MedEdPORTAL (Mar 2016)
Early Psychiatry Experience Faculty Development: Preparing Preceptors to Facilitate Patient Interviews by Second-Year Medical Students With Debrief
Abstract
Abstract Introduction Faculty development programs are standards of practice in medical education to develop teaching skills of faculty. Programs that involve direct faculty feedback from a trained observer are more effective in impacting behaviors. An observed structured teaching encounter (OSTE) uses standardized trainees in scripted cases to assess teaching skills. The goal of the OSTE assessment can be program evaluation or specific teaching and feedback skills used in medical education with trainees. The OSTE allows practice followed by immediate feedback on performance. Methods In this OSTE, faculty development was provided to psychiatry preceptors. Their role was to precept two to three second-year medical students during a psychiatric patient encounter. The goal was to conduct a complete history and mental status exam on the patient. Using a standardized patient in the role of a psychiatric patient and fourth-year medical students in the role of second-year students, a simulated interaction was conducted in a small group. This role-play mimicked the preceptor, student, and patient encounter. The focus was on patient interviewing skills in addition to keeping all three students, who were observers, engaged in the interaction and learning. This was followed by a small-group discussion focusing on teachable moments. Results We used the evaluation by the second-year students, who completed a required initial clinical experience (ICE) in psychiatry, as evidence that this faculty development was effective. The psychiatry ICE data from 2014–2015 (N = 77) had 12 evaluation questions with a mean score of 3.9 out of 4.0. The one question that directly related to the faculty development OSTE (“Directly observes my clinical skills when interacting with patients”) scored 4.0 out of 4.0. Discussion To engage preceptors who are required to participate as preceptors in an early clinical experience, it is important to consider faculty development strategies beyond introductory letters, how-to manuals, videos, and PowerPoints. The OSTE framework permits enactment of the desired education strategy and reinforces what we expect from clinical teachers as well as expectations from students during a teaching encounter. It also unveils gaps that can be addressed in future faculty developments to assure learning for our students is consistent and on target.
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