Abstract Body

Background and purpose: Learning and assessing skilled communication requires considering contextual factors in clinical encounters. Purpose is to develop narrative profiles describing behavioural patterns of consultation performance of trainees in Family Medicine (FM) and identify challenges for future learning.

Methods: A qualitative study was conducted in FM residency training consisting of three phases: 1. From year 1 (N=6) and year 3 (N=7) trainees, in total 81 videotaped consultations were observed and overall trainee consultation performance classified in one of four-pre-existing typologies, 2. During an individual interview, FM supervisors (N=20) observed four selected consultations mirroring each of these typologies and reflected on trainee behaviours, 3. Development of four narrative profiles based on template analysis of the interviews and a content comparison with the typologies. (1)

Results: Four narrative profiles describing trainee attitude, patterns of consultation behaviours and challenges for future learning, align with the pre-existing typologies. There is a shared frame of reference between supervisors when identifying behavioural patterns mirroring proficiency in doctor patient interaction. Learning challenges focus on balancing patient-centeredness with effectively working on clinical tasks, while outlining the developmental route for contextual adaptation.

Discussion: Narrative profiles support meaningful and tailored feedback on consultation performance and stimulate monitoring of individual competence development integrating learning and assessment during workplace based learning. The value of using the narrative profiles in workplace-based learning needs further exploration in future studies.

1. Oerlemans M, et al. Should we assess clinical performance in single patient encounters or consistent behaviors of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles. Medical Teacher. 2017;39(3):300-7.