Related Experiment Video
Updated: May 15, 2025
Observational Study Protocol for Repeated Clinical Examination and Critical Care Ultrasonography Within the Simple Intensive Care Studies
Published on: January 16, 2019
Evaluation of a Direct Observation, Coaching and Assessment Model for the Internal Medicine Clerkship
Katherine C Wrenn1,2, Cancan Zhang2, Amy R Weinstein1,2
1Harvard Medical School, Boston, Massachusetts, USA.
Background:
With a trend towards competency-based assessment in medical education, there is a need for increased direct observation, feedback and coaching of medical students during clinical rotations.
Approach:
To increase observation and provide more coaching and feedback, we designed a model in which a faculty coach met with students longitudinally during the internal medicine clerkship. The first session included an observed history and physical (H&P), and the coach and student identified skill areas to focus on in remaining sessions. All sessions included a debrief with feedback.
Evaluation:
Students received a survey to rate the amount and quality of observation and feedback received, and we used ordinal logistic regression models to assess the intervention. We conducted thematic analysis to assess what students found most useful. Students in the intervention group reported more direct observation performing the H&P (OR = 9.17, 95% CI [1.86, 70.05], p = 0.01) and found the personalized feedback and increased opportunities to discuss clinical reasoning valuable.
Implications:
With a growing need for longitudinal observation of clinical skills to allow for competency-based assessments, at a time in which there is often insufficient continuity between students and supervising physicians, this model helps address needs for increased direct observation, coaching and feedback on skill development over time.
Related Concept Videos
01:29Assessment of the Cardiovascular System II: Inspection
Head and Neck
01:05Data Collection III
The principles to begin the physical assessment include conducting a comprehensive or problem-related history in a quiet, well-lit room, emphasizing privacy and comfort for the...
01:15Nursing Evaluation
01:20Nursing Process for Patient and Caregiver Teaching III: Evaluation and Documentation
Nurses can use several methods to evaluate patient outcomes. For example, oral questions can assess cognitive learning,...
01:25Assessment of the Abdomen I: Inspection and Auscultation
The abdominal examination is a cornerstone of clinical medicine, serving as a critical tool in diagnosing various gastrointestinal (GI) diseases. It involves a systematic approach that includes inspection and auscultation, each with distinct yet complementary roles in assessing the abdomen. This article will delve into these two primary methods healthcare professionals use to examine the abdomen.
Inspection of the Abdomen
The first step in any abdominal examination is inspection....
01:27Assessment of the Cardiovascular System III: Palpation
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...