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The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use?
Joan Sargeant1, Jocelyn M Lockyer, Karen Mann
1J. Sargeant is professor, Continuing Professional Development Program and Division of Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. J.M. Lockyer is professor, Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. K. Mann was professor emeritus, Division of Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. H. Armson is assistant dean, Continuing Professional Development, and associate professor, Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada. A. Warren is associate professor, Department of Pediatrics, and associate dean, Postgraduate Medical Education, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. M. Zetkulic is assistant professor, Seton Hall School of Medicine, Director of Medical Education, Department of Medicine, Hackensack University Hospital, Hackensack, New Jersey. S. Soklaridis is assistant professor, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. K.D. Könings is associate professor, Department of Educational Development & Research and School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. K. Ross is research associate, Department of Evaluation, Research and Development, American Board of Internal Medicine, Philadelphia, Pennsylvania. I. Silver is vice president of education, Centre for Addiction and Mental Health, and professor, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. E. Holmboe is senior vice president of milestones development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois, adjunct professor of medicine, Yale University, New Haven, Connecticut, and adjunct professor, Uniformed Services University of the Health Sciences, Bethesda, Maryland. C. Shearer is evaluation specialist, Postgraduate Medical Education, Dalhousie University, Halifax, Nova Scotia, Canada. M. Boudreau is evaluation specialist, Continuing Professional Development, Dalhousie University, Halifax, Nova Scotia, Canada.
The R2C2 model enhances performance feedback for medical residents, fostering reflective discussions and collaborative change plans. Its effectiveness is influenced by various factors within residency programs.
Area of Science:
- Medical Education Research
- Healthcare Professional Development
- Performance Feedback Systems
Background:
- The R2C2 model was previously developed to facilitate performance feedback for practice improvement.
- The model comprises four phases: relationship building, exploring reactions, exploring content, and coaching.
Purpose of the Study:
- To investigate the utilization and effectiveness of the R2C2 model across diverse residency programs.
- To identify factors influencing the model's effectiveness and implementation.
Main Methods:
- A case study methodology was employed from July 2014 to October 2016.
- Data were collected from five residency programs in three countries, including interviews and learning change plans (LCPs).
- Content, thematic, template, and cross-case analyses were performed.
Main Results:
- The R2C2 model, integrated with LCPs, effectively engaged residents in reflective, goal-oriented discussions on performance data.
- It supported coaching and facilitated the collaborative development of change plans.
- Model utilization varied, influenced by supervisor/resident characteristics, relationship quality, assessment methods, program context, and author support.
Conclusions:
- The R2C2 model effectively promotes productive, reflective feedback conversations centered on resident development.
- It facilitates the collaborative creation of actionable change plans.
- Key factors contributing to the successful application of the R2C2 model were identified.
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