Exploring typologies of consultation performance using authentic clinical experiences to support learning and assessment in postgraduate medical training

Angelique Timmerman; Marjolein Oerlemans; Cees van der Vleuten; Teresa Pawlikowska; Paul Ram; Jean Muris

doi:10.1016/j.pec.2021.10.035

Exploring typologies of consultation performance using authentic clinical experiences to support learning and assessment in postgraduate medical training

Angelique Timmerman^*, Marjolein Oerlemans, Cees van der Vleuten, Teresa Pawlikowska, Paul Ram, Jean Muris

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To validate and refine typologies of consultation performance from previous research to identify learning needs associated with each typology.

METHODS: We performed a qualitative study in a General Practice Specialty Training programme, using a two-stage design. First, we selected four exemplars from 80 videotaped consultations of 7 first-year and 6 third-year trainees that reflected the four typologies. We subsequently held individual interviews with clinical supervisors (N = 20) who observed these consultations to identify recurrent trainee behaviours.

RESULTS: The 'doctor-patient interaction' dimension from previous research was specified to encompass relationship-building, exploring, structuring, and shared decision-making competencies. Medical expertise was a moderating factor. The attitude and consultation behaviours included in the typologies were validated and we formulated directions for learning based on learning needs identified per typology.

CONCLUSION: Supervisors have a shared frame of reference for the behaviours reflecting proficient consultation performance. Serving as a developmental road map, all learning needs emphasised contextual adaptation, calling for an improved balance between patient-centred relationship building and application of medical expertise.

PRACTICE IMPLICATIONS: By providing rich and tailored feedback on consultation performance, the refined typologies - albeit subject to additional refinement in future research - may promote the monitoring of individual competence development over time.

Original language	English
Pages (from-to)	2276-2284
Number of pages	9
Journal	Patient Education and Counseling
Volume	105
Issue number	7
Early online date	11 Nov 2021
DOIs	https://doi.org/10.1016/j.pec.2021.10.035
Publication status	Published - Jul 2022

Keywords

Physician-patient communication
Assessment
Consultation performance
Narrative profiles
Contextual adaptation
Patient centredness
Graduate medical education
COMMUNICATION-SKILLS
ENCOUNTERS
BEHAVIORS

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10.1016/j.pec.2021.10.035

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title = "Exploring typologies of consultation performance using authentic clinical experiences to support learning and assessment in postgraduate medical training",

abstract = "OBJECTIVE: To validate and refine typologies of consultation performance from previous research to identify learning needs associated with each typology.METHODS: We performed a qualitative study in a General Practice Specialty Training programme, using a two-stage design. First, we selected four exemplars from 80 videotaped consultations of 7 first-year and 6 third-year trainees that reflected the four typologies. We subsequently held individual interviews with clinical supervisors (N = 20) who observed these consultations to identify recurrent trainee behaviours.RESULTS: The 'doctor-patient interaction' dimension from previous research was specified to encompass relationship-building, exploring, structuring, and shared decision-making competencies. Medical expertise was a moderating factor. The attitude and consultation behaviours included in the typologies were validated and we formulated directions for learning based on learning needs identified per typology.CONCLUSION: Supervisors have a shared frame of reference for the behaviours reflecting proficient consultation performance. Serving as a developmental road map, all learning needs emphasised contextual adaptation, calling for an improved balance between patient-centred relationship building and application of medical expertise.PRACTICE IMPLICATIONS: By providing rich and tailored feedback on consultation performance, the refined typologies - albeit subject to additional refinement in future research - may promote the monitoring of individual competence development over time.",

keywords = "Physician-patient communication, Assessment, Consultation performance, Narrative profiles, Contextual adaptation, Patient centredness, Graduate medical education, COMMUNICATION-SKILLS, ENCOUNTERS, BEHAVIORS",

author = "Angelique Timmerman and Marjolein Oerlemans and {van der Vleuten}, Cees and Teresa Pawlikowska and Paul Ram and Jean Muris",

