Accepted Type
Oral
Code
OC3-1-1
Acceptance Declaration
Accept
Additional Information
I declare I have no actual or potential conflict of interest in relation to this program.
Was this work accepted for CCME 2020?
no
Category
General Call (Workshop, Oral Presentation, Poster Presentation)
Type
Oral
Sub Type
Education Research
Will the presenter be a:
Resident
Affiliation
Considered for Poster
yes
Title
In Support of Meaningful Assessment and Feedback: A Study of 'Reasoning Tasks' Used During Case Review in the Ambulatory Setting
Length of Presentation
Background/Purpose
Faculty and trainees are familiar with clinical tasks, but less familiar with metacognitive 'reasoning tasks' that influence clinical task performance. As part of a multi-phase study exploring reasoning tasks across internal medicine settings, the purpose of this study is to explore patterns of reasoning tasks used in ambulatory geriatric clinics.
Methods
Data consists of 18 audio-recorded case review discussions between 4 geriatricians and 11 trainees (medical students, residents and fellows). Transcript analysis included constant comparison and template analysis using a previously validated list of 3 overarching and 23 supportive reasoning tasks.
Results
The most addressed reasoning tasks reflect the nature of this specialty: trainees emphasize precipitants to the current problem, explore physical and psychosocial consequences of the current conditions or treatment, and may formulate tentative management plans contextualized to the psychosocial. Faculty refine management plans by weighing alternative treatment options, considering the impact of comorbid illness on management and vice versa. They also demonstrate expertise with the healthcare system via collaborative practices and navigation of resource constraints. Theoretically, 2 new reasoning tasks were identified: 1) consider the quality of the data source, including credibility, reliability and other barriers to effective data collection; 2) determine the need for further data gathering.
Conclusion
Developing a shared language around reasoning tasks will support trainee preparation and development, through more explicit feedback around patterns of omission and inter-specialty differences. Understanding which tasks are commonly addressed by trainees vs. faculty can also help delineate the competency continuum and support assessment design.
Keyword 1
Clinical reasoning
Keyword 2
Assessment
Keyword 3
Competency
Level of Training
Post Graduate
Abstract Themes
Teaching and learning
Teaching and Learning
- Ambulatory Care
- Competency-Based Education
- Feedback
Additional Theme (First choice)
Assessment
Additional Theme (Second Choice)
Additional Theme (Third Choice)
Authors
Presenter
Radha Joseph
Term 1
Yes
Term 2
Yes
Term 3
Yes
Term 4
Yes
Term 5
Yes
