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The Patient Experience Debrief Interview: How Conversations With Hospitalized Families Influence Medical Student Learning and Reflection.

PURPOSE
To determine the effect of patient debrief interviews on pediatric clerkship student depth of reflection and learning.


METHOD
The authors conducted a multi-institutional, mixed-methods, cluster randomized trial among pediatric clerkship students from July 2016 to February 2017. Intervention students completed a debrief interview with a patient-caregiver, followed by a written reflection on the experience. Control students completed a written reflection on a memorable patient encounter. Three blinded authors scored written reflections according to the 4-level REFLECT rubric to determine depth of reflection. Inter-rater reliability was examined using kappa. REFLECT scores were analyzed using a chi-squared test; essays were analyzed using content analysis.


RESULTS
Eighty percent of eligible students participated. One hundred eighty-nine essays (89 control, 100 intervention) were scored. Thirty-seven percent of the control group attained reflection and critical reflection, the two highest levels of reflection, compared to 71% in the intervention group; 2% of the control group attained critical reflection, the highest level, compared to 31% in the intervention group (χ(3, N=189) = 33.9, P < .001). Seven themes were seen across both groups, three focused on physician practice and four focused on patients. Patient-centered themes were more common in the intervention group whereas physician-focused themes were more common in the control group.


CONCLUSIONS
Patient debrief interviews offer a unique approach to deepen self-reflection through direct dialogue and exploration of patient-caregiver experiences during hospitalization.