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Gore KM, Schiebout J, Peksa GD, Hock S, Patwari R, Gottlieb M. The integrative feedback tool: assessing a novel feedback tool among emergency medicine residents. Clin Exp Emerg Med 2023; 10:306-314. [PMID: 36796780 PMCID: PMC10579731 DOI: 10.15441/ceem.22.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/19/2023] [Accepted: 02/07/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Feedback is critical to the growth of learners. However, feedback quality can be variable in practice. Most feedback tools are generic, with few targeting emergency medicine. We created a feedback tool designed for emergency medicine residents, and this study aimed to evaluate the effectiveness of this tool. METHODS This was a single-center, prospective cohort study comparing feedback quality before and after introducing a novel feedback tool. Residents and faculty completed a survey after each shift assessing feedback quality, feedback time, and the number of feedback episodes. Feedback quality was assessed using a composite score from seven questions, which were each scored 1 to 5 points (minimum total score, 7 points; maximum, 35 points). Preintervention and postintervention data were analyzed using a mixed-effects model that took into account the correlation of random effects between study participants. RESULTS Residents completed 182 surveys and faculty members completed 158 surveys. The use of the tool was associated with improved consistency in the summative score of effective feedback attributes as assessed by residents (P=0.040) but not by faculty (P=0.259). However, most of the individual scores for attributes of good feedback did not reach statistical significance. With the tool, residents perceived that faculty spent more time providing feedback (P=0.040) and that the delivery of feedback was more ongoing throughout the shift (P=0.020). Faculty felt that the tool allowed for more ongoing feedback (P=0.002), with no perceived increase in the time spent delivering feedback (P=0.833). CONCLUSION The use of a dedicated tool may help educators provide more meaningful and frequent feedback without impacting the perceived required time needed to provide feedback.
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Affiliation(s)
- Katarzyna M. Gore
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Jessen Schiebout
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Gary D. Peksa
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Sara Hock
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Rahul Patwari
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Michael Gottlieb
- Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA
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Wolffgramm M, Bücker J, Van der Heijden B. “Expecting the unexpected?” Uncovering role expectation differences in a Dutch hospital. Front Psychol 2022; 13:951359. [PMID: 36248562 PMCID: PMC9561906 DOI: 10.3389/fpsyg.2022.951359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/19/2022] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to empirically investigate differences in role expectations, among the stakeholders involved, about the devolved personnel management role of front-line managers (FLMs). In particular, we researched the role expectation differences between FLMs, their middle managers, and Human Resource (HR) practitioners. In total, nineteen semi-structured interviews have been conducted involving eleven FLMs, eight middle managers, and two HR practitioners working at the same Dutch hospital. Most discovered role expectation differences were related to how FLMs should execute their HR tasks (i.e., process ambiguity). FLMs were often uncertain if their role enactment met those of their middle managers and/or HR practitioners, herewith indicating role stress. Our findings underline the importance of paying attention to role expectations’ differences in aligning components of the HRM-performance relationship. Future research could include the role expectations of other important stakeholders, such as: subordinates and top management. The outcomes of this empirical work are translated into four interventions to diminish FLMs’ role stress.
