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Shafian S, Ilaghi M, Shahsavani Y, Okhovati M, Soltanizadeh A, Aflatoonian S, Karamoozian A. The feedback dilemma in medical education: insights from medical residents' perspectives. BMC MEDICAL EDUCATION 2024; 24:424. [PMID: 38641609 PMCID: PMC11031893 DOI: 10.1186/s12909-024-05398-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 04/05/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Feedback is a critical component of the learning process in a clinical setting. This study aims to explore medical residents' perspectives on feedback delivery and identify potential barriers to feedback-seeking in clinical training. METHODS This cross-sectional study involved 180 medical residents across seventeen specialties. We employed the validated Residency Education Feedback Level Evaluation in Clinical Training (REFLECT) tool to assess residents' perspectives on their attitude toward feedback, quality of feedback, perceived importance, and reaction to feedback. Additionally, we explored barriers to feedback-seeking behavior among medical residents. RESULTS The majority of medical residents held positive attitudes toward feedback. They agreed that feedback improves their clinical performance (77.7%), professional behavior (67.2%), and academic motivation (56.7%), while also influencing them to become a better specialist in their future career (72.8%). However, the study revealed critical deficiencies in the feedback process. Only 25.6% of residents reported receiving regular feedback and less than half reported that feedback was consistently delivered at suitable times and locations, was sufficiently clear or included actionable plans for improvement. A minority (32.2%) agreed that faculty had sufficient skills to deliver feedback effectively. Moreover, peer-to-peer feedback appeared to be a primary source of feedback among residents. Negative feedback, though necessary, often triggered feelings of stress, embarrassment, or humiliation. Notably, there were no significant differences in feedback perceptions among different specialties. The absence of a feedback-seeking culture emerged as a central barrier to feedback-seeking behavior in the clinical setting. CONCLUSIONS Establishing shared expectations and promoting a culture of feedback-seeking could bridge the gap between residents' perceptions and faculty feedback delivery. Furthermore, recognizing the role of senior and peer residents as valuable feedback sources can contribute to more effective feedback processes in clinical training, ultimately benefiting resident development and patient care.
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Affiliation(s)
- Sara Shafian
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehran Ilaghi
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran.
- Institute of Neuropharmacology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Yasamin Shahsavani
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Okhovati
- Medical Informatics Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Adel Soltanizadeh
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sarah Aflatoonian
- Department of Medical Education, Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Karamoozian
- Department of Biostatistics and Epidemiology, Kerman University of Medical Sciences, Kerman, Iran
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Krystallidou D, Kersbergen MJ, de Groot E, Fluit CRMG, Kuijer-Siebelink W, Mertens F, Oosterbaan-Lodder SCM, Scherpbier N, Versluis MAC, Pype P. Interprofessional education for healthcare professionals. A BEME realist review of what works, why, for whom and in what circumstances in undergraduate health sciences education: BEME Guide No. 83. MEDICAL TEACHER 2024:1-18. [PMID: 38513054 DOI: 10.1080/0142159x.2024.2314203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 01/31/2024] [Indexed: 03/23/2024]
Abstract
AIM To provide an evidence-informed program theory (PT) for Interprofessional Education (IPE) that adds to the knowledge base of how IPE in undergraduate health sciences education works. METHODS We undertook a realist review of the literature and synthesis of the evidence combined with stakeholder experience. Our initial program theory (IPT), built around development, delivery and evaluation of IPE interventions, was tested and refined following an in-depth search of the literature and consultation with stakeholders. The literature (2010-2022) was selected based on the realist criteria of relevance and rigor, as well as on conceptual richness of the studies. RESULTS Our PT is built upon 124 CMOs (Context of IPE interventions, Mechanisms that fired within that context, and IPE Outcomes), from 58 studies. Our PT comprises an array of elements found in the Context, including traits and behavioral displays of students and facilitators, and discusses four Mechanisms (feeling responsible, feeling enthusiastic/excited, feeling safe to take risks, and feeling ready), which are likely to lead to outcomes related to the Interprofessional Education Collaborative (sub)competencies. DISCUSSION Results were linked to learning theories to further build our understanding. The PT can serve as a guide for the development, delivery, and evaluation of IPE interventions.
