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Table 3 Perceptions regarding learning and feedback

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

Scheduled Observation-ResidentsUnscheduled Observation-Residents
• “Overall, it’s been positive … the feedback we get from the observing faculty is way more specific than the feedback we would get if were just to present the patient.”
• “I think observation definitely affects my learning. I can think of five specific things that I do now because of the feedback that I received during observed encounters.”
• “I derived the most learning from having my physical exam observed.”
• “So having an observer during challenging patient conversations really helped with my communications skills.”
• “Scheduled observed visits adds efficiency when you are staffing cases. Then you’re afforded time to get to some of the more polishing details and advanced principles.”
• “When they [faculty] already have heard the entire history, you can jump straight to the impression, report and plan and spend more time discussing differentials and what you would do and follow-up, rather than going back to the history and starting from scratch.”
• “I think the type of feedback, the quality of feedback from the preceptors given both verbally as well as written is more helpful and more direct, more specific when someone has directly observed me than some of the more generic comments that come when you just staff cases in the clinic and weren’t observed.”
• “Specific examples in real time are far more educational.”
• “Direct observation is better for learning exam skills because they can watch and correct you.”
• “I feel like some of the best kind of timely, specific feedback that I’ve gotten has been as I am discussing a patient with a preceptor who just observed me in that encounter.”
• “I’ve found feedback useful in many ways. Getting feedback on the art of medicine and how to communicate better has been very pivotal for my training.”
Scheduled Observation-FacultyUnscheduled Observation-Faculty
• “When we are not observing, the evaluation and feedback is an assessment of their knowledge verses observation allows more feedback about skills and attitudes.”
• “Observation allows us to give feedback on the how, not the what.”
• “Feedback after observation is much more specific. It’s much more behavioral. It’s what I saw, it’s what you said, it’s how you said it, it’s all that sort of stuff we wouldn’t capture otherwise.”
• “Observation allows us to give feedback on the attitudes. Attitudes are important.”