PROMOTING AUTONOMY IN CLINICAL MEDICINECoaching Meeting

November 10, 2014

Carrie Rassbach, MD

What is autonomy?

“Freedom from external control or influence; independence”

“The need to have a voice, choice, and a sense of initiative in one’s actions

and work”

Techniques for Promoting Autonomy• Set expectations• Positioning• Create a positive learning climate• Stay quiet • Probe for understanding• Get a commitment on the assessment and plan• Help them get to the right answer• Redirect questions to learner• Praise trainees in front of patients/others

Bolster Autonomy

Positive Learning Climate

Promoting Clinical

Reasoning

Opportunity to make decisions and learn from

errors

Self-Determination Theory

Techniques for Residents• Set expectations/goals (for supervisor)• Self-directed learning• Positioning• Make a commitment• Probe the preceptor

Take-home points• Autonomy for learner means:

• Competence• Self-directedness• Reflection/self-assessment

• Autonomy for supervisor means:• Faculty development• Learner-centered• Probing/reinforcing