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CMAJ. 1992 February 15; 146(4): 489–497.
PMCID: PMC1488471

Nature of the clinical difficulties of first-year family medicine residents under direct observation.

Abstract

OBJECTIVE: To determine and classify the difficulties of first-year family medicine residents observed during clinical interviews. DESIGN: Retrospective, descriptive study. SETTING: Family practice unit at a teaching hospital. PARTICIPANTS: Forty-seven of the 56 first-year family medicine residents during their 2-month compulsory rotation in ambulatory family medicine, between July 1983 and December 1988, and 4 physicians who supervised the residents. MAIN OUTCOME MEASURE: The residents' difficulties noted on the observation forms. MAIN RESULTS: A total of 1500 difficulties were observed during 194 interviews, an average of 7.7 (standard deviation 5.2) per interview. There were 167 different difficulties, which were classified into seven categories (introduction, initial contract, body of the interview, techniques and organization, interpersonal aspects, final contract and miscellaneous) and 20 subcategories. The 17 most frequently noted difficulties accounted for 40% of the total. CONCLUSIONS: The results constitute a useful starting point for developing a classification of residents' difficulties during clinical interviews. We believe that the list of difficulties is applicable to residents at all levels and in other specialties, especially in ambulatory settings. The list can be used to develop learning materials for supervisors and residents.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Alexander DA, Knox JD, Morrison AT. Medical students talking to patients. Med Educ. 1977 Nov;11(6):390–393. [PubMed]
  • Harper AC, Roy WB, Norman GR, Rand CA, Feightner JW. Difficulties in clinical skills evaluation. Med Educ. 1983 Jan;17(1):24–27. [PubMed]
  • Comstock LM, Hooper EM, Goodwin JM, Goodwin JS. Physician behaviors that correlate with patient satisfaction. J Med Educ. 1982 Feb;57(2):105–112. [PubMed]
  • Meuleman JR, Caranasos GJ. Evaluating the interview performance of internal medicine interns. Acad Med. 1989 May;64(5):277–279. [PubMed]
  • Hinz CF., Jr Direct observation as a means of teaching and evaluating clinical skills. J Med Educ. 1966 Feb;41(2):150–161. [PubMed]
  • Links PS, Colton T, Norman GR. Evaluating a direct observation exercise in a psychiatric clerkship. Med Educ. 1984 Jan;18(1):46–51. [PubMed]
  • Stewart M, Brown J, Levenstein J, McCracken E, McWhinney IR. The patient-centred clinical method. 3. Changes in residents' performance over two months of training. Fam Pract. 1986 Sep;3(3):164–167. [PubMed]
  • Corley JB, Mason RL. A study on the effectiveness of one-way mirrors. J Med Educ. 1976 Jan;51(1):62–63. [PubMed]
  • Wiener S, Nathanson M. Physical examination. Frequently observed errors. JAMA. 1976 Aug 16;236(7):852–855. [PubMed]
  • Enelow AJ, Adler LM, Wexler M. Programmed instruction in interviewing. An experiment in medical education. JAMA. 1970 Jun 15;212(11):1843–1846. [PubMed]
  • Tiberius RG, Sackin HD. Observation as a method of learning: a useful learning experience or a waste of time? Med Educ. 1988 Jul;22(4):287–293. [PubMed]
  • Frost GJ, Cater JI, Forsyth JS. The use of the Objective Structured Clinical Examination (OSCE) in paediatrics. Med Teach. 1986;8(3):261–269. [PubMed]
  • Brown J, Stewart M, McCracken E, McWhinney IR, Levenstein J. The patient-centred clinical method. 2. Definition and application. Fam Pract. 1986 Jun;3(2):75–79. [PubMed]

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