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Affiliation(s)
- Demi Krystallidou
- School of Languages and Literature, Centre for Translation Studies, University of Surrey, Guildford, UK
| | - Maria J Kersbergen
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
- School of Health Studies, Research group Organisation of Healthcare and Social Services, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Esther de Groot
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Cornelia R M G Fluit
- Health Academy, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
| | - Wietske Kuijer-Siebelink
- School of Education, Research on Responsive Vocational and Professional Education, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Radboudumc Health Academy, Research on Learning and Education, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Fien Mertens
- Department of Public Health and Primary Care, Centre for Interprofessional Collaboration in Education, Research and Practice, Ghent University, Ghent, Belgium
| | | | - Nynke Scherpbier
- Department of Primary and Long-term Care, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Marco A C Versluis
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Pype
- Department of Public Health and Primary Care, Centre for Interprofessional Collaboration in Education, Research and Practice, Ghent University, Ghent, Belgium
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Buléon C, Minehart RD, Rudolph JW, Blanié A, Lilot M, Picard J, Plaud B, Pottecher J, Benhamou D. Strategy to Develop a Common Simulation Training Program: Illustration with Anesthesia and Intensive Care Residency in France. TEACHING AND LEARNING IN MEDICINE 2023; 35:537-549. [PMID: 36251797 DOI: 10.1080/10401334.2022.2127730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 08/03/2022] [Indexed: 06/16/2023]
Abstract
Phenomenon: The urgency of having fair and trustworthy competency-based assessment in medical training is growing. Simulation is increasingly recognized as a potent method for building and assessing applied competencies. The growing use of simulation and its application in summative assessment calls for comprehensive and rigorously designed programs. Defining the current baseline of what is available and feasible is a crucial first step. This paper uses anesthesia and intensive care (AIC) in France as a case study in how to document this baseline. Approach: An IRB-approved, online anonymous closed survey was submitted to AIC residency program directors and AIC simulation program directors in France from January to February 2021. The researcher-developed survey consisted of 65 questions across five sections: centers' characteristics, curricular characteristics, courses' characteristics, instructors' characteristics, and simulation perceptions and perspectives. Findings: The participation rate was 31/31 (100%) with 29 centers affiliated with a university hospital. All centers had AIC simulation activities. Resident training was structured in 94% of centers. Simulation uses were training (100%), research and development (61%), procedural or organizational testing (42%), and summative assessment (13%). Interprofessional full-scale simulation training existed in 90% of centers. Procedural training on simulators prior to clinical patients' care was performed "always" in 16%, "most often" in 45%, "sometimes" in 29% and "rarely" or "not" in 10% of centers. Simulated patients were used in 61% of centers. Main themes were identified for procedural skills, full-scale and simulated patient simulation training. Simulation activity was perceived as increasing in 68% of centers. Centers expressed a desire to participate in developing and using a national common AIC simulation program. Insights: Based on our findings in AIC, we demonstrated a baseline description of nationwide simulation activities. We now have a clearer perspective on a decentralized approach in which individual institutions or regional consortia conduct simulation for a discipline in a relatively homogeneous way, suggesting the feasibility for national guidelines. This approach provides useful clues for AIC and other disciplines to develop a comprehensive and meaningful program matching existing expectations and closing the identified gaps.
