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      Developing essential professional skills: a framework for teaching and learning about feedback

      1 , 1 , , 1

      BMC Medical Education

      BioMed Central

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          Abstract

          Background

          The ability to give and receive feedback effectively is a key skill for doctors, aids learning between all levels of the medical hierarchy, and provides a basis for reflective practice and life-long learning. How best to teach this skill?

          Discussion

          We suggest that a single "teaching the skill of feedback" session provides superficial and ineffective learning in a medical culture that often uses feedback skills poorly or discourages feedback. Our experience suggests that both the skill and the underlying attitude informing its application must be addressed, and is best done so longitudinally and reiteratively using different forms of feedback delivery. These feedback learning opportunities include written and oral, peer to peer and cross-hierarchy, public and private, thereby addressing different cognitive processes and attitudinal difficulties.

          Summary

          We conclude by asking whether it is possible to build a consensus approach to a framework for teaching and learning feedback skills?

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          Most cited references 24

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          Social constructivist perspectives on teaching and learning.

           A Palincsar (1998)
          Social constructivist perspectives focus on the interdependence of social and individual processes in the co-construction of knowledge. After the impetus for understanding the influence of social and cultural factors on cognition is reviewed, mechanisms hypothesized to account for learning from this perspective are identified, drawing from Piagetian and Vygotskian accounts. The empirical research reviewed illustrates (a) the application of institutional analyses to investigate schooling as a cultural process, (b) the application of interpersonal analyses to examine how interactions promote cognition and learning, and (c) discursive analyses examining and manipulating the patterns and opportunities in instructional conversation. The review concludes with a discussion of the application of this perspective to selected contemporary issues, including: acquiring expertise across domains, assessment, educational equity, and educational reform.
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            Suicide in doctors: a study of risk according to gender, seniority and specialty in medical practitioners in England and Wales, 1979-1995.

            To investigate the suicide risk of doctors in England and Wales, according to gender, seniority and specialty. Retrospective cohort study. Suicide rates calculated by gender, age, specialty, seniority and time period. Standardised mortality ratios calculated for suicide (1991-1995), adjusted for age and sex. England and Wales. Doctors in the National Health Service who died by suicide between 1979 and 1995, identified by death certificates. Population at risk based on Department of Health manpower data. Two hundred and twenty three medical practitioners in the National Health Service who died by suicide or undetermined cause were identified. The annual suicide rates in male and female doctors were 19.2 and 18.8 per 100 000 respectively. The suicide rate in female doctors was higher than in the general population (SMR 201.8; 95% CI 99.7, 303.9), whereas the rate in male doctors was less than that of the general population (SMR 66.8; 95% CI 46.6, 87.0). The difference between the mortality ratios of the female and male doctors was statistically significant (p=0.01), although the absolute suicide risk was similar in the two genders. There were significant differences between specialties (p=0.0001), with anaesthetists, community health doctors, general practitioners and psychiatrists having significantly increased rates compared with doctors in general hospital medicine. There were no differences with regard to seniority and time period. There is an increased risk of suicide in female doctors, but male doctors seem to be at less risk than men in the general population. The excess risk of suicide in female doctors highlights the need to tackle stress and mental health problems in doctors more effectively. The risk requires particular monitoring in the light of the very large increase in the numbers of women entering medicine.
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              Stresses on women physicians: consequences and coping techniques.

               Gail Robinson (2003)
              We review current data on types of stressors acting on women physicians, the consequences of these stressors and methods of coping with them. We undertook a systematic review of original articles published in the last 15 years and registered mainly on Medline and on the internet websites focusing on these issues. In addition to the pressures acting on all physicians, women physicians face specific stressors related to discrimination, lack of role models and support, role strain, and overload. The depression rate in women physicians does not vary from that of the general public but the rates of successful suicide and divorce are much higher. Women in academic settings are promoted more slowly, have lower salaries, receive fewer resources, and suffer from a range of micro-inequities. They often lack mentors to provide advice and guidance. They must cope with the pressures of choosing when to have a child and conflicts between being a wife and mother and having a career. Despite these pressures, they report a high degree of career satisfaction. Although women physicians suffer from a variety of stressors that can lead to career impediments, stress reactions, and psychiatric problems, generally they are satisfied with their careers. Personal coping techniques can help women deal with these stressors. Pressures will continue until attitudes and practices change in institutional settings. Some institutions are initiating changes to end discrimination against women faculty.
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                Author and article information

                Journal
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                2005
                1 April 2005
                : 5
                : 11
                Affiliations
                [1 ]Department of Anatomy, University of Cambridge, Downing Street, Cambridge, CB2 3DY, UK
                Article
                1472-6920-5-11
                10.1186/1472-6920-5-11
                1087486
                15804360
                Copyright © 2005 Henderson et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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