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Cited by 148Innovations in Medical EducationStudent Assessment and FeedbackClinical Reasoning and Diagnostic Skills

The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use?

Open access
Sargeant, Joan, Lockyer, Jocelyn M., Mann, Karen, Armson, Heather, Warren, Andrew, Zetkulic, Marygrace, Soklaridis, Sophie, Könings, Karen D. +5 more·2018·Academic Medicine
DOI 10.1097/acm.0000000000002131
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Abstract

Purpose: The authors previously developed and tested a reflective model for facilitating performance feedback for practice improvement, the R2C2 model. It consists of four phases: r elationship building, exploring r eactions, exploring c ontent, and c oaching. This research studied the use and effectiveness of the model across different residency programs and the factors that influenced its effectiveness and use. Method: From July 2014–October 2016, case study methodology was used to study R2C2 model use and the influence of context on use within and across five cases. Five residency programs (family medicine, psychiatry, internal medicine, surgery, and anesthesia) from three countries (Canada, the United States, and the Netherlands) were recruited. Data collection included audiotaped site assessment interviews, feedback sessions, and debriefing interviews with residents and supervisors, and completed learning change plans (LCPs). Content, thematic, template, and cross-case analysis were conducted. Results: An average of nine resident–supervisor dyads per site were recruited. The R2C2 feedback model, used with an LCP, was reported to be effective in engaging residents in a reflective, goal-oriented discussion about performance data, supporting coaching, and enabling collaborative development of a change plan. Use varied across cases, influenced by six general factors: supervisor characteristics, resident characteristics, qualities of the resident–supervisor relationship, assessment approaches, program culture and context, and supports provided by the authors. Conclusions: The R2C2 model was reported to be effective in fostering a productive, reflective feedback conversation focused on resident development and in facilitating collaborative development of a change plan. Factors contributing to successful use were identified.

AI snapshot

Written from the paper’s full text.

TL;DR

The R2C2 feedback model plus a learning change plan (LCP) was reported to be effective across five residency programs in three countries in fostering reflective feedback conversations, coaching, and collaborative change plans. Use varied by six general factors, and supervisors/residents returned to the LCP in only about half of second feedback sessions.

Key findings

  • Across five residency programs (family medicine, psychiatry, internal medicine, surgery, anesthesia) in Canada, the United States, and the Netherlands, almost all supervisors and residents reported that R2C2 facilitated resident engagement in reflective discussion about assessment data and planning improvement.
  • The coaching phase and LCP were especially valued: participants reported they helped create concrete plans and shifted feedback from “assessment and judgment” toward “development.”
  • Use varied across cases and was influenced by six general factors: supervisor characteristics, resident characteristics, qualities of the resident–supervisor relationship, program assessment approaches, program culture and context, and supports provided by the authors.
  • Supervisors and residents reported returning to the goals and LCPs from the first session in only about half of second-session feedback interviews; among three dyads with a struggling resident, development of a specific improvement plan appeared to depend on supervisor coaching skill.

Methods

  • Case study methodology within a UK Medical Research Council complex-interventions/realist evaluation framing, conducted July 2014–October 2016 across five residency programs in three countries.
  • Recruited 45 residents (3–14 per site) and 21 supervisors (2–8 per site), averaging 9 resident–supervisor dyads per site; data included audiotaped site assessment interviews, feedback sessions, debrief interviews, and completed LCPs.
  • Analysis used content, thematic, template, and cross-case analysis; template analysis used the four R2C2 phases as an a priori coding structure.

Limitations

  • Stated by the paper: sites, residents, and supervisors volunteered; both resident and current supervisor had to agree to participate, which in some cases delayed or limited recruitment; the quality of site-specific assessment reports and data could not be ascertained.
  • Evident in the text: LCP use was variable, written completion was less consistent across sites, and return to the original LCP in the second session occurred in only about half of interviews; the paper attributes this partly to omitted instructions in the R2C2 brochure and limited preparatory instruction.
  • Evident in the text: only three dyads involved a resident who appeared to be struggling, limiting the basis for conclusions about R2C2/LCP use across the performance spectrum.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1097/acm.0000000000002131

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 44 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In each of the three dyads with a struggling resident, both the resident and supervisor reported on the usefulness of the R2C2 model and LCP in enabling the resident to gain insight into their progress and ways to improve.

    “In each instance, both the resident and supervisor reported on the usefulness of the R2C2 model and LCP in enabling the resident to gain insight into their progress and ways to improve.”
    Quote in the paperSubstantial claim
  • Findingown data

    The R2C2 feedback model, used with an LCP, was reported to support coaching.

