Abstract

Research Article

In at the deep end: Psychosocial aspects of developing autonomy in histopathology training

AI Finall*

Published: 10 July, 2018 | Volume 2 - Issue 2 | Pages: 013-019

Medical postgraduate trainees are given increasing levels of responsibility during training in the apprenticeship-model of training [1-3]. Responsibility is said to be a key driver of deep learning and understanding [4-7]. Trainees with greater levels of responsibility for decision making have higher levels of motivation to learn compared with trainees who self-assess as having less autonomy [5]. The Royal College of Pathologists (RCPath) indicate that ‘graded responsibility’ is part of training histopathologists and provided a framework for implementation with increasingly complex specimens suitable for reporting by more senior trainees [8,9]. 

Read Full Article HTML DOI: 10.29328/journal.apcr.1001007 Cite this Article Read Full Article PDF

References

  1. Kennedy TJ, Regehr G, Baker GR, Lingard LA. Progressive independence in clinical training: a tradition worth defending? Acad Med. 2005; 80: S106- S111. Ref.: https://tinyurl.com/y9unbo6c
  2. Olle ten C. Trust, competence and the supervisors’ role in postgraduate training. BMJ. 2006; 333: 748-751. Ref.: https://tinyurl.com/y8udcwwk
  3. Williamson HA, Glenn JK, Spencer DC, Reid JC. The development of clinical independence: resident-attending physician interactions in an ambulatory care setting. J Fam Pract. 1988; 26: 60-64. Ref.: https://tinyurl.com/yd6yg7zm
  4. Boud D, Keogh R, Walker D. Reflection: turning experience into learning. London. 1985.
  5. Cantillon P, MacDermott M. Does responsibility drive learning? Lessons from intern rotations in general practice. Med Teach. 2008; 30: 254-259. Ref.: https://tinyurl.com/ybftmc4m
  6. Del Rio P, Alvarez A. Inside and outside the zone of proximal development: an Eco functional reading of Vygotsky. In: Daniels H, Cole M, Wertsch JV. The Cambridge Companion to Vygotsky. Cambridge: Cambridge University Press. 2007; 276-306.
  7. Vygotsky LS. Mind in society. The development of higher psychological processes. London: Harvard University Press. 1978.
  8. Joint Committee on Pathology Training. Curriculum for speciality training in histopathology. London: RCPath, 2010.
  9. Joint Committee on Pathology Training. A competency based framework for graded responsibility for specialist registrar and specialty registrars in histopathology and cytopathology. 2009.
  10. Ten Cate O, Chen HC, Hoff RG, Peters H, Bok H, et al. Curriculum development for the workplace using entrustable professional activities (EPAs): AMEE Guide No. 99. Med Teach. 2015; 37: 983-1002. Ref.: https://tinyurl.com/y6wybo72
  11. Sterkenburg A, Barach P, Kalkman C, Gielen M, ten Cate O. When do supervising physicians decide to entrust residents with unsupervised tasks? Acad Med. 2010; 85: 1408-1417. Ref.: https://tinyurl.com/yd9ooq8b
  12. Davey DD, Talkington S, Kannon V, Masood S, Davila R, et al. Cytopathology and the pathology resident: a survey of residency program directors. Arch Path Lab Med. 1996; 120: 101-114. Ref.: https://tinyurl.com/y7f23vru
  13. Allen TC. Graduated responsibility for pathology residents: no time for half measures. Arch Pathol Lab Med. 2013; 137: 457-461. Ref.: https://tinyurl.com/y94e6xd5
  14. Dijksterhuis MG, Voorhuis M, Teunissen PW, Schuwirth LW, ten Cate OT, et al. Assessment of competence and progressive independence in postgraduate clinical training. Med Educ. 2009; 43: 1156-1165. Ref.: https://tinyurl.com/ycklkozw
  15. Finall A, Allery L. Ready, Steady Go! What do histopathology trainees think they need from training to enable them to develop autonomy in surgical pathology reporting? J Clin Pathol. 2016; 69: 42-46. Ref.: https://tinyurl.com/yafztynj
  16. Pascal RR. Graded responsibility of residents in anatomic pathology: a survey and commentary. Am J Clin Pathol. 1993; 100: S41- S43. Ref.: https://tinyurl.com/y9nppv8q
  17. Davis P, Mann P, Cave A, McBennett S, Cook D. Use of focus groups to assess the educational needs of the primary care physician for the management of asthma. Med Educ. 2000; 34: 987-993. Ref.: https://tinyurl.com/yd6n24ap
