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Characteristics of A Good Field Note 2015

A good field note serves three main purposes: to support learner development, provide evidence for assessment of competency, and document progress for program decisions. It should focus on higher-order clinical skills, provide a detailed behavioral description of performance, and identify areas for continued growth. A field note is just one part of an overall competency-based assessment system and should be used along with frequent feedback to paint a comprehensive picture of a learner's development over time.

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Vaishali Jain
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17 views2 pages

Characteristics of A Good Field Note 2015

A good field note serves three main purposes: to support learner development, provide evidence for assessment of competency, and document progress for program decisions. It should focus on higher-order clinical skills, provide a detailed behavioral description of performance, and identify areas for continued growth. A field note is just one part of an overall competency-based assessment system and should be used along with frequent feedback to paint a comprehensive picture of a learner's development over time.

Uploaded by

Vaishali Jain
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Characteristics of a Good Field Note

Purposes of a Field Note:

1. For the Learner: support further development

2. For the Clinical and Academic Coach: provide evidence to support assessment, judgement
around competency development and a prescription for future growth

3. For the Program: document the learners’ path to support program summative decisions
concerning program extension, enrichment, completion or termination

Principles:

1. Field Notes do not replace feedback*, they only document it.

2. In general terms there are parts of clinical encounters that require thinking/problem solving
(higher order skills**) beyond basic knowledge. Focusing on these areas better support
competency development and assessments.

3. Not all Field Notes require direct observation of the patient encounter but all Field Notes do
require direct involvement and reflective discussion with the resident. Think broadly for sources
of feedback and Field Notes… i.e. a Field Note could be based on their clinical reasoning
following a discussion and/or chart review, witnessing their collaboration with AHC, professional
behaviours, leadership skills…….

4. Competency-based assessment requires looking for patterns of performance and trajectory. If


there is a previously identified area needing improvement, follow up on this to ensure that
improvement/growth has occurred.

5. Field Notes alone are not sufficient. They must be part of an assessment system that collates,
summarizes and interprets the data to make decisions. As such they should cover a broad range
of identified desired competencies, pick up on past performance to follow trajectory and be
numerous enough to provide a high resolution picture of competency.

Characteristics of a Good Field Note:

 Has a date (for trajectory)

 Identifies a topic and a competency

 Is behaviourally specific and uses clear unambiguous language

 Is detailed enough to paint a picture of the performance being commented on

 Is focussed on the individual (not a comparator to others)

Authors:
Working Group on the Certification Process, College of Family Physicians of Canada
August 2014 R:\Family\postgrad\AA - Main\Field Notes\Field Note Documents
 Is focussed on a manageable amount of information

 Is focused on higher order skills

 Includes an application of the assessment standards***

 Has a judgement about the performance

 Identifies things to continue doing, things for further growth

 Promotes reflection

*The characteristics of good feedback include:

a) Ensuring the discussion is timely (at least the same day)


b) Ensuring it is frequent (at least daily)
c) Being specific and commenting on behaviours, not intentions or personal attributes
d) Having reflective discussions that focus on challenging/discerning case characteristics
e) Stimulating learning through making a judgement and documenting and discussing
pertinent coaching points with each case
f) Focusing on one take-home message each for the behaviours to continue and the
behaviours to modify
g) Making judgements based on standards, not comparators to others
h) Using the CFPC Evaluation Objectives to help identify key messages

** Higher Order Skills: Consider focusing on:

a) History vs Physical Exam


b) Diagnosis vs Treatment—(although higher order skills could go into treatment decisions
if the focus is on patient centeredness and/or acuity rather than just knowledge)
c) Data gathering vs Data interpretation
d) Analytic Diagnosis vs Pattern Recognition
e) Differential Diagnosis (and why), vs Diagnosis
f) Undifferentiated Cases vs Clear Cut Cases

***http://www.cfpc.ca/uploadedFiles/Education/Certification_in_Family_Medicine_Examinatio
n/Definition%20of%20Competence%20Complete%20Document%20with%20skills%20and%20ph
ases.pdf

Authors:
Working Group on the Certification Process, College of Family Physicians of Canada
August 2014 R:\Family\postgrad\AA - Main\Field Notes\Field Note Documents

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