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Affiliation(s)
- Milan Wolffgramm
- Research Group Employability Transition, Saxion University of Applied Sciences, Enschede, Netherlands
- *Correspondence: Milan Wolffgramm,
| | - Joost Bücker
- Institute for Management Research, Radboud University, Nijmegen, Netherlands
| | - Beatrice Van der Heijden
- Institute for Management Research, Radboud University, Nijmegen, Netherlands
- Faculty of Management, Open University of the Netherlands, Heerlen, Netherlands
- Department of Marketing, Innovation and Organisation, Ghent University, Ghent, Belgium
- School of Business, Hubei University, Wuhan, China
- Kingston Business School, Kingston University, London, United Kingdom
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Shrivastava S, Shrivastava P. Strengthening the delivery of feedback in medical institutions by establishing feedback culture. MEDICAL JOURNAL OF BABYLON 2022. [DOI: 10.4103/mjbl.mjbl_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tariq M, Boulet J, Motiwala A, Saeed S, Awan S, Zehra T, Ali SK. Strengthening the feedback culture in a postgraduate residency program. EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2021; 34:96-100. [PMID: 35488655 DOI: 10.4103/efh.efh_144_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Feedback is defined as specific information presented to a learner that facilitates professional development through the process of reflection. Timely provision of constructive feedback to learner is important in optimizing the learning curve. The aim of the current study was to see the effectiveness of various interventions on feedback practices of faculty members. METHODS This is a quasi-experimental study (pre- and postdesign). It was conducted from November 2009 to March 2011 at The Aga Khan University, Pakistan. Faculty development workshops, allotment of specified feedback time, and restructuring of residency feedback forms were done as interventions. Data collection was done pre- and postintervention. Resident's and faculty satisfaction regarding the feedback process were evaluated using a prepiloted questionnaire. Paired t-test was applied to assess the effect of interventions on faculty and resident's satisfaction. RESULTS The mean satisfaction scores of residents were significantly improved (P < 0.05). Pre- and postintervention faculty satisfaction score also demonstrated significant difference in overall satisfaction level, from 47.88 ± 13.92 to 63.40 ± 8.72 (P < 0.05). DISCUSSION This study showed improved faculty engagement and satisfaction for the provision of feedback to the trainee resident. Strengthening this, culture requires continuous reinforcement, individualized feedback to the faculty members regarding their feedback practices, and continuing faculty development initiatives.
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Affiliation(s)
- Muhammad Tariq
- Department for Educational Development, Aga Khan University, Karachi, Pakistan
| | - Jack Boulet
- Medical Council of Canada, Ottawa, ON, Canada
| | - Afaq Motiwala
- Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Sana Saeed
- Department for Educational Development, Aga Khan University, Karachi, Pakistan
| | - Safia Awan
- Department of Medicine, The Aga Khan University, Karachi, Pakistan
| | - Tabassum Zehra
- Department for Educational Development, Aga Khan University, Karachi, Pakistan
| | - Syeda Kausar Ali
- Department of Medical Education, Jinnah Sindh Medical University, Karachi, Pakistan
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Fredette J, Michalec B, Billet A, Auerbach H, Dixon J, Poole C, Bounds R. A qualitative assessment of emergency medicine residents' receptivity to feedback. AEM EDUCATION AND TRAINING 2021; 5:e10658. [PMID: 34527849 PMCID: PMC8426887 DOI: 10.1002/aet2.10658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Effective feedback is the cornerstone of competency-based education. The emergency department (ED) is a unique learning and feedback environment. Developing our understanding of emergency medicine (EM) residents' experiences around feedback will improve resident training and inform EM faculty development programs. OBJECTIVE This qualitative study explores the feedback culture and practices in EM and resident's experiences and attitudes toward feedback in this specific training environment. METHODS At a large categorical EM program, 15 residents voluntarily participated in semistructured interviews regarding feedback. These individual interviews were performed by a nonphysician investigator and transcripts underwent an inductive multistep coding process. Transcripts were analyzed to identify common factors influencing feedback and then comparisons were made between residents to explore the interconnectedness of identified factors and further categorize consistent themes. RESULTS Factors inherent to the ED environment make the delivery of effective feedback challenging. Residents also revealed that feedback-seeking/-avoidant behavior and receptivity to feedback are multifactorial. Residents actively seek feedback when they feel that they performed well but tend to avoid feedback interactions when they expect constructive feedback. Finally, residents filter feedback based on attending personality and perceived practice style as well as their own desired practice style. CONCLUSIONS It is important for program leaders to understand their residents' experiences with feedback and engage both faculty and residents in conversations around feedback delivery and receptivity. An improved understanding of these experiences might also reveal barriers to performance assessment and guide efforts to improve the accuracy and reliability of resident evaluations.
