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Feedback that works in the era of milestone assessment – the R2C2 model.


Zetkulic MG. — Saint Peter's University Hospital/Rutgers Robert Wood Johnson Medical School

McDonald FS. — American Board of Internal Medicine

VanHoven AM. — Rutgers New Jersey Medical School

Presented: Association of Program Directors in Internal Medicine Conference, April 2016

Abstract: Providing performance feedback using milestone assessment presents new challenges to program directors and clinical competency committees. Learners do not always readily accept or use performance feedback for improvement. Possible explanations include inconsistency of the feedback with self-assessment, concerns about data credibility, and perceived barriers to feedback use and change. We have taken a four-stage model for facilitating acceptance and use of formal feedback (the R2C2 model) and applied it to the six-month feedback that accompanies milestone assessment. The model has already been researched and validated for providing feedback that fosters change in practicing physicians. This approach integrates three bodies of learning theory and research: informed self-assessment, which helps physicians to assimilate and use external data; person-centered approaches, which actively engage recipients in taking ownership of their feedback; and behavior change approaches, to enable recipients to identify goals and plans for change. Initial resident reaction of this approach has been enthusiastic, with comments such as “milestone feedback as goal-directed therapy.” This interactive workshop will use multiple learning activities. Following an interactive presentation of theories and evidence underlying the model, participants will experience the R2C2 model through role playing using sample milestone assessments. At the end of the workshop, participants will be able to describe the four-stage model of building relationships, exploring reactions, exploring content, and coaching for change; discuss the theory and evidence informing the model; and experience and critique the model through role play using milestone scenarios.

For more information about this presentation, please contact Research@abim.org.