year = "2022",

month = jul,

doi = "10.1016/j.pec.2021.10.035",

language = "English",

volume = "105",

pages = "2276--2284",

journal = "Patient Education and Counseling",

issn = "0738-3991",

publisher = "Elsevier Ireland Ltd",

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}

Exploring typologies of consultation performance using authentic clinical experiences to support learning and assessment in postgraduate medical training. / Timmerman, Angelique; Oerlemans, Marjolein; van der Vleuten, Cees et al.
In: Patient Education and Counseling, Vol. 105, No. 7, 07.2022, p. 2276-2284.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Exploring typologies of consultation performance using authentic clinical experiences to support learning and assessment in postgraduate medical training

AU - Timmerman, Angelique

AU - Oerlemans, Marjolein

AU - van der Vleuten, Cees

AU - Pawlikowska, Teresa

AU - Ram, Paul

AU - Muris, Jean

PY - 2022/7

Y1 - 2022/7

N2 - OBJECTIVE: To validate and refine typologies of consultation performance from previous research to identify learning needs associated with each typology.METHODS: We performed a qualitative study in a General Practice Specialty Training programme, using a two-stage design. First, we selected four exemplars from 80 videotaped consultations of 7 first-year and 6 third-year trainees that reflected the four typologies. We subsequently held individual interviews with clinical supervisors (N = 20) who observed these consultations to identify recurrent trainee behaviours.RESULTS: The 'doctor-patient interaction' dimension from previous research was specified to encompass relationship-building, exploring, structuring, and shared decision-making competencies. Medical expertise was a moderating factor. The attitude and consultation behaviours included in the typologies were validated and we formulated directions for learning based on learning needs identified per typology.CONCLUSION: Supervisors have a shared frame of reference for the behaviours reflecting proficient consultation performance. Serving as a developmental road map, all learning needs emphasised contextual adaptation, calling for an improved balance between patient-centred relationship building and application of medical expertise.PRACTICE IMPLICATIONS: By providing rich and tailored feedback on consultation performance, the refined typologies - albeit subject to additional refinement in future research - may promote the monitoring of individual competence development over time.

AB - OBJECTIVE: To validate and refine typologies of consultation performance from previous research to identify learning needs associated with each typology.METHODS: We performed a qualitative study in a General Practice Specialty Training programme, using a two-stage design. First, we selected four exemplars from 80 videotaped consultations of 7 first-year and 6 third-year trainees that reflected the four typologies. We subsequently held individual interviews with clinical supervisors (N = 20) who observed these consultations to identify recurrent trainee behaviours.RESULTS: The 'doctor-patient interaction' dimension from previous research was specified to encompass relationship-building, exploring, structuring, and shared decision-making competencies. Medical expertise was a moderating factor. The attitude and consultation behaviours included in the typologies were validated and we formulated directions for learning based on learning needs identified per typology.CONCLUSION: Supervisors have a shared frame of reference for the behaviours reflecting proficient consultation performance. Serving as a developmental road map, all learning needs emphasised contextual adaptation, calling for an improved balance between patient-centred relationship building and application of medical expertise.PRACTICE IMPLICATIONS: By providing rich and tailored feedback on consultation performance, the refined typologies - albeit subject to additional refinement in future research - may promote the monitoring of individual competence development over time.

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KW - Consultation performance

KW - Narrative profiles

KW - Contextual adaptation

KW - Patient centredness

KW - Graduate medical education

KW - COMMUNICATION-SKILLS

KW - ENCOUNTERS

KW - BEHAVIORS

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DO - 10.1016/j.pec.2021.10.035

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SN - 0738-3991

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SP - 2276

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JO - Patient Education and Counseling

JF - Patient Education and Counseling

IS - 7

ER -

Exploring typologies of consultation performance using authentic clinical experiences to support learning and assessment in postgraduate medical training

Abstract

Keywords

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