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Affiliation(s)
| | | | - Amber Billet
- Wellspan York Hospital SystemYorkPennsylvaniaUSA
| | | | - Jessica Dixon
- Thomas Jefferson Medical SchoolPhiladelphiaPennsylvaniaUSA
| | | | - Richard Bounds
- University of Vermont Medical CenterBurlingtonVermontUSA
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Natesan S, Todd B, Hsu RS, Ren RK, Clark R, Jara‐Almonta G, Vissoci JRN, Narajeenron K. Novel tool for assessing the quality of feedback in the emergency room (FEED-ER). AEM EDUCATION AND TRAINING 2021; 5:e10698. [PMID: 34859168 PMCID: PMC8616187 DOI: 10.1002/aet2.10698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 09/09/2021] [Accepted: 09/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The Accreditation Council for Graduate Medical Education (ACGME) emphasizes constructive feedback as a critical component of residency training. Despite over a decade of using competency-based milestone evaluations, emergency medicine (EM) residency programs lack a standardized method for assessing the quality of feedback. We developed two novel EM-specific feedback surveys to assess the quality of feedback in the ER (FEED-ER) from both the resident and the faculty perspectives. This study aimed to evaluate the surveys' psychometric properties. METHODS We developed FEED-ER using a Likert scale with faculty and resident versions based on the ACGME framework and a literature review. The preliminary survey consisted of 25 questions involving the feedback domains of timeliness, respect/communication, specificity, action plan, and feedback culture. We conducted two modified Delphi rounds involving 17 content experts to ensure respondent understanding of the items, item coherence to corresponding feedback domains, thematic saturation of domain content, and time duration. A multicenter study was conducted at five university-based EDs in the United States and one in Thailand in 2019. We evaluated the descriptive statistics of the frequency of responses, validity evidence, and reliability of FEED-ER. RESULTS A total of 147 EM faculty and 126 EM residents completed the survey. Internal consistency was adequate (Cronbach's alpha > 0.70) and test-retest reliability showed adequate temporal stability (ICC > 0.80) for all dimensions. Content validity was deemed acceptable (CVC > 0.80) for all items. From the 25 items of FEED-ER, 23 loaded into the originally theorized dimensions (with factor loadings > 0.50). Additionally, the five feedback domains were found to be statistically distinct, with correlations between 0.40 and 0.60. The final survey has 23 items. CONCLUSIONS This is the first study to develop and provide validity evidence for an EM-specific feedback tool that has strong psychometric properties, is reproducible and reliable, and provides an objective measure for assessing the quality of feedback in the ED.
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Affiliation(s)
- Sreeja Natesan
- Division of Emergency MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Brett Todd
- Department of Emergency MedicineOakland University William Beaumont School of MedicineBeaumont HealthRoyal OakMichiganUSA
| | - Robert S. Hsu
- Christiana Care Emergency Medicine Residency ProgramSidney Kimmel Medical CollegeThomas Jefferson UniversityCherry HillNew JerseyUSA
| | | | - Ryan Clark
- Department of Emergency MedicineUMMS‐BaystateWilliamsburgMassachusettsUSA
| | - Geoff Jara‐Almonta
- Icahn School of Medicine at Mt Sinai Dept of Emergency MedicineNew York City Health and HospitalsElmhurst Hospital Center Department of Emergency MedicineNew YorkNew YorkUSA
| | | | - Khuansiri Narajeenron
- Department of Emergency Medicine, Faculty of MedicineChulalongkorn UniversityKing Chulalongkorn Memorial Hospital, The Thai Red Cross SocietyBangkokThailand
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Areemit RS, Cooper CM, Wirasorn K, Paopongsawan P, Panthongviriyakul C, Ramani S. Hierarchy, "Kreng Jai" and Feedback: A Grounded Theory Study Exploring Perspectives of Clinical Faculty and Medical Students in Thailand. TEACHING AND LEARNING IN MEDICINE 2021; 33:235-244. [PMID: 33023318 DOI: 10.1080/10401334.2020.1813584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Phenomenon: Institutional learning culture influences how feedback is provided, accepted, and acted upon. The Thai societal culture, characterized by strict hierarchy and collectivism, may have a significant impact on the learning culture and, therefore, feedback conversations between teachers and learners. This study explored: common approaches used by faculty to provide feedback to students; and faculty and student perspectives regarding sociocultural factors that impact feedback seeking, provision, and acceptance. Approach: Using a constructivist paradigm, we