Table 3 Results of Content Analysis for Student Reflective Comments for Strengths and Areas of Confidence
Theme | Representative Quote(s) for Confidence/Strength | Representative Quote(s) for Barriers and Areas for Improvement |
|---|---|---|
Patient interaction | “I feel confident in history taking and providing an outlet for the patient to speak because I tend to use open-ended questions and convey empathy quite easily.” (B1) | “Obtaining & organizing chronological information obtained from patients and collateral because I sometimes have trouble following patient stories when given a lot of info or out of order.” |
Documentation/Reporting | “Oral presentations - I think that I present effectively and with enough detail while still reserving additional details included in the notes.” (Q?) | “Presentations: Still unsure what info is more relevant and still learning what normal/abnormal lab values look like.” |
Team/Structure/Workflow | “Communicating with the healthcare team with questions and patient information because I was told my presentations were clear and concise.” (B1) “Communicating with team members especially the residents - asking what I can do to help to clarify expectations for notes, presentations; Speaking up if I don’t understand something or have a question.” (B3) | “Not knowing what I should be doing. I usually ask, but at times I don’t want to annoy others/make more work for them. (Also I do know I’m paying a lot of money to be here so that usually helps me to remind myself of this.)” (B1) “[Electronic Medical record] being confusing, repeated practice, residents and staff [not] communicating expectations clearly” (B3) |
Knowledge and Organization | “I believe I’m doing well in my studying, having made time to read through the case files book and complete a substantial number of [practice] questions so far.” (Q?) | “Time management - I feel like there is an incredible breadth of information I need to learn in OB/GYN that it is difficult for me to know how to learn it all while also being in a clinical setting. I also have responsibilities outside of clinical rotations that I am trying to juggle.” |
Physical exam | “I feel confident in my general pertinent physical exam skills and am getting more confident in the pelvic exam. This is through good feedback on what I am doing well/how I can improve.” (B1) “Physical exams: I know the exams and I am beginning to see some abnormal physical exams which is helping.” (B3) | “Time/experience: some practice with Simulated Patients is not enough to feel confident in the physical exam skills we learned or knowing how to distinguish between similar patient presentations.” (B1) “I need to become more proficient with physical examination maneuvers associated with orthopedic complaints.” (B3) |
Clinical reasoning/information synthesis | “I feel confident in initially evaluating a problem list and setting a logical agenda to follow through the history taking process.” (B1) “Formulating differential diagnoses with pertinent history and physical information by developing clinical evaluation skills in general medicine.” (B3) | “Broader knowledge base of medicine - forgot from pre-clinical; difficulty managing more complicated patients.” (B1) |
Confidence/anxiety/experience/practice | N/A | “Shyness in requesting feedback for fear of harsh criticism; Drawing a blank when asked for an assessment and plan.” (B1) |