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PROMOTING AUTONOMY IN CLINICAL MEDICINECoaching 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
Bolster Autonomy
Positive Learning Climate
Promoting Clinical
Reasoning
Opportunity to make decisions and learn from
errors
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