explored perspectives of clinical faculty and medical students at an academic medical center in Thailand using focus groups (students) and a focus group and individual interviews (faculty). Sessions were audiotaped, transcribed, and de-identified prior to analysis. Constant comparative analysis was performed on transcripts, focusing on perceived cultural factors that impacted feedback conversations. Findings: Thirty faculty participated in the study, four participated in a focus group, and 27 participated in individual interviews. Twenty-two medical students participated in four focus groups. We identified the following key themes, which could be grouped under three categories: (1) Faculty approaches to providing feedback (1.1) Feedback should be initiated by faculty. (1.2) Feedback is initiated primarily for deficit identification and correction. (2) Factors impacting students' feedback seeking and acceptance. (2.1) Students are willing to accept harsh feedback when it provides suggestions for improvement. (2.2) Feedback is most credible when faculty have direct knowledge of the student's effort. (2.3) Feedback seeking is considered a burden on teachers. (3) Cultural factors that influence feedback (3.1) Societal hierarchy perpetuates unidirectional top-down feedback. (3.2) Kreng jai (the balance between consideration for others and self-interests) affects feedback seeking and provision. Insights: Though the value of feedback on learning was emphasized by all participants, the hierarchical culture of Thai society was perceived to have a significant influence on feedback seeking, provision, and acceptance. Identifying and addressing societal as well as institutional cultural factors would be key in designing growth-enhancing feedback initiatives relevant to the local context. One size feedback training does not fit all.
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Affiliation(s)
- Rosawan S Areemit
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Cynthia M Cooper
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kosin Wirasorn
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | | | - Subha Ramani
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Gupta K, Badyal D, Mahajan R, Singla G, Goyal R, Kaur H, Singla B, Ahi RS. Introduction of Structured Feedback to Medical Undergraduate Students in the First Professional. Int J Appl Basic Med Res 2021; 11:21-26. [PMID: 33842291 PMCID: PMC8025954 DOI: 10.4103/ijabmr.ijabmr_138_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/18/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022] Open
Abstract
Context: Feedback is integral in medical education as it improves learner's knowledge, skills, and professional competence, however it is not routinely practiced in medical colleges. Therefore, the present educational research project was designed in a need-based attempt to introduce and implement a program of structured feedback in the department of biochemistry in the first professional MBBS. Aim: The aim was to introduce and implement a program of structured feedback in biochemistry for 1st year medical undergraduates and to collect students' and faculty perceptions about its effectiveness. Settings and Design: it was a prospective, nonrandomized, interventional study. Methods: The study was conducted over 135 first professional undergraduates with six faculties. The feedback questionnaires to assess the perceptions of students and faculty on the feedback program were designed and peer-expert validated. An educational program for giving structured feedback was designed, peer-expert validated, and introduced and perceptions of students and faculty were collected using the feedback questionnaires. The collected data were analyzed in terms of percentages, medians, modes, and satisfaction index and represented in graphs. Transcripts were prepared for qualitative data, themes were identified, and a thematic map was prepared. Results: Students (n = 135) perceived the feedback sessions to be helpful in making them aware about their learning gaps (70%) and facilitated the process of bridging the learning gaps (62%). Students strongly agreed that feedback has helped in better understanding of the topic (82%), better retention (69%), and acted as effective learning tool (68%). The faculty did not find the feedback sessions as extra burden in their routine schedule (83%). The main themes identified were “More interaction with teacher,” “Increased motivation,” “Student centric,” “Less stressful,” “Improved confidence,” “Identification and bridging of learning gaps,” “Improved efficacy to attempt questions,” and “Improved learning.” Conclusions: The feedback program was perceived satisfactory by both students and faculty agreeing upon more of such sessions and implementation in the curriculum in the near future.