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Affiliation(s)
- Clément Buléon
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, Caen, France
- Medical School, University of Caen Normandy, Caen, France
- Center for Medical Simulation, Boston, MA, USA
| | - Rebecca D Minehart
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jenny W Rudolph
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Antonia Blanié
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - Marc Lilot
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Edouard Herriot University Hospital, HCL, Lyon, France
| | - Julien Picard
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Grenoble University Hospital, Grenoble, France
| | - Benoît Plaud
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Saint-Louis University Hospital, APHP, Paris, France
| | - Julien Pottecher
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Strasbourg University Hospital, Strasbourg, France
| | - Dan Benhamou
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
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Coelho V, Scott A, Bilgic E, Keuhl A, Sibbald M. Understanding Feedback for Learners in Interprofessional Settings: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10732. [PMID: 36078451 PMCID: PMC9517787 DOI: 10.3390/ijerph191710732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Interprofessional feedback is becoming increasingly emphasized within health professions' training programs. The objective of this scoping review is to determine what is known about how learners perceive and interact with feedback in an interprofessional context for learning. METHODS A search strategy was developed and conducted in Ovid MEDLINE. Title and abstract screening were performed by two reviewers independently. Next, full texts of selected articles were reviewed by one reviewer to determine the articles included in the review. Data extraction was performed to determine the articles' study population, methodologies and outcomes relevant to the research objective. RESULTS Our analysis of the relevant outcomes yielded four key concepts: (1) issues with the feedback process and the need for training; (2) the perception of feedback providers, affecting how the feedback is utilized; (3) professions of the feedback providers, affecting the feedback process; and (4) learners' own attitude toward feedback, affecting the feedback process. CONCLUSIONS The learner's perception of interprofessional feedback can be an obstacle in the feedback process. Training around interprofessional feedback should be included as part of interprofessional programs. Research is needed to explore how to address barriers in feedback interaction that stem from misguided perceptions of feedback providers' professions.
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Affiliation(s)
- Varun Coelho
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Andrew Scott
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Elif Bilgic
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Amy Keuhl
- Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Matthew Sibbald
- Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada
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An Educational Module to Teach Interprofessional Learner Feedback Skills for Trauma Simulation Events. World J Surg 2022; 46:1602-1608. [PMID: 35397676 PMCID: PMC8994676 DOI: 10.1007/s00268-022-06551-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2022] [Indexed: 10/26/2022]
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Bochatay N, Bajwa NM, Ju M, Appelbaum NP, van Schaik SM. Towards equitable learning environments for medical education: Bias and the intersection of social identities. MEDICAL EDUCATION 2022; 56:82-90. [PMID: 34309905 DOI: 10.1111/medu.14602] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/12/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023]
Abstract
CONTEXT Medical educators are increasingly paying attention to how bias creates inequities that affect learners across the medical education continuum. Such bias arises from learners' social identities. However, studies examining bias and social identities in medical education tend to focus on one identity at a time, even though multiple identities often interact to shape individuals' experiences. METHODS This article examines prior studies on bias and social identity in medical education, focusing on three social identities that commonly elicit bias: race, gender and profession. By applying the lens of intersectionality, we aimed to generate new insights into intergroup relations and identify strategies that may be employed to mitigate bias and inequities across all social identities. RESULTS Although different social identities can be more or less salient at different stages of medical training, they intersect and impact learners' experiences. Bias towards racial and gender identities affect learners' ability to reach different stages of medical education and influence the specialties they train in. Bias also makes it difficult for learners to develop their professional identities as they are not perceived as legitimate members of their professional groups, which influences interprofessional relations. To mitigate bias across all identities, three main sets of strategies can be adopted. These strategies include equipping individuals with skills to reflect upon their own and others' social identities; fostering in-group cohesion in ways that recognise intersecting social identities and challenges stereotypes through mentorship; and addressing intergroup boundaries through promotion of allyship, team reflexivity and conflict management. CONCLUSIONS Examining how different social identities intersect and lead to bias and inequities in medical education provides insights into ways to address these problems. This article proposes a vision for how existing strategies to mitigate bias towards different social identities may be combined to embrace intersectionality and develop equitable learning environments for all.