  18. Randell R, Ruddle RA, Quirke P, Thomas RG, Treanor D. Working at the microscope. Analysis of the activities involved in diagnostic pathology. Histopathology. 2012; 60: 504-510. Ref.: https://tinyurl.com/ya3z3beo
  19. Cross V, Hicks C, Parle J, Field S. Perceptions of the learning environment in higher specialist training of doctors. Implications for recruitment and retention. Med Educ. 2006; 40: 121-128. Ref.: https://tinyurl.com/yb6r9jzp
  20. McKee M, Preist P, Ginzler M, Black N. Which tasks performed by pre-registration house officers out of hours are appropriate? Med Edu. 2012; 26: 51-57. Ref.: https://tinyurl.com/ybw8cmdh
  21. Halpern S, Detsky AS. Graded autonomy in Medical Education- Managing things that go bump in the night. N Eng J Med. 2014; 370: 1086-1089. Ref.: https://tinyurl.com/yasugqqb
  22. Babbott S. Commentary: Watching closely at a distance: Key tensions in supervising resident physicians. Acad Med. 2010; 85: 1399-1400. Ref.: https://tinyurl.com/y8bu9rff
  23. Evans, C. E. Nothing Becomes Real Until it is Experienced. RC Path Bulletin. 2004; 126: 18-20.
  24. Raab SS, Grzybicki DM, Janosky JE, Zarbo RJ, Meier FA, et al. Clinical Impact and Frequency of Anatomic Pathology Errors in Cancer Diagnoses. Cancer. 2005; 104: 2205-2230. Ref.: https://tinyurl.com/y9uopx8j
  25. Furness PN, Lauder I. A questionnaire-based survey of errors in diagnostic histopathology throughout the United Kingdom. J Clin Pathol. 1997; 50: 457-460. Ref.: https://tinyurl.com/y7n4tznb
  26. Graber M, Gordon R, Franklin N. Reducing diagnostic errors in medicine: What’s the goal? Acad Med. 2002; 77: 281-991. Ref.: https://tinyurl.com/ya2eg66t
  27. Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, et al. Accuracy of physician self-assessment compared with observed measures of competence: A systematic review. JAMA. 2006; 296: 1094-1102. Ref.: https://tinyurl.com/y7wjq5h9
  28. Lingard L, Garwood K, Schryer CF, Spafford MM. A certain art of uncertainty: case presentation and the development of professional identity. Soc Sci Med. 2003; 56: 603-616. Ref.: https://tinyurl.com/yc2nomt3
  29. Bush RW. Supervision in Medical Education: Logical Fallacies and Clear Choices. J Grad Med Educ. 2010; 2: 141-143. Ref.: https://tinyurl.com/y7cc7lbd
  30. Bailey DM, Gill MJ, Mutton K, Shine B. Future-proofing the specialty training curricula: Compliance with PMETB “Standards for Curricular and Assessment Systems”. RC Path Bullletin. 2010; 150: 106-110.
  31. Crommelinck M, Anseel F. Understanding and encouraging feedback-seeking behaviour: a literature review. Med Educ. 2013; 47: 232-241. Ref.: https://tinyurl.com/y93wma52
  32. Kennedy TJT, Regehr G, Baker GR, Lingard LA. Progressive independence in clinical training: A tradition worth defending? Acad Med. 2005; 80: S106-S111. Ref.: https://tinyurl.com/y9unbo6c
  33. Boud D. Creating the space for reflection at work. In Productive Reflection at Work. Boud D. Cressey P. Docherty P. (Eds) 2006. Abingdon, Oxon: Routledge.
  34. Davies S. Embracing reflective practice. Educ Prim Care. 2012; 23: 9-12. Ref.: https://tinyurl.com/ybateffl
  35. Moon J. Reflection in Learning and Professional Development. 1999 London: Kogan Page Ltd.
  36. Schon DA. The Reflective Practitioner: How professionals think in action. 1983 London: Temple Smith.
  37. Cantillon P, MacDermott M. Does responsibility drive learning? Lessons from intern rotations in general practice. Med Teach. 2008; 30: 254-259. Ref.: https://tinyurl.com/ybftmc4m
  38. Vermont JD, Verloop N. Congruence and friction between learning and teaching. Learn Instruct. 1999; 9: 257-280.
  39. Launer J. Supervision quartets. Postgrad Med J. 2012; 88: 185-186. Ref.: https://tinyurl.com/y89x8blq
  40. Cooper A. Supervision in primary care: Support or persecution? in: Burton J. and Launer J. (Eds) Supervision and Support in Primary Care. 2003 Oxon: Radcliffe Medical Press.
  41. Cooper N, Melville CR. Putting a curriculum into practice. In: Cooper, N and Forrest, K. (Eds) Essential guide to educational supervision in postgraduate medical education. 2009 Chichester: Blackwell Publishing.
  42. Li ST, Tancredi DJ, Scwartz A, Guillot AP, Burke AE, et al. Competent for Unsupervised Practice: Use of Pediatric Residency Training Milestones to Assess Readiness. Acad Med. 2017; 92: 385-393. Ref.: https://tinyurl.com/ybs46art

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