Recommended Approach for Advising in Medical Education
Adopt an Appreciative Inquiry (AI) framework that focuses on identifying and amplifying learners' existing strengths rather than solely addressing deficits, while integrating this positive approach within a competency-based educational structure. 1
Core Framework: Appreciative Inquiry
The AI approach represents a paradigm shift from traditional problem-focused advising to a strengths-based methodology that asks "what is going well" rather than only "what is going wrong." 1 This generative process helps envision future success and mobilizes both individual and collective strengths to achieve valued outcomes in medical training. 1
Key Principles for Implementation:
Focus on existing competencies and positive attributes rather than beginning with deficit identification, which enhances learner motivation and professional identity formation 1, 2
Define competence as multi-domain clinical expertise encompassing medical knowledge, skills, attitudes, and metacognitive capabilities that reflect healthcare stakeholder needs 2
Integrate advising within competency-based frameworks that move beyond rigid, time-based approaches to emphasize practical skillsets and attitudes required for real-world clinical practice 2
Practical Advising Structure
Individual Learner Development:
Identify and amplify individual strengths through structured conversations that explore what the learner does well, their successful clinical encounters, and moments of professional satisfaction 1
Address the four essential physician attributes systematically: altruism (compassionate patient treatment), knowledge (understanding of body systems and disease), skillfulness (clinical competencies including pain relief), and dutifulness (population health awareness and professional responsibility) 3
Support professional identity formation by helping learners integrate multi-domain competencies in ways commensurate with their training stage 2
Assessment and Feedback Integration:
Use performance evaluations to infer competence rather than relying solely on knowledge testing, recognizing that construct validity and reliability remain ongoing challenges in competency assessment 2
Provide immediate feedback on clinical performance, which is a primary advantage when combined with experiential learning opportunities 4
Measure outcomes related to attitudes and values, not just clinical knowledge, though better assessment methods for these domains continue to need development 3
Common Pitfalls to Avoid:
Do not rely exclusively on traditional problem-solving approaches that only identify deficits, as this can undermine learner confidence and motivation 1
Avoid overemphasis on clinical content knowledge at the expense of practical skillsets, attitudes, and metacognitive capabilities needed for actual practice 2
Do not assume time-based progression equals competence—the shift to competency-based education recognizes that learners develop at different rates and require individualized support 2
Integration with Modern Educational Methods:
Incorporate simulation-based learning for developing new skills, identifying knowledge gaps, and maintaining clinical skills without compromising patient safety 4
Utilize multiple modern teaching modalities including case-based learning, problem-based learning, and team-based learning to address individual learning differences and develop critical thinking 5
Implement early integrative approaches that develop student competency and leadership, facilitating smooth transition into clinical practice 5
The AI framework provides the relational foundation for effective advising, while competency-based structures ensure learners meet the evolving needs of healthcare delivery. 1, 2 This combination addresses both the human development aspects of medical training and the practical requirements for safe, effective patient care. 4, 3