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Affiliation(s)
- Naike Bochatay
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Nadia M Bajwa
- Unit of Development and Research in Medical Education, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland
| | - Mindy Ju
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Nital P Appelbaum
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, Texas, USA
| | - Sandrijn M van Schaik
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
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Miles A, Ginsburg S, Sibbald M, Tavares W, Watling C, Stroud L. Feedback from health professionals in postgraduate medical education: Influence of interprofessional relationship, identity and power. MEDICAL EDUCATION 2021; 55:518-529. [PMID: 33259070 DOI: 10.1111/medu.14426] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/13/2020] [Accepted: 11/27/2020] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Capitalising on direct workplace observations of residents by interprofessional team members might be an effective strategy to promote formative feedback in postgraduate medical education. To better understand how interprofessional feedback is conceived, delivered, received and used, we explored both feedback provider and receiver perceptions of workplace feedback. METHODS We conducted 17 individual interviews with residents and eight focus groups with health professionals (HPs) (two nurses, two rehabilitation therapists, two pharmacists and two social workers), for a total of 61 participants. Using a constructivist grounded theory approach, data collection and analysis proceeded as an iterative process using constant comparison to identify and explore themes. RESULTS Conceptualisations and content of feedback were dependent on whether the resident was perceived as a learner or a peer within the interprofessional relationship. Residents relied on interprofessional role understanding to determine how physician competencies align with HP roles. The perceived alignment was unique to each profession and influenced feedback credibility judgements. Residents prioritised feedback from physicians or within the Medical Expertise domain-a role that HPs felt was over-valued. Despite ideal opportunities for direct observation, operational enactment of feedback was influenced by power differentials between the professions. DISCUSSION Our results illuminate HPs' conceptualisation of feedback for residents and the social constructs influencing how their feedback is disseminated. Professional identity and social categorisation added complexity to feedback acceptance and incorporation. To ensure that interprofessional feedback can achieve desired outcomes, education programmes should implement strategies to help mitigate intergroup bias and power imbalance.
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Affiliation(s)
- Amy Miles
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shiphra Ginsburg
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
| | - Matthew Sibbald
- Department of Medicine, Centre for Simulation-Based Learning, McMaster University, Hamilton, ON, Canada
| | - Walter Tavares
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Chris Watling
- Department of Oncology, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Lynfa Stroud
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
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Ference K, Mackesy BL, Reinert P, Foote EF. The Importance of Written Feedback on the Individual and Team Performance of Student Pharmacists. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:ajpe7870. [PMID: 34283784 PMCID: PMC7779883 DOI: 10.5688/ajpe7870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 08/19/2020] [Indexed: 06/13/2023]
Abstract
Objective. To analyze the impact of written feedback provided using an online peer and self-evaluation tool on the individual and team performance of student pharmacists.Methods. Student pharmacists enrolled in two sections (section A=29 students; section B=32 students) of a required first-year pharmacy course were assigned to teams of six and given a project-based assignment in which they worked together to solve an authentic health care-related problem. Students used the Comprehensive Assessment of Team-Member Effectiveness (CATME) online peer and self-evaluation system to evaluate their peers at several points during the project. Students in section A were given both the survey ratings and written feedback from their peers, while students in section B were only given the survey ratings. Data from CATME as well as from student focus groups were used to assess students' perceptions of the usefulness of peer assessments and the impact of written feedback.Results. For 14 of the 15 items on the survey, mean scores of students in section A were higher than those for students in section B, indicating that students in section A had generally higher agreement with and affirmation of positive statements related to peers giving and receiving feedback from one another. Quantitative and qualitative data indicated that students had an overall positive perception about the usefulness of the CATME tool for evaluating individual and team performance. More specifically, both the quantitative analysis and focus group feedback revealed notable differences in perceptions about peer feedback between students in the group that only received survey ratings and students in the group that received both survey ratings and written feedback.Conclusion. The survey results and focus group themes indicated that student pharmacists had positive perceptions about the CATME tool but that the ratings had a more meaningful impact when the written comments of their peers were also shared with them.