    “The R2C2 feedback model, used with an LCP, was reported to be effective in engaging residents in a reflective, goal-oriented discussion about performance data, supporting coaching, and enabling collaborative development of a change plan.”
    • Also stated in: § Identification of opportunities for improvement and development of an LCP · plain
      “All participants particularly valued the coaching phase and observed that it was the most unique feature compared with traditional feedback models.”
    Quote in the paperSubstantial claim
  • Findingown data

    Many supervisors reported that it was beneficial to use the R2C2 and LCP with residents who were excelling, as they provided substance and structure for the feedback conversation.

    “Many supervisors reported that it was beneficial to use the R2C2 and LCP with those who were excelling, as they provided substance and structure for the feedback conversation.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Almost all participants noted that the R2C2 sample coaching questions and items on the LCP helped create a concrete plan.

    “Almost all participants noted that the R2C2 sample coaching questions and items on the LCP helped create a concrete plan and changed the orientation of the feedback conversation from”
    Quote in the paperSubstantial claim
  • Findingown data

    Where progress was not made, supervisors engaged the resident in a discussion about the barriers to progress.

    “Most residents whose supervisor did return to the LCP reported progress related to their plan, and where progress was not made, supervisors engaged the resident in a discussion about the barriers to progress.”
    Quote in the paperNot a substantial claim
  • The quote only partly states this claim. 2
  • May combine two claims. 35
  • Classified as probably not a substantial claim. 27

  • The quote only partly states this claim.

    Findingown data

    Use of the R2C2 model varied across cases.

    “Supervisors across the five sites, however, used the LCP variably to support coaching.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Almost all residents reported that the facilitative format increased their comfort and ability to honestly share concerns and needs for improvement.

    “Almost all residents reported that the facilitative format increased their comfort and ability to honestly share concerns and needs for improvement:”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    We identified three dyads in which a resident appeared to be struggling.

    “We identified three dyads in which a resident appeared to be struggling.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    At three sites, supervisors required residents to complete a written LCP, while in two, they only used it to guide the coaching discussion.

    “At three sites, they required residents to complete a written LCP, while in two, they only used it to guide the coaching discussion.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Almost all participants noted that the R2C2 sample coaching questions and items on the LCP changed the orientation of the feedback conversation from assessment and judgment to development.

    “Almost all participants noted that the R2C2 sample coaching questions and items on the LCP helped create a concrete plan and changed the orientation of the feedback conversation from”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    All participants particularly valued the coaching phase and observed that it was the most unique feature compared with traditional feedback models.

    “All participants particularly valued the coaching phase and observed that it was the most unique feature compared with traditional feedback models.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The open-ended questions in each of the four R2C2 model phases encouraged residents' critical reflection and self-assessment.

    “The openended questions in each of the four model phases encouraged residents' critical reflection and self-assessment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Those who returned to the goals and LCPs spoke of the benefits of doing so; it provided a way to evaluate the planned activity and a longitudinal view of progress.

    “Those who did spoke of the benefits of doing so; it provided a way to evaluate the planned activity and a longitudinal view of progress.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Although all residents appeared to be meeting their program expectations, some appeared to be excelling and some struggling.

    “Although all residents appeared to be meeting their program expectations, some appeared to be excelling and some struggling.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Some supervisors noted that there was inadequate guidance regarding the need to return to the original LCP in the second feedback session and how to do this.

    “some noted that there was inadequate guidance regarding the need to return to the original LCP in the second feedback session and how to do this.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Two supervisors appeared to be skilled and one less so in coaching and using the LCP.

    “However, the subsequent development of a specific plan for improvement appeared to depend on the skill of the supervisor in coaching the resident and in using the LCP; two supervisors appeared to be skilled and one less so.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Contributing factors to not returning to the plan during the second interview were omission of instructions for using the LCP in the R2C2 brochure and limited instruction in the preparatory interventions about returning to the original LCP in the second feedback session.

    “Contributing factors to not returning to the plan during the second interview were omission of instructions for using the LCP in the R2C2 brochure and limited instruction in the preparatory interventions about returning to the original LCP in the second feedback session.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Programs varied in assessment and feedback approaches and in the extent to which they had formally implemented CBME.

