Observing trainee encounters using a one-way mirror

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. Aim: 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.