Post on 17-Jan-2016
The University of British ColumbiaThe University of British ColumbiaFaculty of MedicineFaculty of MedicineDepartment of Family PracticeDepartment of Family PracticePost Graduate ProgramPost Graduate Program
ObjectivesOutline the College of Family
Physician’s requirements for observation in the Evaluation Process
Explore what Direct Observation is and how it aids evaluation
Create a Framework to understand the process of evaluation through observation
Understand how to make our observation and evaluation effective
The Red Book (College Standards for
Accreditation)
Defines a number of requirements that all teaching programs must incorporate in their evaluation process:MUST focus on the 4 principles of Family MedicineMust document that the learner is learning
quantitative and qualitative information.Must record 32 direct observations, some of which
are video tapedMust involve a variety of patients and skills,
including history –taking, physical exam, procedural skills and the doctor patient relationship with difficult patients.
The Red BookHow many
observations?32 over 2 years4 direct observations
per month on block time.
1 observation per month on half days back
Our program requires 8 video taped sessions.
What is Direct Observation?ObservingBeing ObservedTaking notes and Recording
Making a judgement
Question/discussionWhen sitting in the room with a patient and the resident, how do you avoid or at least reduce interaction with the patient while you are trying to observe the resident’s interaction?
Trying to be invisible
Question:What are the Pros and Cons of video taped encounters?
Video taped encountersPros:
Removes interference of the teacher
Allows learner to see himself or herself as an observer
Observation by the teacher can be done at his or her convenience
Cons:Requires written
consent from the patient
Makes patient or resident self -conscious/uneasy
Requires planning and set-up
Video tips for the preceptor1/ You don’t need a camera.
The resident has a camera available to him or her through the Program. He or she can set it up before the office begins.
2/ The resident is responsible to explain the process of video taping to the patient and get informed consent.
3/ You can review the tape at your convenience.You can concentrate on one aspect of the video.
You don’t have to review it all with your resident
A framework for observation and evaluationCuesHypotheses
generationTestingManagement
decisionsFollow-up .........
And back to Cues
Clinical Content Direct Observation Evaluation Encounter
CUES
HYPOTHESIS GENERATION
TESTING
MANAGEMENT
FOLLOW - UP
Eg. Non-verbal cues
Eg. Interviewing skills
Eg. Lab test assessment
Diagnosis
Stated Plan
Assesss
Assess
Assess
Assess
Assess
Evaluation
Feedback
Cues
Clinical Content Direct Observation Evaluation Encounter
CUES
HYPOTHESIS GENERATION
TESTING
MANAGEMENT
FOLLOW - UP
Eg. Non-verbal cues
Eg. Interviewing skills
Eg. Lab test assessment
Diagnosis
Stated Plan
Assesss
Assess
Assess
Assess
Assess
Evaluation
Feedback
Management
Hypothesis Generation
Clinical Content Direct Observation Evaluation Encounter
CUES
HYPOTHESIS GENERATION
TESTING
MANAGEMENT
FOLLOW - UP
Eg. Non-verbal cues
Eg. Interviewing skills
Eg. Lab test assessment
Diagnosis
Stated Plan
Assesss
Assess
Assess
Assess
Assess
Evaluation
Feedback
Question:Your resident is about to
see a new mom and her one week old daughter for a first routine check.
Suggest what skills or functions you might decide to observe on this encounter?
Observations
Making your observations and evaluation effective“Effective” means “Having the intended or expected effect; producing a strong impression or response”
Your observation and evaluation is effective when it has a positive benefit for the resident and the Program
To be effective we need to consider:The learning
objectives of the resident for the rotation based on the resident’s past experience and his or her perceived needs.
The Educational objectives of the Program based on the Four Principles of Family Medicine of the College of Family Physicians.
What to observe?When using your observation framework,
plan to observe areas of weakness you have previously identified or items identified in your resident’s learning objectives.
The advantage of observation over a post encounter discussion with your resident is that you will observe issues that should be addressed that you hadn’t previously considered.
RememberBeing observed during a clinical encounter creates anxiety for the resident.
RecordingForms to record observation sessions are available on our website at :http://www.familymed.ubc.ca/residency/evaluation/evaluation.htm
Good luck with your observation.
Thank you This module was written as an aid to the
Preceptors in the Postgraduate Family Practice Program at the University of BC.Study credit is available to groups of
preceptors who complete the modulePlease give us your feedback on the module
so that we may improve it for others.Email your comments to Dr. John
Edworthy, Faculty Development, UBC Family Practice
jedworthy@shaw.ca