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If you want to understand how behavior occurs, one of the best ways to gain information is to simply observe the behavior in its natural context. However, people might change their behavior in unexpected ways if they know they are being observed. How do researchers obtain accurate information when people tend to hide their natural behavior? As an example, imagine that your professor asks everyone in your class to raise their hand if they always wash their hands after using the restroom. Chances...
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Exploring Medical Student Experiences With Direct Observation During the Pediatric Clerkship.

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    This summary is machine-generated.

    Direct observation (DO) of medical students is inconsistent, with attendings observing vital clinical skills less often than expected. Improving DO quality is crucial for developing a competent physician workforce.

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    Area of Science:

    • Medical Education Research
    • Clinical Skills Assessment
    • Graduate Medical Education

    Background:

    • Direct observation (DO) is mandated for assessing medical student competencies during clerkships.
    • The frequency, duration, quality, and context of DOs are not well-documented.
    • This study investigates DOs during pediatrics clerkships across multiple institutions.

    Purpose of the Study:

    • To examine the quality, quantity, and characteristics of direct observations (DOs) during pediatrics clerkships.
    • To identify factors influencing the perceived value of DOs for medical students.
    • To assess the current state of DO practices in pediatrics clerkships.

    Main Methods:

    • A multimethod study involving 6 U.S. institutions from March to October 2022.
    • Qualitative phase: Focus groups and semistructured interviews with third-year medical students.
    • Quantitative phase: Anonymous surveys administered post-interviews, analyzed thematically and statistically.

    Main Results:

    • 73 students participated; 71 completed surveys. DOs were primarily conducted by residents (87.3%) not attendings (8.4%).
    • Attendings frequently observed clinical reasoning (53.5%), communication (54.9%), and presentation skills (81.7%).
    • One-third of students were never observed taking a history (32.4%), and one-quarter never observed performing a physical exam (25.4%) by an attending.

    Conclusions:

    • Direct observation of vital clinical skills by attendings is less frequent than anticipated in inpatient settings.
    • Medical students value DOs when expectations are clear, the environment is safe, and feedback is actionable.
    • Current DO practices are suboptimal, necessitating improvements for competency-based clinical education and future patient care.