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Affiliation(s)
- Kimberly Ference
- Wilkes University, Nesbitt School of Pharmacy, Wilkes-Barre, Pennsylvania
| | | | - Paul Reinert
- Wilkes University, School of Education, Wilkes-Barre, Pennsylvania
| | - Edward F Foote
- University of the Sciences, Philadelphia College of Pharmacy, Philadelphia, Pennsylvania
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Feller K, Berendonk C. Identity matters - perceptions of inter-professional feedback in the context of workplace-based assessment in Diabetology training: a qualitative study. BMC MEDICAL EDUCATION 2020; 20:33. [PMID: 32013924 PMCID: PMC6998209 DOI: 10.1186/s12909-020-1932-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/10/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Inter-professional collaboration is acknowledged as essential for quality patient-care. However, little is known about receptiveness to inter-professional feedback in the postgraduate training. This study explores, in light of social identity theory, the perceptions of residents, supervising physicians and allied health care professionals regarding inter-professional feedback in the context of workplace-based assessment. METHODS For 6 months, residents in Diabetology at the University Hospital of Bern performed formative workplace-based assessments under direct observation of a supervising physician and an allied health care professional. Feedback from both observers was given to the resident after every assessment. Subsequently, focus group discussions were conducted to collect the participants' perceptions of inter- and intra-professional feedback. Transcripts were analyzed qualitatively using a thematic analysis approach. RESULTS We identified four main themes: (1) Identity and hierarchy; (2) Interdependence of feedback source and feedback content; (3) Impact on collaboration and patient-care; (4) Logistical and organizational requirements. While different social identities are the source of inter-professional hierarchies, they did not impede the receptiveness to feedback. Perceived trustworthiness of the feedback was attributed with more importance than professional affiliations, whereas intra-professional hierarchies between physicians led to the perception of a more summative nature of the feedback and rather impeded receptiveness. According to the participants, inter-professional feedback raised awareness of the working reality of other team members and had a positive impact on communication between the different professional groups. Moreover, participants reported positive response from patients regarding the inter-professional collaboration they experienced. Considerable organizational effort is required to enable the parallel observation of a resident's consultation by a supervising physician and an allied health care professional. CONCLUSIONS Feedback from allied health care professionals can be a valuable learning resource for residents, given its role outside the sometimes conflicting area of intra-professional hierarchies. Inter-professional feedback in the context of workplace-based assessment carries the potential to strengthen collaboration between the different professional groups.
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Affiliation(s)
- Katrin Feller
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Global Interprofessional Therapeutic Communication Scale© (GITCS©): Development and Validation. Clin Simul Nurs 2019. [DOI: 10.1016/j.ecns.2019.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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McGinness AK, Wamsley M, Rivera J. Assessing interprofessional collaboration: Pilot of an interprofessional feedback survey for first-year medical students. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.xjep.2019.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Lockeman KS, Dow AW, Randell AL. Notes from the Field: Evaluating a Budget-Based Approach to Peer Assessment for Measuring Collaboration Among Learners on Interprofessional Teams. Eval Health Prof 2019; 43:197-200. [PMID: 30678491 DOI: 10.1177/0163278719826227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Assessing interprofessional skills poses challenges for health professions educators. While competency frameworks define the skills graduating students should possess, they do not provide guidance for assessment. This brief report explores validity evidence for use of peer assessment to assess learners and provide feedback for improvement. The context was an online learning experience for 477 fourth-year students from medicine, nursing, and pharmacy who worked together on small interprofessional teams to care for a virtual geriatric patient. At the end of each case unit, students were given a budget of points to allocate among teammates to assess their communication and interprofessional collaboration. Ratings were averaged to provide learners with feedback about their performance. Scores were normally distributed, did not demonstrate a leniency effect, were moderately correlated with ratings that preceptors assigned to students, and had smaller correlations with knowledge scores and other case activity measures. Findings support budget-based peer assessment as a valid and feasible approach for differentiating between students with high interprofessional competency and those who may be deficient. Further exploration should focus on the longitudinal effect of peer assessment, how it may influence individual learning and team dynamics, and whether it could be used for other assessment purposes.
