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Behind closed doors.

Kevin Duan1, Leslie Sheu1

  • 1a Department of Medicine , University of California San Francisco , San Francisco , CA , USA.

Medical Teacher
|December 8, 2016
PubMed
Summary
This summary is machine-generated.

Physicians often discuss team concerns privately rather than directly with the learner. Shifting feedback culture in medical training towards direct clinical micro-coaching is recommended.

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Area of Science:

  • Medical Education
  • Physician Communication
  • Healthcare Leadership

Background:

  • Physicians at all training levels tend to discuss concerns about team members privately.
  • This indirect communication pattern is prevalent amongst attendings, residents, and interns.
  • Chief residents observe this tendency firsthand through direct experience.

Purpose of the Study:

  • To analyze the current feedback culture in medical training.
  • To highlight the prevalent practice of discussing concerns behind closed doors.
  • To advocate for a shift towards direct feedback and micro-coaching.

Main Methods:

  • Personal experiences of internal medicine chief residents were utilized.
  • Observations were made regarding how physicians discuss team member concerns.
  • Qualitative analysis of communication patterns in a clinical setting.

Main Results:

  • A significant tendency exists for physicians to raise concerns about colleagues indirectly.
  • This behavior is observed across various levels of medical training.
  • Direct communication with the learner is often avoided.

Conclusions:

  • The current feedback culture in medical training requires a fundamental shift.
  • Moving away from indirect "behind closed doors" discussions is crucial.
  • Adopting a clinical "micro-coaching" approach can improve feedback delivery and team dynamics.