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Table 1 Scheduled vs. Unscheduled observations

From: Perceptions of scheduled vs. unscheduled directly observed visits in an internal medicine residency outpatient clinic

Scheduled Observation-ResidentsUnscheduled Observation-Residents
• “If I had to choose, I would choose knowing ahead of time but with the understanding that you do lose a lot when you do know … because you might change how you act.”
• “I think scheduled is definitely more comfortable, but I do see the advantage of not having scheduled observations because, inherently, we are all prone to that bias. When someone’s observing you, you are going to behave differently.”
• “It [scheduled observation] is more comfortable and I focus on things that I think I need to work on and have them specifically observe those skills, which allows me to walk away from that encounter with more learning from it.”
• “When it is scheduled, I actively invest in what I hope to walk away from that experience with.”
• “If you don’t know, it’s a truer situation and what they observe is more realistic.”
• “I prefer not knowing about an observation.”
• “My preference is towards the not knowing or not having it scheduled.”
• “I do recognize that not knowing probably is more organic and gives me better feedback.”
• “I think not knowing enhances the ability for you to get more honest feedback if you don’t know when you’re being observed, I guess would be the biggest positive aspect to it. Because oftentimes when we’re doing something wrong, we don’t know that we’re doing it wrong. It’s not like we’re inherently doing it wrong on purpose, so I think that’s the best positive aspect.”
• “I think you learn more by having someone see what you actually do in clinic versus what you’re showing them you can do. I think it’s more valuable to have them see what you do when you’re not on the stage.”
• “I think you learn more in that setting because people are observing you in your natural habitat versus you putting on a show. You learn more because it makes you change what your actual habits are versus your habits when you’re being observed.”
Scheduled Observation-FacultyUnscheduled Observation-Faculty
• “I would prefer the residents to know about the observation.”
• “Scheduled observation makes it a point of having them self-reflect on what they want advice or feedback on, then I think that provides a greater, richer opportunity for learning than unscheduled.”
• “I think it [scheduled observation] probably does affect the resident performance. When you know you’re going to be watched, everybody does things a little more thoroughly.”
• “I prefer unscheduled when residents don’t know if they’re being observed, so we really are seeing them doing what it is they do.”
• “Unscheduled is not as contrived.”
• “I prefer unscheduled as some residents, if they know they’re being observed, will put forth a different effort which can be quite painful to watch.”