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Affiliation(s)
- Kelly S Lockeman
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan W Dow
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Autumn L Randell
- School of Education, Virginia Commonwealth University, Richmond, VA, USA
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Bientzle M, Lechner C, Cress U, Kimmerle J. Online peer consulting for health professionals. CLINICAL TEACHER 2018; 16:463-467. [DOI: 10.1111/tct.12950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Martina Bientzle
- Leibniz‐Institut fuer Wissensmedien, Knowledge Media Research Center Tuebingen Germany
| | - Christine Lechner
- ulmkolleg, Institute for Vocational Education and Training of Physiotherapy, Massage and Podiatry Ulm Germany
| | - Ulrike Cress
- Leibniz‐Institut fuer Wissensmedien, Knowledge Media Research Center Tuebingen Germany
- Department of PsychologyUniversity of Tuebingen Tuebingen Germany
| | - Joachim Kimmerle
- Leibniz‐Institut fuer Wissensmedien, Knowledge Media Research Center Tuebingen Germany
- Department of PsychologyUniversity of Tuebingen Tuebingen Germany
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Alfehaid LS, Qotineh A, Alsuhebany N, Alharbi S, Almodaimegh H. The Perceptions and Attitudes of Undergraduate Healthcare Sciences Students of Feedback: A Qualitative Study. HEALTH PROFESSIONS EDUCATION 2018. [DOI: 10.1016/j.hpe.2018.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Addressing Dual Patient and Staff Safety Through A Team-Based Standardized Patient Simulation for Agitation Management in the Emergency Department. ACTA ACUST UNITED AC 2018; 13:154-162. [DOI: 10.1097/sih.0000000000000309] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bing-You R, Ramesh S, Hayes V, Varaklis K, Ward D, Blanco M. Trainees' Perceptions of Feedback: Validity Evidence for Two FEEDME (Feedback in Medical Education) Instruments. TEACHING AND LEARNING IN MEDICINE 2018; 30:162-172. [PMID: 29240456 DOI: 10.1080/10401334.2017.1392863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED Construct: Medical educators consider feedback a core component of the educational process. Effective feedback allows learners to acquire new skills, knowledge, and attitudes. Learners' perceptions of feedback are an important aspect to assess with valid methods in order to improve the feedback skills of educators and the feedback culture. BACKGROUND Although guidelines for delivering effective feedback have existed for several decades, medical students and residents often indicate that they receive little feedback. A recent scoping review on feedback in medical education did not reveal any validity evidence on instruments to assess learner's perceptions of feedback. The purpose of our study was to gather validity evidence on two novel FEEDME (Feedback in Medical Education) instruments to assess medical students' and residents' perceptions of the feedback that they receive. APPROACH After the authors developed an initial instrument with 54 items, cognitive interviews with medical students and residents suggested that 2 separate instruments were needed, one focused on the feedback culture (FEEDME-Culture) and the other on the provider of feedback (FEEDME-Provider). A Delphi study with 17 medical education experts and faculty members assessed content validity. The response process was explored involving 31 medical students and residents at 2 academic institutions. Exploratory factor analysis and reliability analyses were performed on completed instruments. RESULTS Two Delphi consultation rounds refined the wording of items and eliminated several items. Learners found both instruments easy and quick to answer; it took them less than 5 minutes to complete. Learners preferred an electronic format of the instruments over paper. Factor analysis revealed a two- and three-factor solution for the FEEDME-Culture and FEEDME-Provider instruments, respectively. Cronbach's alpha was greater than 0.80 for all factors. Items on both instruments were moderately to highly correlated (range, r = .3-.7). CONCLUSIONS Our results provide preliminary validity evidence of 2 novel feedback instruments. After further validation of both FEEDME instruments, sharing the results of the FEEDME-Culture instrument with educational leaders and faculty may improve the culture of feedback on specific educational rotations and at the institutional level. The FEEDME-Provider instrument could be useful for faculty development targeting feedback skills. Additional research studies could assess whether both instruments may be used to help learners receive feedback and prompt reflective learning.
