Medical students’ perception of dyad practice

(1) What do you think about training in pairs of two?

Initial versus further training

‘I would not like to be two every time—only in the beginning’

‘Reasonable to have someone as a sparring partner the first times’

‘Helped breaking the ice’

‘Good way to break the first consultations—a mix would be perfect’

‘Important that you try both being alone and together’

‘Good idea the first few times’

Social dynamics

‘Learning outcome depends on the chemistry and levels between partners…’

Observation

‘Observing another student managing the patient encounter was very helpful’

‘Good to observe during patient encounter and to talk about it afterwards’

‘You see what works and what seems awkward’

‘Possibility of observation under peaceful conditions’

‘It was difficult to interrupt and then it really does not matter’

‘It was lovely to be able to have someone observe you while being able to have someone to discuss the case with later on’

‘Exciting to watch fellow students and really good to have opportunity to be reminded of what you don’t remember yourself’

‘Helpful to have someone to observe and someone to observe you’

‘You learn something from seeing the other managing the examination—that way you figure things out in the situation’

‘In the situation my performance becomes weaker because I become stressed by someone else observing me. This is only the first time—you become better in the following encounters because you have learned from your partner’

‘Helpful to observe another person perform the examination’

‘Helpful to learning to observe another person’

Confidence

‘It felt safe to be two to begin with’

‘It was nice and comforting not to be alone’

‘It made the first few encounters less awkward ‘

‘Provided some confidence’

‘You feel less insecure in the beginning’

‘Dyad training made it more safe in the beginning’

‘Cool to have this kind of back-up’

Feedback

‘It was nice to have feedback immediately after finishing the encounter’

‘Good to provide each other with missing information’

‘It was good to discuss findings and missing information in pairs after each encounter’

‘Nice to support each other with the things you forget’

‘Possibility of supplementing each other’

‘Good to have someone to discuss with during and after the encounter’

‘Helpful to have someone to remember the things you forgot’

‘Feedback is an advantage, although your partner is just as new as you are’

‘Comforting and interesting to get advice from a peer’

Learning

‘You learn better when you had someone to talk to’

(2) Which benefits for learning did dyad training provide?

Confidence/social security

‘Support each other’

‘Less insecurity and just pleasant’

‘Safeness in the learning process’

‘Potential insecurity is removed when working in pairs’

‘It removes some of the first-time insecurity when you have someone with you carrying a check-list’

‘Beneficial social effects—everything is more manageable when you are not alone the first time’

‘No insecurity, if that should be a problem’

‘Safety’

Reflection

‘The option to discuss patients and […] to evaluate diagnoses’

‘If you are ‘on’ it is difficult to think about what you are doing’

‘You learn things faster as you become more aware of your own mistakes and of things you forgot to ask’

‘By observing you free capacity to think about what to do better’

‘Allows opportunity for more in depth history taking and physical examination’

‘Able to supplement each other and discuss diagnoses and complications’

‘You learn much from each other’s mistakes’

‘I get inspired with new ideas about how and what questions to ask’

Feedback

‘Evaluating own work and supplying suggestions for improvement’

‘Less need for asking questions to the supervising officer’

‘Good way to give feedback to each other’

‘The one who observed pointed out the things you forgot’

‘An advantage to evaluate and being observed’

‘Feedback right away’

Learning

‘Better insight, easier to remember, better learning’

(3) Which limitations to learning does dyad training provide?

Independence/individualism

‘I get impatient and I want to examine myself!’

Social dynamics

‘It is irritating to work with someone, who you are not on the same page with’

‘You aren’t under the same state of pressure’

‘One can feel shy when another person observes you’

‘You can feel monitored by your peer’

‘If your partner is very much better than you, you do not benefit that much from it’

Hands-on

‘It is difficult to interrupt and you only get half the training time’

‘Less active yourself’

‘Less experience in the physical examination’

‘Fewer cases’

‘You see fewer patients’

Quality of encounter

‘You don’t recognize your own weaknesses because there’s someone to support you’

‘Decreases interaction with patients—not significantly though’

‘Risk of being less thorough because you always have someone to remind you of things you forget’

‘Sometimes you may be less focused when you are not the one who is active’

(4) Describe how you interacted with your training partner?

Case-based discussion

‘Discussion of our encounter and each other’s deficits…discussion of symptoms, work-up and treatments options’

‘Exchanging ideas’

‘Good feedback after encounters’

‘Got advice from each other—supply each other with additional information’

‘Discussion of what you have done and what you forgot—was very useful’

‘We talked freely about differential diagnoses and patient work-up’

‘Discussing diagnoses and being a spare memory’

‘Discussing the case at hand’

‘Discussion of the case and of the history taking and physical examination’

‘Supplying each other with questions we forgot to ask’

‘Discussion of treatment options—adding up information’

‘Interaction and creation of common write-up and diagnoses’

‘Making sure that you got all the important information’

‘You can become blinded by all the possibilities but having a partner makes you see the obvious’

‘The one, who was the ‘doctor’ asked after each element in the history taking if he/she forgot something’

‘Discussing and agreeing before writing the journal’

‘Discuss the encounter’

‘Cooperate about a joint treatment plan and suggestions for diagnoses’

‘Discussion and evaluation of performance’

‘Discussion of what to do differently next time’

Social support

‘Support from buddy if unconfident’

Deliberate practice

‘We had a relevant discussion of why we did as we did and what to improve’