Interdisciplinary direct observation: impact on precepting, residents, and faculty

Area of Science:

• Medical Education
• Health Professions Education
• Clinical Training

Background:

• Direct observation is crucial for resident training and assessment.
• Limited research exists on the impact of direct observation and interdisciplinary precepting.
• An Interdisciplinary Direct Observation Precepting Model (IDOPM) was implemented using closed-circuit television observation by a behavioral scientist and family physician team.

Purpose of the Study:

• To examine the impact of the Interdisciplinary Direct Observation Precepting Model (IDOPM) on medical residents and preceptors.
• To identify the effects of interdisciplinary direct observation on training and faculty development.

Main Methods:

• Surveys and focus groups were employed to gather data.
• Survey responses and focus group transcripts were analyzed using an immersion/crystallization approach.
• The study involved 24 residents, 14 physician faculty, and 8 behavioral science faculty over 19 clinics.

Main Results:

• Residents and faculty reported discussing essential skills like communication, time management, EMR use, emotional complexity, and physical exam techniques.
• The IDOPM reinforced a biopsychosocial approach to patient care.
• Residents expressed mixed feelings about being observed, while faculty valued the team approach for training and development.

Conclusions:

• The IDOPM effectively addresses core skills neglected in traditional precepting.
• Interdisciplinary direct observation can enhance faculty's formative competency assessment skills.
• This model better prepares residents for the complexities of modern primary care practice.