    “Programs varied in assessment and feedback approaches and in the extent to which they had formally implemented CBME (Table 1).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Factors contributing to success were, at each site, the presence of an author and/or a research associate, preparatory supervisor workshop or session, and specific resource materials (R2C2 brochure and LCP), as well as how well the model aligned with the supervisor's natural feedback style and the program's culture and context.

    “Factors contributing to success were, at each site, the presence of an author and/or a research associate, preparatory supervisor workshop or session, and specific resource materials (R2C2 brochure and LCP), as well as how well the model aligned with the supervisor's natural feedback style and the program's culture and context.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Residents appeared to be active, reflective participants in the feedback conversation and in using their assessment data.

    “Residents appeared to be active, reflective participants in the feedback conversation and in using their assessment data”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Although the R2C2 model was generally perceived positively, there was variability in supervisor and resident reactions and use across sites and programs.

    “Although the model was generally perceived positively, there was variability in supervisor and resident reactions and use across sites and programs.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    By asking open-ended questions, supervisors seemed to be able to create a safe learning environment and express commitment to residents and their development.

    “By asking open-ended questions, supervisors seemed to be able to create a safe learning environment and express commitment to residents and their development.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The R2C2 model, combined with the LCP, was reported to be effective in enabling a rich discussion about performance data, fostering reflection, and supporting coaching and collaborative development of a change plan across five residency programs in three countries, with each program using different assessment and feedback approaches.

    “The R2C2 model, combined with the LCP, was reported to be effective in enabling a rich discussion about performance data, fostering reflection, and supporting coaching and collaborative development of a change plan across five residency programs in three countries, with each program using different assessment and feedback approaches.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Most resident-supervisor dyads appeared to have prior work experience and knew each other, but a few did not.

    “Although most dyads appeared to have prior work experience and knew each other, a few did not.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The variability in reactions and use did not appear to arise from differences in specialty per se but from six more general factors: supervisor characteristics, resident characteristics, qualities of the resident-supervisor relationship, program assessment approaches, program culture and context, and the supports provided.

    “However, this variability did not appear to arise from differences in specialty per se but from six more general factors: supervisor characteristics, resident characteristics, qualities of the resident-supervisor relationship, program assessment approaches, program culture and context, and the supports we provided (Table 3).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    The R2C2 model oriented the feedback conversation toward coaching and residents' use of assessment data.

    “The way it oriented the feedback conversation toward coaching and residents' use of assessment data”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingnone given

    The presence of an open, supportive relationship was a quality of the resident-supervisor relationship influencing use and effectiveness.

    “Presence of an open, supportive relationship.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Reflection on oral feedback and using the oral feedback to plan change was found to be effective.

    “reflection on oral feedback and using the oral feedback to plan change was found to be effective.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    The R2C2 model encouraged supervisor-resident collaboration and codevelopment of residents' goals and change plans.

    “The way it encouraged supervisorresident collaboration and codevelopment of residents' goals and change plans.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    At each level of analysis, differences were identified and resolved by discussion and by returning to the data as required.

    “At each level of analysis, differences were identified and resolved by discussion and by returning to the data as required.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    To conduct comparisons across cases and confirm overall findings, the authors held a face-to-face analysis meeting in April 2016, with those unable to attend participating by web conferencing.

    “To conduct comparisons across cases and confirm overall findings, we held a faceto-face analysis meeting in April 2016, with those unable to attend participating by web conferencing.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The principles of programmatic assessment and CBME direct attention to actively engaging learners in their assessment, feedback, and development activities.

    “Foundationally, the principles of programmatic assessment and CBME direct our attention to actively engaging learners in their assessment, feedback, and development activities.9,13,15”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [9] source

      Not checked in the free run.

    • cites [13] source

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    • cites [15]

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Realist evaluation studies the social system and context in which an intervention occurs as well as the intervention itself.

    “Realist evaluation studies the social system and context in which an intervention occurs as well as the intervention itself.20,24”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [20] source

      Not checked in the free run.

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The goal was to recruit 10 dyads per site to enable saturation of themes.

    “Our goal was to recruit 10 dyads per site to enable saturation of themes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    A small pilot study identified implementation challenges and demonstrated positive reactions to the use of the R2C2 model.

    “A small pilot study identified implementation challenges and demonstrated positive reactions to the use of the R2C2 model, but was limited because it occurred at one residency site with only a few residents and supervisors.22”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [22] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    CBME and programmatic assessment promote the longitudinal compilation of performance data to coach the learner's continuing development and to make evidence-based decisions about the learner's progress.

