Faculty development seminars based on the one-minute preceptor improve feedback in the ambulatory setting.

摘要

OBJECTIVE: While several models of medical student instruction in the ambulatory setting exist, few have been formally studied. We wished to assess the impact of a faculty development workshop based on the One-Minute Preceptor model on the amount and quality of feedback in the outpatient setting. DESIGN: Ambulatory teaching behaviors were studied during consecutive outpatient precepting sessions before and after 3 faculty development workshops. Student-teacher interactions were assessed using audiotapes of teaching encounters coded through qualitative techniques, and surveys of teacher, learner, and patient satisfaction. SETTING: Ambulatory internal medicine clinic in a tertiary care medical center. PATIENTS/PARTICIPANTS: Nine board-certified internist faculty preceptors and 44 third-year medical students. INTERVENTIONS: Three 90-minute faculty development seminars based on the One-Minute Preceptor teaching model. MEASUREMENTS AND MAIN RESULTS: Ninety-four encounters with 18577 utterances were recorded, half before and half after the seminars. After the workshops, the proportion of utterances that contained feedback increased from 17% to 22% (P =.09) and was more likely to be specific (9% vs 15%; P =.02). After the workshops, teachers reported that the learning encounters were more successful (P =.03) and that they were better at letting the students reach their own Conclusions (P =.001), at evaluating the learners (P =.03), and at creating plans for post-encounter learning (P =.02). The workshops had no effect on the duration of the student-teacher encounter or on student or patient satisfaction with the encounters. CONCLUSIONS: Brief, interactive, faculty development workshops based on the One-Minute Preceptor model of clinical teaching resulted in modest improvements in the quality of feedback delivered in the ambulatory setting.