Should we assess clinical performance in single patient encounters or consistent behaviors of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles

Marjolein Oerlemans*, Patrick Dielissen, Angelique Timmerman, Paul Ram, Bas Maiburg, Jean Muris, Cees van der Vleuten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Web of Science)

Abstract

Background: A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. We therefore explored experienced clinical supervisors' perceptions of behavioral patterns that potentially exist in postgraduate general practice trainees expressed as narrative profiles to aid the grading of clinical performance.Methods: We conducted semistructured interviews with clinical supervisors who had frequently observed clinical performance in trainees. Supervisors were asked to describe which behavioral patterns they had discerned in excellent and underperforming trainees, during different stages of training, in their careers as clinical supervisor. We analyzed the interviews using a grounded theory approach.Results: The analysis resulted in a conceptual framework that distinguishes between desirable and undesirable narrative profiles. The framework consists of two dimensions: doctor-patient interaction and medical expertise. Personal values appear to be a moderating factor.Conclusions: According to experienced clinical supervisors, consistent behaviors do exist in GP trainees when observing clinical performance over time. The conceptual framework has to be validated by further observational studies to assess its potential for making robust and fair assessments of clinical performance and monitor the development of consultation performance over time.

Original languageEnglish
Pages (from-to)300-307
Number of pages8
JournalMedical Teacher
Volume39
Issue number3
DOIs
Publication statusPublished - Mar 2017

Keywords

  • WORKPLACE-BASED ASSESSMENT
  • MEDICAL-EDUCATION
  • COMMUNICATION-SKILLS
  • COMPETENCE
  • FEEDBACK
  • CONTEXT
  • PERSPECTIVES
  • PHYSICIAN
  • RETHINKING
  • BARRIERS

Cite this