The challenge of feedback and the burden of accountability in clinical medical education

Have you received good feedback in a clinical setting as a doctor or medical student?

Some of the best feedback I received was during my GP reg training year when my trainer reviewed most of my consultations with me every day for the first 4 or 5 months. I knew it would be a chance to ask what he thought about a patient, and also that I would have to justify some of the decisions I had made or hadn't made. It was above and beyond any feedback I have ever had before or since on my clinical work.

We know what makes good feedback. Here is a great paper about this from 31 years ago. There was no talk about eportfolios or skills logs or apps at that time. 16 years later when I was during my GP trainee year we didn't have the burden of documenting our feedback either.

So do current moves to use technology, including smart phones, to try and document feedback in clinical settings enhance the quality of feedback given? Do they make it more likely to happen? If they don't why do we do them?

Is there a risk that in an effort to be accountable, we are making it harder for learners to achieve good feedback because of the burden of documentation? If you want to read more about this I strongly recommend Onora O'Neill on 'Intelligent Accountability in Education'.

#1carejc - Primary Care Journal Club

This was an idea that started last summer- why don't we have an online primary care journal club? #twitjc - Twitter journal club is still going strong, but we always had the idea that wanted to try something different and try different forms of social media. A few weeks ago I spoke to Peter Sloane, an Irish GP, on google plus and he mentioned that he wanted to explore the potential of G+ for education so I suggested that #1carejc would be a great thing to try and get going.

We picked a paper on osteopathy in primary care that was suggested by David Lewis a few weeks before his death last summer. On our panel we had primary care researcher Ceri Butler who has also lived with chronic back pain for many years. Joining us from Australia was Karen Price, an Australian GP and educationalist who knew David Lewis well. I was just off the train from Cardiff to Manchester. Unfortunately we couldn't get Prof John Licciardione, the 1st author of the paper to join  the conversation- but we hope to catch up with him again.

Was it a success? Well yes, we had a good discussion about the context of this research on back pain- the experience of GPs and of patients. We had a little bit of time to discuss the research itself but we were missing the voice of the researcher. Our teething technical problems limited the amount of time we had to discuss the paper but it was only ever intended that the google plus hangout should be one part of a wider discussion about the research topic.

We hope that the discussion can continue in the google plus community we have started. And that the videos will be a resource that people can look back on. We'd appreciate any feedback you have especially if you can leave it in the google plus community.

So here it is! Skip the 1st part (technical mishaps) and start at about 27 mins in - or even at 32 mins in when Ceri starts speaking very powerfully about her experiences.

Del.ic.ious doctors!

I've been using del.ic.ious now for a few weeks, but I have bookmarked very little that is relevant to my other life as a GP. By searching for tags such as appendicitis, bts (for british thoracic society), and rosuvastatin I am establishing that there are few tagging clinicians out there.

It may be hard to convince medical students that social bookmarking will be relevant to their lives unless there are a few examples of early adopter clinicians using it well.

Are there clinicians out there using social bookmarking? I'd be interested to find you. And if there aren't, why not?