Transcript How to Promote Autonomy in the Clinical Setting

PROMOTING
AUTONOMY IN
CLINICAL MEDICINE
Coaching Meeting
November 10, 2014
Carrie Rassbach, MD
What is autonomy?
“Freedom from external control or
influence; independence”
“The need to have a voice, choice, and
a sense of initiative in one’s actions and
work”
Techniques for Promoting Autonomy
• Set expectations
• Positioning
• Create a positive learning climate
• Stay quiet
• Probe for understanding
• Get a commitment on the assessment and plan
• Help them get to the right answer
• Redirect questions to learner
• Praise trainees in front of patients/others
Promoting
Clinical
Reasoning
Opportunity to
make decisions
and learn from
errors
Positive
Learning
Climate
Bolster
Autonomy
Self-Determination Theory
Techniques for Residents
• Set expectations/goals (for supervisor)
• Self-directed learning
• Positioning
• Make a commitment
• Probe the preceptor
Take-home points
• Autonomy for learner means:
• Competence
• Self-directedness
• Reflection/self-assessment
• Autonomy for supervisor means:
• Faculty development
• Learner-centered
• Probing/reinforcing