate clinical education, yet junior doctors receive little training in goal-directed, professional telephone communication.

Aim: To assess educational needs for telephone talk and develop a simulation-based educational intervention.

Methods: Thematic analysis of 17 semi-structured interviews with doctors-in-training from various training levels and specialties.

Results: We identified essential elements to incorporate into simulation-based telephone talk, including common challenging situations for junior doctors as well as explicit and informal aspects that promote learning. These elements have implications for both junior doctors and clinical supervisors, including: (a) explicit teaching and feedback practices and (b) informal conversational interruptions and questions. The latter serve as “disguised” feedback, which aligns with recent conceptualizations of feedback as “performance relevant information”.

Conclusions: In addition to preparing clinical supervisors to support learning through telephone talk, we propose several potential educational strategies: (a) embedding telephone communication skills throughout simulation activities and (b) developing stand-alone curricular elements to sensitize junior doctors to “disguised” feedback during telephone talk as a mechanism to augment future workplace learning, i.e. 'learning how to learn' through simulation.

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Corrigendum

Disclosure statement

Dr. Eppich receives salary support from the Center for Medical Simulation (Boston/USA) to teach on simulation educator courses. He also receives per diem honoraria from PAEDSIM e.V. to teach on simulation educator courses.

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Notes on contributors

Walter J. Eppich

Walter J. Eppich, MD, MEd, is an Associate Professor of Paediatrics-Emergency Medicine and Medical Education, Northwestern University Feinberg School of Medicine, Chicago, USA.

Jan-Joost Rethans

Jan-Joost Rethans, MD, PhD, is a Professor of Human Simulation and Director of Medical Education Programs Maastricht University, the Netherlands.

Timothy Dornan

Timothy Dornan, MD, PhD, is a Professor of Medical Education, Queens University, Belfast, UK, and Emeritus Professor at Maastricht University, the Netherlands.

Pim W. Teunissen

Pim W. Teunissen, MD, PhD, is a Professor of Medical Education at Maastricht University, the Netherlands.