    “Finally, they promote the longitudinal compilation of performance data to coach the learner's continuing development (assessment for learning) and to make evidence-based decisions about the learner's progress (assessment of learning).[11][12][13][14][15]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [11] source

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  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Within education, coaching is learner centered and has dual goals: to achieve immediate improvement in the specific activity at hand, and to build skills for longitudinal self-monitoring and self-directed learning.

    “Within education, coaching is also learner centered and has dual goals: to achieve immediate improvement in the specific activity at hand, and to build skills for longitudinal self-monitoring and selfdirected learning.19”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Developmental learning perspectives, such as Dreyfus's five-stage model and Ericsson's model of deliberate practice, ground approaches to assessment and feedback.

    “Such approaches are grounded in developmental learning perspectives, such as Dreyfus's 37 five-stage model (novice, advanced beginner, competent, proficient, expert) and Ericsson's 38,39 model of deliberate practice.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [37]

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    • cites [39]

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The authors endeavored to be reflective and reflexive by being attentive to and disclosing personal involvement in and opinions about the R2C2 model and about assessment and feedback.

    “We also endeavored to be reflective and reflexive by being attentive to and disclosing personal involvement in and opinions about the R2C2 model and about assessment and feedback, which may have influenced our analysis.31,32”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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    • cites [32]

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Summaries prepared by the pairs were shared with the whole team, and critical discussions of findings were encouraged.

    “Summaries prepared by the pairs were shared with the whole team, and critical discussions of findings were encouraged.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Each R2C2 phase, informed by theory and research, guides the feedback conversation and includes specific open-ended questions to promote self-reflection and self-direction.

    “Each phase, informed by theory and research, guides the feedback conversation and includes specific open-ended questions to promote self-reflection and selfdirection (see Supplemental Digital Appendix 1 at http://links.lww.com/ ACADMED/A522).20,21”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [20] source

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Premisecitation

    Coaching's intent is to help individuals develop both effectively and efficiently and to perform at their best.

    “Drawing from the sports world, its intent is to help individuals develop both effectively and efficiently and to perform at their best.17,18”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Premisecitation

    Coaching is developmental and moves feedback away from its historic tie to assessment and closer to learning.

    “Coaching is developmental, and philosophically it moves feedback away from its historic tie to assessment and moves it closer to learning.9,15,16”
    Quote in the paperNot a substantial claim0 of 3 sources checked
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    • cites [15]

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    • cites [16]

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  • Classified as probably not a substantial claim.

    Premisecitation

    The R2C2 feedback model consists of four phases: relationship building, exploring reactions to the feedback, exploring understanding of feedback content, and coaching for performance change.

    “This model consists of four phases: relationship building, exploring reactions to the feedback, exploring understanding of feedback content, and coaching for performance change.20”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [20] source

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  • May combine two claims.

    Premisecitation

    Invested, credible supervisors and a supportive, open culture are integral to positive learning and coaching in medicine and education.

    “Invested, credible supervisors 2,4-7 and a supportive, open culture [33][34][35][36] are integral to positive learning and coaching in medicine 8 and education.16,19”
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    • cites [33][34][35][36]

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  • Classified as probably not a substantial claim.

    Premisecitation

    The Medical Research Council framework recommends undertaking exploratory studies to ensure understanding and accounting for factors that influence the outcomes of an intervention before conducting comparative effectiveness studies.

    “The Medical Research Council framework recommends undertaking exploratory studies to ensure understanding and accounting for factors that influence the outcomes of an intervention (e.g., the R2C2 model) before conducting comparative effectiveness studies.”
    Quote in the paperSubstantial claim0 of 2 sources checked
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  • Classified as probably not a substantial claim.

    Study design and conductown data

    To minimize bias, the authors did not analyze transcripts from their own site.

    “To minimize bias, we did not analyze transcripts from our own site.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Features important to the provision of feedback include actively engaging providers and recipients in the feedback interaction and addressing factors that influence feedback credibility and use, such as relationships, context, and culture.

    “Features seen to be especially important to the provision of feedback include actively engaging providers and recipients in the feedback interaction and addressing factors that influence feedback credibility and use, such as relationships, context, and culture.[2][3][4][5][6][7][8]”
    Quote in the paperSubstantial claim0 of 3 sources checked
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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The study used author pairs to analyze each transcript and discuss interpretations and findings with each other and then with the larger team.

    “These included the use of author pairs to analyze each transcript and discuss their interpretations and findings with each other and then with the larger team.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisenone given

    The R2C2 is a learner-centered approach designed to engage the resident, facilitate reflection, and guide informed self-assessment.

