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Coaching for Chaos: A Qualitative Study of Instructional Methods for Multipatient Management in the Emergency Department
Author(s) -
Chan Teresa M.,
Van Dewark Kenneth,
Sherbino Jonathan,
Lineberry Matthew
Publication year - 2019
Publication title -
aem education and training
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 9
ISSN - 2472-5390
DOI - 10.1002/aet2.10312
Subject(s) - coaching , emergency department , medical education , psychology , qualitative research , variety (cybernetics) , outpatient clinic , medicine , computer science , nursing , artificial intelligence , social science , sociology , psychotherapist
Background Busy environments, like the emergency department ( ED ), require teachers to develop instructional strategies for coaching trainees to function within these same environments. Few studies have documented the strategies used by emergency physician ( EP )‐teachers within these busy, chaotic environments, instead emphasizing teaching in more predictable environments such as the outpatient clinic, hospital wards, or operating room. The authors sought to discover what strategies EP ‐teachers were using and what trainees recalled experiencing when learning to handle these unpredictable, overcrowded, complex, multipatient environments. Method An interpretive description study was conducted at multiple teaching hospitals affiliated with McMaster University from July 2014 to May 2015. Participants (10 EP ‐teachers and 10 junior residents) were asked to recall teaching strategies related to handling ED patient flow. Participants were asked to describe techniques that they used, observed, or experienced as trainees. Two independent coders read through interview transcripts, analyzing these documents inductively and iteratively. Results Two main types of strategies to teach ED management were discovered: 1) workplace‐based methods, including both observation and in situ instruction; and 2) principle‐based advice. The most often described techniques were workplace‐based methods, which included a variety of in situ techniques ranging from conversations to managerial coaching (e.g., collaborative problem‐solving of real‐life administrative dilemmas). Conclusions A mix of strategies are used to teach and coach trainees to handle multipatient environments. Further research is required to determine how to optimize the use of these techniques and innovate new strategies to support the learning of these crucial skills.