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Affiliation(s)
- Kapil Gupta
- Biochemistry, Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - Dinesh Badyal
- Department of Pharmacology/Medical Education, CMCL FAIMER Regional Institute, Ludhiana, Punjab, India
| | - Rajiv Mahajan
- Department of Pharmacology, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India
| | - Gesu Singla
- Biochemistry, Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - Rahul Goyal
- Biochemistry, Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - Harsharan Kaur
- Biochemistry, Adesh Institute of Medical Sciences and Research, Bathinda, India
| | - Bharti Singla
- Biochemistry, Adesh Institute of Medical Sciences and Research, Bathinda, India
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Davila-Cervantes A, Foulds JL, Gomaa NA, Rashid M. Experiences of Faculty Members Giving Corrective Feedback to Medical Trainees in a Clinical Setting. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:24-30. [PMID: 33290299 DOI: 10.1097/ceh.0000000000000322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Imperative to medical training is the observation and provision of feedback. In this era of competency-based medical education, feedback is one of the core components of this new model. A better understanding of the medical faculty's attitudes and experiences when providing feedback is essential. Currently, there are limited qualitative studies that have explored attitudes and experiences of faculty members when giving corrective feedback to medical trainees. METHODS To allow an in-depth exploration of this phenomenon, a hermeneutics phenomenology approach was used, by conducting semistructured interviews with 10 faculty members representing six disciplines and used thematic analysis to create data-driven codes and identify key themes through an iterative consensus-building process. RESULTS Four themes were identified by the authors: (1) Elements of effective feedback, (2) Faculty members' perception of giving corrective feedback, (3) Challenges as it relates to the assessment culture of the institution, and (4) Providing effective corrective feedback as a mutual process focused on relationship building between learners and preceptors. DISCUSSION By exploring faculty members' perceptions of providing perceived corrective feedback, we identified actionable recommendations based on the study participants' experiences, expectations, and challenges which could be addressed involving future faculty development with the focus on modifying concepts of feedback and institutional changes that will promote an attitudinal and a cultural shift.
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Affiliation(s)
- Andrea Davila-Cervantes
- Dr. Davila-Cervantes: Senior Program Officer, Office of Lifelong Learning, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada. Dr. Foulds: Assistant Program Director, General Pediatrics Residency Program, Assistant Professor, Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada. Dr. Gomaa: Associate Clinical Professor and Director of Quality Improvement, Division of Otolaryngology- Head and Neck Surgery, Department of Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada. Dr. Rashid: Educational Qualitative Researcher, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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McCutcheon S, Duchemin AM. Overcoming barriers to effective feedback: a solution-focused faculty development approach. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2020; 11:230-232. [PMID: 33099519 PMCID: PMC7882126 DOI: 10.5116/ijme.5f7c.3157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/06/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Samar McCutcheon
- Department of Psychiatry, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Anne-Marie Duchemin
- Department of Psychiatry, The Ohio State University College of Medicine, Columbus, OH, USA
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Sharma N. Providing Effective Feedback in Breast Imaging to Improve Trainee Performance. JOURNAL OF BREAST IMAGING 2020; 2:390-397. [PMID: 38424963 DOI: 10.1093/jbi/wbaa036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Indexed: 03/02/2024]
Abstract
While feedback is an essential component of medical education, feedback to trainees is frequently nonspecific and not focused on performance improvement. Providing specific feedback to trainees helps them to reflect, develop self-assessment skills, and recalibrate. In light of increasing clinical volumes, stresses related to modern healthcare delivery, and high physician burnout, instructors need efficient methods to provide actionable feedback to trainees. For breast imaging radiologists involved in education, improving feedback skills can help their learners develop expertise in breast imaging while also attracting and inspiring the next generation of radiologists.
