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首页> 外文期刊>BMC Medical Education >Supervisors’ intention to observe clinical task performance: an exploratory study using the theory of planned behaviour during postgraduate medical training
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Supervisors’ intention to observe clinical task performance: an exploratory study using the theory of planned behaviour during postgraduate medical training

机译：监督员意图遵守临床任务绩效：在研究生医疗培训期间使用计划行为理论的探索性研究

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Direct observation of clinical task performance plays a pivotal role in competency-based medical education. Although formal guidelines require supervisors to engage in direct observations, research demonstrates that trainees are infrequently observed. Supervisors may not only experience practical and socio-cultural barriers to direct observations in healthcare settings, they may also question usefulness or have low perceived self-efficacy in performing direct observations. A better understanding of how these multiple factors interact to influence supervisors’ intention to perform direct observations may help us to more effectively implement the aforementioned guidelines and increase the frequency of direct observations. We conducted an exploratory quantitative study, using the Theory of Planned Behaviour (TPB) as our theoretical framework. In applying the TPB, we transfer a psychological theory to medical education to get insight in the influence of cognitive and emotional processes on intentions to use direct observations in workplace based learning and assessment. We developed an instrument to investigate supervisors intention to perform direct observations. The relationships between the TPB measures of our questionnaire were explored by computing bivariate correlations using Pearson’s R tests. Hierarchical regression analysis was performed in order to assess the impact of the respective TPB measures as predictors on the intention to perform direct observations. In our study 82 GP supervisors completed our TPB questionnaire. We found that supervisors had a positive attitude towards direct observations. Our TPB model explained 45% of the variance in supervisors’ intentions to perform them. Normative beliefs and past behaviour were significant determinants of this intention. Our study suggests that supervisors use their past experiences to form intentions to perform direct observations in a careful, thoughtful manner and, in doing so, also take the preferences of the learner and other stakeholders potentially engaged in direct observations into consideration. These findings have potential implications for research into work-based assessments and the development of training interventions to foster a shared mental model on the use of direct observations.
机译：直接观察临床任务表现在基于能力的医学教育中起着重要作用。虽然正式指导方针需要主管从事直接观察，但研究表明，学员很少观察到。主管不仅可能在医疗环境中直接观察到实际和社会文化障碍，他们也可能质疑有用性或在执行直接观察方面的自我效能低。更好地理解这些多个因素如何互动以影响监管者执行直接观察的意图可能有助于我们更有效地实施上述准则并增加直接观察的频率。我们使用计划行为理论（TPB）作为我们理论框架进行了探索性的定量研究。在应用TPB时，我们将心理学理论转移到医学教育，以了解认知和情绪过程对在基于工作场所的学习和评估中使用直接观察的意图影响的洞察力。我们开发了一种努力调查主管的意图来执行直接观察。通过使用Pearson R测试计算双变量相关性，探讨了我们调查问卷的TPB措施之间的关系。进行分层回归分析，以评估各自的TPB措施的影响作为履行直接观察的预测因子。在我们的研究中，82个GP监督员完成了我们的TPB问卷。我们发现主管对直接观察有积极的态度。我们的TPB模型解释了监督员意图的45％的差异来执行它们。规范性信仰和过去的行为是这个意图的重要决定因素。我们的研究表明，监事会用他们过去的经历以谨慎，深思熟虑的方式形成直接观察，并在这样做，也取得了潜在地考虑直接观察的学习者和其他利益相关者的偏好。这些调查结果对研究基于工作的评估以及培训干预措施的发展具有潜在的影响，以促进对使用直接观察的共同心理模型。

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