Cyclical Variation of Field Notes Completion in a Family Medicine Residency Program

<ns4:p>Background Field Notes (FN) is a competency-based assessment tool used in Canadian Family Medicine programs, that provide low-stakes feedback to learners while documenting their progress towards competency. Data from the University of Toronto’s Department of Family and Community Medicine revealed cyclical variations in FN use over 10 years. We explored the perspectives of Family Medicine residents and preceptors regarding factors influencing motivators and barriers in FN generation. Methods Nine one-on-one interviews of residents and preceptors were conducted, recorded, de-identified, and transcribed. Thematic analysis of codes was performed using deductive and inductive techniques by three independent reviewers, with group review to resolve discrepancies. Results Five themes emerged: 1) FN completion correlated with residents’ learning curves, 2) curricular factors impacted FN use, 3) FN were influenced by vacation periods, 4) Residents and preceptors had different motivators for FN initiation, and 5) barriers such as administrative burdens and lack of standardized guidelines hindered FN use. Conclusions Strategic interventions such as scheduled reminders, standardized guidelines, and improvements to the FN platform could enhance FN utilization, ensuring consistent feedback and promoting competency development. Future studies should involve larger samples across multiple institutions to validate these findings and enhance generalizability across Canadian Family Medicine programs.</ns4:p>