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Affiliation(s)
- Nidhi Sharma
- University of Texas at Austin, Department of Diagnostic Radiology, Austin, TX
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Buckley C, Natesan S, Breslin A, Gottlieb M. Finessing Feedback: Recommendations for Effective Feedback in the Emergency Department. Ann Emerg Med 2020; 75:445-451. [DOI: 10.1016/j.annemergmed.2019.05.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Indexed: 01/11/2023]
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Boazak M, Cotes RO, Ward MC, Schwartz AC. Explorations with a Residency-Wide, Online, Anonymous Suggestion Box: A Roller Coaster Ride. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:627-630. [PMID: 31222576 DOI: 10.1007/s40596-019-01084-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/03/2019] [Accepted: 06/12/2019] [Indexed: 06/09/2023]
Affiliation(s)
- Mina Boazak
- Emory University School of Medicine, Atlanta, GA, USA
| | | | - Martha C Ward
- Emory University School of Medicine, Atlanta, GA, USA
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Cheng A, Nadkarni VM, Mancini MB, Hunt EA, Sinz EH, Merchant RM, Donoghue A, Duff JP, Eppich W, Auerbach M, Bigham BL, Blewer AL, Chan PS, Bhanji F. Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e82-e122. [PMID: 29930020 DOI: 10.1161/cir.0000000000000583] [Citation(s) in RCA: 189] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The formula for survival in resuscitation describes educational efficiency and local implementation as key determinants in survival after cardiac arrest. Current educational offerings in the form of standardized online and face-to-face courses are falling short, with providers demonstrating a decay of skills over time. This translates to suboptimal clinical care and poor survival outcomes from cardiac arrest. In many institutions, guidelines taught in courses are not thoughtfully implemented in the clinical environment. A current synthesis of the evidence supporting best educational and knowledge translation strategies in resuscitation is lacking. In this American Heart Association scientific statement, we provide a review of the literature describing key elements of educational efficiency and local implementation, including mastery learning and deliberate practice, spaced practice, contextual learning, feedback and debriefing, assessment, innovative educational strategies, faculty development, and knowledge translation and implementation. For each topic, we provide suggestions for improving provider performance that may ultimately optimize patient outcomes from cardiac arrest.
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Albano S, Quadri SA, Farooqui M, Arangua L, Clark T, Fischberg GM, Tayag EC, Siddiqi J. Resident Perspective on Feedback and Barriers for Use as an Educational Tool. Cureus 2019; 11:e4633. [PMID: 31312559 PMCID: PMC6623994 DOI: 10.7759/cureus.4633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Feedback in physician graduate medical education is not clearly defined. Some parties may view questioning as a form of feedback, others the conversations over lunch, some the comments in the operating room (OR), and still others the written evaluation at planned meetings. The lack of clarity in defining what constitutes feedback is concerning when this is considered a fundamental means of education to enhance practices and care for patients. If residents do not recognize they are receiving feedback, or the response to feedback is met with opposition, then feedback as an educational device can be limited. For this manuscript, feedback is defined as written or verbal comments regarding medical knowledge, performance, technique, or patient care. Objective This study attempts to identify barriers to feedback by identifying attitudes toward feedback processes through a questionnaire. Methods Ten questions were provided to residents at a single institution representing, emergency medicine, family medicine, internal medicine, neurology, and neurosurgery during the 2017-2018 academic year. Response was voluntary and the study was granted exemption by local institutional review board since no identifying information was collected to link responses to specific residents. Questions were formulated to identify how positive or negative a resident felt toward specific aspects of feedback. Results Of the possible 84 resident respondents, 40 residents participated reflecting a response of approximately 48%. Questionnaires revealed that 22.5% of respondents found feedback to be a stressful event. Sixty-seven point five percent (67.5%) of resident respondents associated the prompt that they are about to receive feedback as concerning. Only 2.5% of residents identified a meeting with the program director as a sign that the resident may be doing well. Appointments for feedback were viewed as a positive event in 12.5% of respondents. Ninety-five percent (95%) of residents do not feel that all feedback will affect their permanent record. Ten percent (10%) of residents identified receiving feedback as a positive event. Ninety-five percent (95%) of residents indicated that they have actively tried to change behavior or practices based on feedback. Forty percent (40%) of residents found themselves censoring "negative" feedback. Conclusions Barriers to feedback include the inability to present sensitive subjects in a constructive manner and superficial relationships between the evaluator and resident physician. Research directed at addressing these barriers could lead to improved use of feedback as an educational tool.
