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Insightful Practice : a robust measure of medical students' professional response to feedback on their performance

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Murphy_2015_Insightful_Practice_BMCMedEdu_125_CC.pdf (572.8Kb)
Date
01/08/2015
Author
Murphy, Douglas
Aitchison, Patricia
Hernandez Santiago, Virginia
Davey, Peter
Mires, Gary
Nathwani, Dilip
Keywords
Continuous professional development
Feedback
Patient safety
Professionalism
Remediation
LB Theory and practice of education
R Medicine
Medicine(all)
Education
NDAS
Metadata
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Abstract
Background: Healthcare professionals need to show accountability, responsibility and appropriate response to audit feedback. Assessment of Insightful Practice (engagement, insight and appropriate action for improvement) has been shown to offer a robust system, in general practice, to identify concerns in doctors' response to independent feedback. This study researched the system's utility in medical undergraduates. Methods: Setting and participants: 28 fourth year medical students reflected on their performance feedback. Reflection was supported by a staff coach. Students' portfolios were divided into two groups (n∈=∈14). Group 1 students were assessed by three staff assessors (calibrated using group training) and Group 2 students' portfolios were assessed by three staff assessors (un-calibrated by one-to-one training). Assessments were by blinded web-based exercise and assessors were senior Medical School staff. Design: Case series with mixed qualitative and quantitative methods. A feedback dataset was specified as (1) student-specific End-of-Block Clinical Feedback, (2) other available Medical School assessment data and, (3) an assessment of students' identification of prescribing errors. Analysis and statistical tests: Generalisability G-theory and associated Decision D- studies were used to assess the reliability of the system and a subsequent recommendation on students' suitability to progress training. One-to-one interviews explored participants' experiences. Main outcome measures: The primary outcome measure was inter-rater reliability of assessment of students' Insightful Practice. Secondary outcome measures were the reaction of participants and their self-reported behavioural change. Results: The method offered a feasible and highly reliable global assessment for calibrated assessors, G (inter-rater reliability)∈>∈0.8 (two assessors), but not un-calibrated assessors G∈<∈0.31. Calibrated assessment proved an acceptable basis to enhance feedback and identify concern in professionalism. Students reported increased awareness in teamwork and in the importance of heeding advice. Coaches reported improvement in their feedback skills and commitment to improving the quality of student feedback. Conclusions: Insightful practice offers a reliable and feasible method to evaluate medical undergraduates' professional response to their training feedback. The piloted system offers a method to assist the early identification of students at risk and monitor, where required, the remediation of students to get their level(s) of professional response to feedback back 'on track'.
Citation
Murphy , D , Aitchison , P , Hernandez Santiago , V , Davey , P , Mires , G & Nathwani , D 2015 , ' Insightful Practice : a robust measure of medical students' professional response to feedback on their performance ' , BMC Medical Education , vol. 15 , 125 . https://doi.org/10.1186/s12909-015-0406-2
Publication
BMC Medical Education
Status
Peer reviewed
DOI
https://doi.org/10.1186/s12909-015-0406-2
ISSN
1472-6920
Type
Journal article
Rights
© 2015 Murphy et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Collections
  • Medicine Research
  • University of St Andrews Research
URI
http://hdl.handle.net/10023/12022

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