title: Observing trainee encounters using a one-way mirror.
abstract: BACKGROUND
  Direct observation of patient encounters is a key component of evaluating residents during training, but there are scarce data on the various methods of observation.
  
  
  OBJECTIVE
  To implement a novel method for direct observation of out-patient encounters via a one-way mirror in an internal medicine resident practice, and to assess the feasibility and acceptance of this method.
  
  
  METHODS
  Each selected resident-patient encounter was directly observed by a preceptor through a one-way mirror. The preceptor provided feedback to the resident at the conclusion of each encounter. A post-visit survey assessed resident satisfaction and comfort with this method of observation.
  
  
  RESULTS
  Using a one-way mirror was a feasible method of observation. Fifty residents had a clinic visit that was directly observed, and 42 (84%) completed the post-visit survey. Residents reported that they preferred direct observation through a one-way mirror compared with other methods, including videotaped encounters or having a preceptor physically present in the room. They also felt that having a preceptor observing through the one-way mirror had no negative effect on the clinic visit. Direct observation of patient encounters is a key component of evaluating residents
  
  
  CONCLUSIONS
  Direct observation through a one-way mirror is a viable method in the out-patient setting, and might be preferable for evaluating certain skills.
authors.affiliation: South Texas Veterans Health Care System and University of Texas Health Science Center at San Antonio, Texas, USA.
authors.forename: Raj
authors.initials: R
authors.lastname: Sehgal
authors.forename: Joseph
authors.initials: J
authors.lastname: Hardman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Haney
mesh_terms: D000553:Ambulatory Care / Q000592:standards; D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000592:standards*; D007721:Knowledge of Results, Psychological; D010817:Physician-Patient Relations; D010865:Pilot Projects; D015397:Program Evaluation; D013663:Teaching / Q000379:methods*