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Affiliation(s)
- Stephen Albano
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Syed A Quadri
- Neurosurgery, California Institute of Neurosciences, Thousand Oaks, USA
| | | | - Luis Arangua
- Neurology, Desert Regional Medical Center, Palm Springs, USA
| | - Thomas Clark
- Neurology, Desert Regional Medical Center, Palm Springs, USA
| | - Glenn M Fischberg
- Neurology and Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Emilio C Tayag
- Neurology and Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
| | - Javed Siddiqi
- Neurosurgery, Desert Regional Medical Center, Palm Springs, USA
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Abstract
Feedback is defined as a regulatory mechanism where the effect of an action is fed back to modify and improve future action. In medical education, newer conceptualizations of feedback place the learner at the center of the feedback loop and emphasize learner engagement in the entire process. But, learners reject feedback if they doubt its credibility or it conflicts with their self-assessment. Therefore, attention has turned to sociocultural factors that influence feedback-seeking, acceptance, and incorporation into performance. Understanding and application of specific aspects of psychosocial theories could help in designing initiatives that enhance the effect of feedback on learning and growth. In the end, the quality and impact of feedback should be measured by its influence on recipient behavior change, professional growth, and quality of patient care and not the skills of the feedback provider. Our objective is to compare and contrast older and newer definitions of feedback, explore existing feedback models, and highlight principles of relevant psychosocial theories applicable to feedback initiatives. Finally, we aim to apply principles from patient safety initiatives to emphasize a safe and just culture within which feedback conversations occur so that weaknesses are as readily acknowledged and addressed as strengths.
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Pooley M, Pizzuti C, Daly M. Optimizing Multisource Feedback Implementation for Australasian Physicians. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:228-235. [PMID: 31567831 DOI: 10.1097/ceh.0000000000000267] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Medical regulatory bodies in Australasia are encouraging greater use of continuing professional development activities, such as multisource feedback (MSF), which are practice-based, include facilitated feedback, and improve performance. The aim of this study was to explore the feasibility, effectiveness, and sustainability of an MSF process that includes a telephone/videoconference debrief, to better design future MSF implementation. METHOD Thirty-seven Australasian physician participants sought feedback from patients and colleagues and debriefed their feedback report with a trained facilitator. The impact was evaluated using quantitative and qualitative measures including surveys and semistructured interviews. RESULTS The feasibility of the MSF process was impacted by the level of support for the participant to complete the MSF, the nature and location of participants' work, and the use of telephone/videoconference to deliver the debrief. Regarding effectiveness, the MSF stimulated reflection on practice and action on areas identified for improvement. In addition, the quality of rater feedback and the inclusion of a debrief impacted participant and facilitator reports of effectiveness. The absence of a culture of feedback, the formative nature of the MSF, and the confidentiality of the results were factors impacting sustainability. DISCUSSION Optimizing MSF is important to encourage broad uptake in the wider medical community in Australasia. Although several factors were identified as having an impact, it is clear that inclusion of a quality debrief will increase the perceived value and the effectiveness of MSF. Delivering that debrief through telephone/videoconference can be effective and will increase the overall feasibility and sustainability.
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Affiliation(s)
- Michael Pooley
- Mr. Pooley: Senior Project Officer, Directorate of Professional Practice, RACP, Sydney, New South Wales, Australia. Ms. Pizzuti: Research Officer, Directorate of Professional Practice, RACP, Sydney, New South Wales, Australia. Ms. Daly: Senior Researcher, Directorate of Professional Practice, RACP, Sydney, New South Wales, Australia. Honorary Research Fellow, School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Moroz A, Horlick M, Mandalaywala N, Stern DT. Faculty feedback that begins with resident self-assessment: motivation is the key to success. MEDICAL EDUCATION 2018; 52:314-323. [PMID: 29205433 DOI: 10.1111/medu.13484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/18/2017] [Accepted: 09/25/2017] [Indexed: 05/12/2023]
Abstract
CONTEXT The seeking and incorporating of feedback are necessary for continuous performance improvement in medicine. We know that beginning feedback conversations with resident self-assessment may reduce some of the tensions experienced by faculty staff. However, we do not fully understand how residents experience feedback that begins with self-assessment, and whether any existing theoretical frameworks can explain their experiences. METHODS We conducted a constructivist grounded theory study exploring physical medicine and rehabilitation residents' experiences as they engaged in a structured self-assessment and faculty staff feedback programme. Utilising purposive sampling, we conducted 15 individual interviews and analysed verbatim transcripts iteratively. We implemented several procedures to enhance the credibility of the findings and the protection of participants during recruitment, data collection and data analysis. After defining the themes, we reviewed a variety of existing frameworks to determine if any fitted the data. RESULTS Residents valued self-assessment followed by feedback (SAFF) and had clear ideas of what makes the process useful. Time pressures and poor feedback quality could lead to a process of 'just going through the motions'. Motivation coloured residents' experiences, with more internalised motivation related to a more positive experience. There were no gender- or year of training-related patterns. CONCLUSIONS Self-determination theory provided the clearest lens for framing our findings and fitted into a conceptual model linking the quality of the SAFF experience and residents' motivational loci. We identified several study limitations including time in the field, evolving characteristics of the SAFF programme and the absence of faculty voices. We believe that by better understanding residents' experiences of SAFF, educators may be able to tailor the feedback process, enhance clinical performance and ultimately improve patient care.
