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Staging a performance: learners' perceptions about direct observation during residency.

Kori A LaDonna1, Rose Hatala2, Lorelei Lingard3

  • 1Centre for Education Research & Innovation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

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This summary is machine-generated.

Direct observation is valued by learners but causes anxiety and alters performance. Addressing opaque expectations and separating observation from assessment is key for effective professional development.

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Area of Science:

  • Medical Education
  • Healthcare Professional Development

Background:

  • Direct observation is a validated assessment tool, but its impact on learning and learners' perceptions are not well understood.
  • Learners often feel ambivalent about being observed, highlighting a gap in understanding how to maximize its educational value.
  • Understanding learner perspectives is crucial for optimizing direct observation in educational settings.

Purpose of the Study:

  • To explore learners' perceptions of direct observation and its impact on their learning and professional development.
  • To identify factors that make direct observation a valuable educational experience for learners.

Main Methods:

  • Constructivist grounded theory approach.
  • Semi-structured interviews with 22 learners about their direct observation experiences.
  • Iterative data collection and analysis using constant comparative analysis.

Main Results:

  • Direct observation is recognized as important but induces significant anxiety.
  • Unclear expectations and the feeling of being assessed lead learners to alter their typical practice.
  • Learners questioned the authenticity of their performance and the observer's perception.

Conclusions:

  • An 'observer effect' contributes to learner ambivalence, role ambiguity, and doubts about feedback credibility.
  • Explicit expectations and awareness of performance alterations are necessary for effective direct observation.
  • Shifting to observation-based coaching, separate from assessment, can foster professional development and practitioner identity.