Leveraging Self-regulated Learning in a Focused Direct-Observation and Feedback Model in the Ambulatory Setting for...

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Self-Regulated Learning

Background:

• Ambulatory learning presents time constraints for observation and feedback.
• Mini-Clinical Evaluation Exercises (CEX) offer feedback but may neglect self-regulated learning (SRL).

Purpose of the Study:

• To implement and evaluate a direct observation and feedback model using mini-CEX and coaching.
• The goal was to enhance resident self-efficacy in a fast-paced clinic.

Main Methods:

• A mixed-methods program evaluation was conducted.
• Primary Care Track residents in an urban, underserved clinic participated.
• Surveys and qualitative analysis of narrative evaluations assessed participant experience and self-efficacy.

Main Results:

• The model was valued by faculty and residents, but only 50% of observations were completed.
• Pre-encounter discussions within an SRL framework fostered self-identified efficacy.
• Key themes included learner initiative, locus of control, and adaptive responses to patient complexity.

Conclusions:

• Pre-encounter priming of direct observation enhances SRL and self-efficacy.
• Challenges in observation completion highlight the need to address external barriers.
• Future models should support learners in navigating these barriers to build proactivity and reactivity.