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Affiliation(s)
- Robert Bing-You
- a Department of Medical Education , Maine Medical Center , Portland , Maine , USA
| | - Saradha Ramesh
- b Office of Educational Affairs , Tufts University School of Medicine , Boston , Massachusetts , USA
| | - Victoria Hayes
- a Department of Medical Education , Maine Medical Center , Portland , Maine , USA
| | - Kalli Varaklis
- a Department of Medical Education , Maine Medical Center , Portland , Maine , USA
| | - Denham Ward
- a Department of Medical Education , Maine Medical Center , Portland , Maine , USA
| | - Maria Blanco
- b Office of Educational Affairs , Tufts University School of Medicine , Boston , Massachusetts , USA
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Donia MB, O'Neill TA, Brutus S. The longitudinal effects of peer feedback in the development and transfer of student teamwork skills. LEARNING AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.lindif.2017.11.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sonnenberg LK, Pritchard-Wiart L, Hodgson CS, Yu Y, King S. Assessment of Resident Physicians' Communicator and Collaborator Competencies by Interprofessional Clinicians: A Mixed-Methods Study. TEACHING AND LEARNING IN MEDICINE 2017; 29:392-401. [PMID: 28498034 DOI: 10.1080/10401334.2017.1301817] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
UNLABELLED Phenomenon: As we move toward competency-based medical education, greater emphasis is being placed on assessing a more comprehensive skill set, including the ability to communicate and collaborate effectively in the workplace. Nonphysician members on interprofessional (IP) teams have valuable perspectives on actual resident performance and are often not adequately engaged in the provision of feedback to residents. Based on the educational theories of collaborative evaluation and social constructivism, this research examined the ability of IP clinicians to provide feedback to residents. The aim of this study was to examine IP clinicians' perceptions of their ability to provide formative feedback, through their observations and assessments of developmental pediatric residents, compared to physician supervisors on the rotation, and to qualitatively explore potential barriers to the feedback process from their perspective. APPROACH This explanatory, sequential mixed-methods design study first examined which and how many of the CanMEDS Communicator and Collaborator training objectives (N = 40) were considered to be observable and assessable by IP clinicians and physicians. A comparison of the mean number of objectives that were observed and practically assessed by (a) each group (IP clinicians vs. physicians) and (b) clinical service teams during the core developmental pediatrics rotations, were examined using independent t tests. Second, a thematic qualitative analysis of focus groups was used to develop a contextual understanding of the factors that influenced this process. Data were analyzed using three levels of open coding and descriptive qualitative analysis techniques. FINDINGS Physicians reported they could observe (M = 33.3, SD = 5.2, 83.3%) and assess (M = 31.5, SD = 7.3, 79%) a larger number of objectives compared to the IP clinician group (M = 24.7, SD = 8.6, 61.8% and M = 20.3, SD = 10.6, 51%, respectively). There were no differences between the clinical service teams (i.e., preschool/school-age and pediatric rehabilitation). The objective that was most observable and assessable by the IP clinicians was "Demonstrates a respectful attitude towards other colleagues and members of an interprofessional team." Four themes identified by the IP clinicians provided more in-depth qualitative information: (a) assessment requires more than simple observation, (b) assumptions and indirect observation influence assessment, (c) clinic culture and structure shapes observation and assessment, and (d) specific assessment criteria are required by IP clinicians. Insights: IP clinicians have the desire and ability to provide formative feedback to residents. Formalized processes with specific evaluation criteria would facilitate meaningful feedback from IP clinicians in the assessment of residents as they journey toward competence.
