Field note use in family medicine residency training: learning needs revealed or avoided?
Bibliographic record
Abstract
BACKGROUND: Field notes (FNs) are used in Family Medicine residency programs to foster reflective learning and facilitate formative assessment. Residents assess their strengths and weaknesses and develop action plans for further improvement. This study explored the use of FNs in the University of Manitoba's Family Medicine residency program 5 years after their implementation. METHODS: This multi-method study examined 520 FNs from 16 recent graduates from the University of Manitoba Family Medicine residency program. Quantitative analysis (frequencies and means) enabled descriptions and comparisons between training sites. Four themes emerged from inductive content analysis highlighting common ideas reflected upon. RESULTS: Residents displayed cyclical variation in the FN generation over 2 years. Eight of the 99 Priority Topics (addressing complex psychosocial issues) were not captured in this data set. The domains of Care of First Nations, Inuit, and Metis; Care of the Vulnerable and Underserved; and Behavioural Medicine and the CanMEDS-FM roles of FM - Procedural Skill, Leader/Manager, and Professional were less frequently reflected upon. Four themes (Patient-Centered Care, Patient Safety, Achieving Balance, and Confidence) were identified from qualitative analysis of residents' narrative notes. CONCLUSIONS: Vygotsky's Sociocultural Theory of Cognitive Development was proposed as a lens through which to examine factors influencing resident learning. Residents' discomfort with certain topics may lead to avoidance in reflecting upon certain competencies in FNs, impacting skill acquisition. Further research should explore factors influencing residents' perceptions FNs and how to best assist residents in becoming competent, confident practitioners.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.169 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".