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The Patient Experience Debrief Interview: How Conversations With Hospitalized Families Influence Medical Student
Ian S Chua1, Alyssa L Bogetz, Priti Bhansali
1I.S. Chua is assistant professor, Department of Pediatrics, Children's National Medical Center, Washington, DC, and clinical instructor, Department of Pediatrics, Stanford School of Medicine, Stanford, California. A.L. Bogetz is associate program director, Department of Pediatrics, Stanford School of Medicine, Stanford, California. P. Bhansali is associate professor, Department of Pediatrics, Children's National Medical Center, Washington, DC. M. Long is associate professor, Department of Pediatrics, University of California, San Francisco, San Francisco, California. R. Holbreich is a medical student, George Washington University School of Medicine and Health Sciences, Washington, DC. T. Kind is professor of pediatrics and associate dean of clinical education, George Washington University School of Medicine and Health Sciences, Washington, DC. M. Ottolini is vice chair of education and professor, Children's National Medical Center, Washington, DC. Y.S. Park is associate professor, Department of Medical Education, University of Illinois, Chicago, Chicago, Illinois. M. Lineberry is assistant professor and director of simulation research, assessment, and outcomes, University of Kansas City Medical Center, Kansas City, Kansas. L.E. Hirshfield is assistant professor, Department of Medical Education, University of Illinois, Chicago, Chicago, Illinois.
Purpose:
To determine the effect of patient debrief interviews on pediatric clerkship student depth of reflection and learning.
Method:
The authors conducted a multi-institutional, mixed-methods, cluster randomized trial among pediatric clerkship students from May 2016 to February 2017. Intervention students completed a debrief interview with a patient-caregiver, followed by a written reflection on the experience. Control students completed a written reflection on a memorable patient encounter. Three blinded authors scored written reflections according to the 4-level REFLECT rubric to determine depth of reflection. Interrater reliability was examined using kappa. REFLECT scores were analyzed using a chi-square test; essays were analyzed using content analysis.
Results:
Eighty percent of eligible students participated. One hundred eighty-nine essays (89 control, 100 intervention) were scored. Thirty-seven percent of the control group attained reflection and critical reflection, the 2 highest levels of reflection, compared with 71% of the intervention group; 2% of the control group attained critical reflection, the highest level, compared with 31% of the intervention group (χ(3, N = 189) = 33.9, P < .001). Seven themes were seen across both groups, 3 focused on physician practice and 4 focused on patients. Patient-centered themes were more common in the intervention group, whereas physician-focused themes were more common in the control group.
Conclusions:
Patient debrief interviews offer a unique approach to deepen self-reflection through direct dialogue and exploration of patient-caregiver experiences during hospitalization.
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