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Affiliation(s)
- Lyn K Sonnenberg
- a Division of Developmental Pediatrics , University of Alberta , Edmonton , Alberta , Canada and Glenrose Rehabilitation Hospital , Edmonton , Alberta , Canada
| | - Lesley Pritchard-Wiart
- b Department of Physical Therapy , University of Alberta , Edmonton , Alberta , Canada and Glenrose Rehabilitation Hospital , Edmonton , Alberta , Canada
| | - Carol S Hodgson
- c Department of Pediatrics , University of Alberta , Edmonton , Alberta , Canada
| | - YongQiang Yu
- d Department of Speech Pathology and Audiology (Communication Sciences and Disorders) , University of Alberta , Edmonton , Alberta , Canada and Department of Otolaryngology, Beifang Hospital , Shenyang , China
| | - Sharla King
- e Department of Educational Psychology , University of Alberta , Edmonton , Alberta , Canada
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Perceptions of Nursing and Physical Therapy Students Toward Peer-Led Interprofessional Education in Manual Handling. Nurse Educ 2017; 42:E1-E6. [DOI: 10.1097/nne.0000000000000319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sklar DP. Interprofessional Education and Collaborative Practice-If Not Now, When? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2016; 91:747-749. [PMID: 27218897 DOI: 10.1097/acm.0000000000001179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Vesel TP, O'Brien BC, Henry DM, van Schaik SM. Useful but Different: Resident Physician Perceptions of Interprofessional Feedback. TEACHING AND LEARNING IN MEDICINE 2016; 28:125-34. [PMID: 27064716 DOI: 10.1080/10401334.2016.1146609] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
UNLABELLED Phenomenon: Based on recently formulated interprofessional core competencies, physicians are expected to incorporate feedback from other healthcare professionals. Based on social identity theory, physicians likely differentiate between feedback from members of their own profession and others. The current study examined residents' experiences with, and perceptions of, interprofessional feedback. APPROACH In 2013, Anesthesia, Obstetrics-Gynecology, Pediatrics, and Psychiatry residents completed a survey including questions about frequency of feedback from different professionals and its perceived value (5-point scale). The authors performed an analysis of variance to examine interactions between residency program and profession of feedback provider. They conducted follow-up interviews with a subset of residents to explore reasons for residents' survey ratings. FINDINGS Fifty-two percent (131/254) of residents completed the survey, and 15 participated in interviews. Eighty percent of residents reported receiving written feedback from physicians, 26% from nurses, and less than 10% from other professions. There was a significant interaction between residency program and feedback provider profession, F(21, 847) = 3.82, p < .001, and a significant main effect of feedback provider profession, F(7, 847) = 73.7, p < .001. On post hoc analyses, residents from all programs valued feedback from attending physicians higher than feedback from others, and anesthesia residents rated feedback from other professionals significantly lower than other residents. Ten major themes arose from qualitative data analysis, which revealed an overall positive attitude toward interprofessional feedback and clarified reasons behind residents' perceptions and identified barriers. Insights: Residents in our study reported limited exposure to interprofessional feedback and valued such feedback less than intraprofessional feedback. However, our data suggest opportunities exist for effective utilization of interprofessional feedback.
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Affiliation(s)
- Travis P Vesel
- a Department of Pediatrics , University of California San Francisco , San Francisco , California , USA
| | - Bridget C O'Brien
- b Department of Medicine , University of California San Francisco , San Francisco , California , USA
| | - Duncan M Henry
- a Department of Pediatrics , University of California San Francisco , San Francisco , California , USA
| | - Sandrijn M van Schaik
- a Department of Pediatrics , University of California San Francisco , San Francisco , California , USA
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