TY - JOUR
T1 - The R2C2 Model in Residency Education
T2 - How Does It Foster Coaching and Promote Feedback Use?
AU - Sargeant, Joan
AU - Lockyer, Jocelyn M.
AU - Mann, Karen
AU - Armson, Heather
AU - Warren, Andrew
AU - Zetkulic, Marygrace
AU - Soklaridis, Sophie
AU - Konings, Karen D.
AU - Ross, Kathryn
AU - Silver, Ivan
AU - Holmboe, Eric
AU - Shearer, Cindy
AU - Boudreau, Michelle
PY - 2018/7
Y1 - 2018/7
N2 - PurposeThe authors previously developed and tested a reflective model for facilitating performance feedback for practice improvement, the R2C2 model. It consists of four phases: relationship building, exploring reactions, exploring content, and coaching. This research studied the use and effectiveness of the model across different residency programs and the factors that influenced its effectiveness and use.MethodFrom July 2014-October 2016, case study methodology was used to study R2C2 model use and the influence of context on use within and across five cases. Five residency programs (family medicine, psychiatry, internal medicine, surgery, and anesthesia) from three countries (Canada, the United States, and the Netherlands) were recruited. Data collection included audiotaped site assessment interviews, feedback sessions, and debriefing interviews with residents and supervisors, and completed learning change plans (LCPs). Content, thematic, template, and cross-case analysis were conducted.ResultsAn average of nine resident-supervisor dyads per site were recruited. The R2C2 feedback model, used with an LCP, was reported to be effective in engaging residents in a reflective, goal-oriented discussion about performance data, supporting coaching, and enabling collaborative development of a change plan. Use varied across cases, influenced by six general factors: supervisor characteristics, resident characteristics, qualities of the resident-supervisor relationship, assessment approaches, program culture and context, and supports provided by the authors.ConclusionsThe R2C2 model was reported to be effective in fostering a productive, reflective feedback conversation focused on resident development and in facilitating collaborative development of a change plan. Factors contributing to successful use were identified.
AB - PurposeThe authors previously developed and tested a reflective model for facilitating performance feedback for practice improvement, the R2C2 model. It consists of four phases: relationship building, exploring reactions, exploring content, and coaching. This research studied the use and effectiveness of the model across different residency programs and the factors that influenced its effectiveness and use.MethodFrom July 2014-October 2016, case study methodology was used to study R2C2 model use and the influence of context on use within and across five cases. Five residency programs (family medicine, psychiatry, internal medicine, surgery, and anesthesia) from three countries (Canada, the United States, and the Netherlands) were recruited. Data collection included audiotaped site assessment interviews, feedback sessions, and debriefing interviews with residents and supervisors, and completed learning change plans (LCPs). Content, thematic, template, and cross-case analysis were conducted.ResultsAn average of nine resident-supervisor dyads per site were recruited. The R2C2 feedback model, used with an LCP, was reported to be effective in engaging residents in a reflective, goal-oriented discussion about performance data, supporting coaching, and enabling collaborative development of a change plan. Use varied across cases, influenced by six general factors: supervisor characteristics, resident characteristics, qualities of the resident-supervisor relationship, assessment approaches, program culture and context, and supports provided by the authors.ConclusionsThe R2C2 model was reported to be effective in fostering a productive, reflective feedback conversation focused on resident development and in facilitating collaborative development of a change plan. Factors contributing to successful use were identified.
KW - MEDICAL-EDUCATION
KW - PROGRAMMATIC ASSESSMENT
KW - CREDIBILITY JUDGMENTS
KW - DELIBERATE PRACTICE
KW - EXPERT-PERFORMANCE
KW - ALLIANCE
KW - PERCEPTIONS
KW - ACQUISITION
KW - FRAMEWORK
KW - LEARNERS
U2 - 10.1097/ACM.0000000000002131
DO - 10.1097/ACM.0000000000002131
M3 - Article
C2 - 29342008
SN - 1040-2446
VL - 93
SP - 1055
EP - 1063
JO - Academic Medicine
JF - Academic Medicine
IS - 7
ER -