    “The R2C2 is a learner-centered approach designed to engage the resident, facilitate reflection, and guide informed self-assessment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The sites, residents, and supervisors volunteered to participate.

    “The sites, residents, and supervisors volunteered to participate.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The quality of the site-specific assessment reports and data could not be ascertained.

    “The quality of the site-specific assessment reports and data could not be ascertained.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Coaching is not just a new skill for supervisors but also a new way of thinking, requiring an educational partnership with residents and collaboratively enabling their development and self-directed learning.

    “coaching is not just a new skill for supervisors but also a new way of thinking, requiring an educational partnership with residents and collaboratively enabling their development and self-directed learning.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisereasoning

    In both Dreyfus's and Ericsson's models, assessment for learning, instruction, feedback, and subsequent practice are integral to developing competence.

    “In both, assessment for learning, instruction, feedback, and subsequent practice are integral to developing competence.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Both residents and their current supervisor had to agree to participate, which in some cases delayed or limited recruitment.

    “Both residents and their current supervisor had to agree to participate, which in some cases delayed or limited recruitment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The R2C2 may be more easily taken on by supervisors who naturally use a facilitative approach and more challenging for those who naturally use a more directive approach.

    “It may be more easily taken on by supervisors who naturally use such a facilitative approach and more challenging for those who naturally use a more directive approach.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Medical education is gradually adopting a system in which ongoing, longitudinal formative assessment and coaching, combined with summative assessment at sentinel progress points, are integral.

    “Medical education is gradually adopting a system in which ongoing, longitudinal formative assessment and coaching, combined with summative assessment at sentinel progress points, are integral.15”
    Quote in the paperNot a substantial claim0 of 1 sources checked
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  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based). May combine two claims.

    Interpretationreasoning

    The R2C2 model for feedback and coaching, and a format such as the LCP to guide development plans, may be helpful in the transition to a system of ongoing formative assessment and coaching.

    “The R2C2 model for feedback and coaching, and a format such as the LCP to guide development plans, may be helpful in this transition.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Use of the R2C2 model and LCP also seemed to contribute to the development of a trusting, collaborative supervisor-resident relationship that facilitated residents' critical reflection, identification of areas for improvement, and codevelopment of LCPs.

    “It also seemed to contribute to the development of a trusting, collaborative supervisorresident relationship that facilitated residents' critical reflection, identification of areas for improvement, and codevelopment of LCPs.”
    Quote in the paperSubstantial claim
54 of 54

  • The paper relies on this without support.

    The quality of assessment data and reports influences the quality of feedback and coaching conversations.

    “This is a concern because the quality of assessment data and reports influences the quality of feedback and coaching conversations.”
1 of 1

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  1. Gawande, Personal best: Top athletes and singers have coaches. Should you?, New Yorker

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Authors
Sargeant, J., Lockyer, J. M., Mann, K., Armson, H., Warren, A., Zetkulic, M., Soklaridis, S., Könings, K. D., Ross, K., Silver, I., Holmboe, E., Shearer, C., & Boudreau, M.
Affiliations
  • Dalhousie University (CA)
  • Maastricht University (NL)
  • American Board of Internal Medicine (US)
  • Uniformed Services University of the Health Sciences (US)
Corresponding author
Sargeant, Joan
ORCID
Venue
Academic Medicine
Publisher
Oxford University Press (OUP)
Published
2018-07
Volume
93
Issue
7
Pages
1055-1063
ISSN
1040-2446 (ISSN-L)
DOI
10.1097/acm.0000000000002131
OpenAlex
W2794418754
Cited by
148
References
31
Citations by year
2026: 11 · 2025: 15 · 2024: 18 · 2023: 16 · 2022: 20 · 2021: 27 · 2020: 14 · 2019: 22 · 2018: 5
FWCI
16.18
Type
journal article
Language
en
Open access
Locations
  • Academic Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion, other-oa)
  • UEA Digital Repository (University of East Anglia) (submittedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
Funders
Universiteit Maastricht
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Social Sciences › Education › Student Assessment and Feedback
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Keywords
performance feedback, coaching, resident education, reflective practice, performance improvement, supervisor characteristics, program culture, family medicine residency, psychiatry residency, internal medicine residency, surgical residency, anesthesiology residency
MeSH terms
Mentoring, Educational Measurement, Feedback, United Kingdom, Humans, Internal Medicine, Internship and Residency, Interviews as Topic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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