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Affiliation(s)
- Alex Moroz
- Department of Rehabilitation Medicine, New York University School of Medicine, New York, New York, USA
| | - Margaret Horlick
- Veterans' Affairs New York Harbor Healthcare System and Department of Medicine, New York University School of Medicine, New York, New York, USA
| | - Neil Mandalaywala
- Department of Rehabilitation Medicine, New York University School of Medicine, New York, New York, USA
| | - David T Stern
- Veterans' Affairs New York Harbor Healthcare System and Department of Medicine, New York University School of Medicine, New York, New York, USA
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Balmer DF, Tenney-Soeiro R, Mejia E, Rezet B. Positive Change in Feedback Perceptions and Behavior: A 10-Year Follow-up Study. Pediatrics 2018; 141:peds.2017-2950. [PMID: 29217671 DOI: 10.1542/peds.2017-2950] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Providing and learning from feedback are essential components of medical education, and typically described as resistant to change. But given a decade of change in the clinical context in which feedback occurs, the authors asked if, and how, perceptions of feedback and feedback behaviors might have changed in response to contextual affordances. METHODS In 2017, the authors conducted a follow-up, ethnographic study on 2 general pediatric floors at the same children's hospital where another ethnographic study on a general pediatric floor was conducted in 2007. Data sources included (1) 21 and 34 hours of observation in 2007 and 2017, respectively, (2) 35 and 25 interviews with general pediatric attending physicians and residents in 2007 and 2017, respectively, and (3) a review of 120 program documents spanning 2007 to 2017. Data were coded and organized around 3 recommendations for feedback that were derived from 2007 data and served as standards for assessing change in 2017. RESULTS Data revealed progress in achieving each recommendation. Compared with 2007, participants in 2017 more clearly distinguished between feedback and evaluation; residents were more aware of in-the-moment feedback, and they had shifted their orientation from evaluation and grades to feedback and learning. Explanations for progress in achieving recommendations, which were derived from the data, pointed to institutional and national influences, namely, the pediatric milestones. CONCLUSIONS On the basis of follow-up, ethnographic data, changes in the clinical context of pediatric education may afford positive change in perceptions of feedback and feedback behavior and point to influences within and beyond the institution.
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Affiliation(s)
- Dorene F Balmer
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and .,Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rebecca Tenney-Soeiro
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.,Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Erika Mejia
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Beth Rezet
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and.,Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Oseni Z, Than HH, Kolakowska E, Chalmers L, Hanboonkunupakarn B, McGready R. Video-based feedback as a method for training rural healthcare workers to manage medical emergencies: a pilot study. BMC MEDICAL EDUCATION 2017; 17:149. [PMID: 28859651 PMCID: PMC5580284 DOI: 10.1186/s12909-017-0975-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 08/07/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Video-based feedback has been shown to aid knowledge retention, skills learning and improve team functionality. We explored the use of video-based feedback and low fidelity simulation for training rural healthcare workers along the Thailand-Myanmar border and Papua New Guinea (PNG) to manage medical emergencies effectively. METHODS Twenty-four study participants were recruited from three Shoklo Malaria Research Unit clinics along the Thailand-Myanmar border and eight participants from Kudjip Nazarene Hospital, PNG. The teams were recorded on video managing a simulated medical emergency scenario and the video was used to aid feedback and assess performance using Observed Structured Clinical Examination (OSCE) scoring and Team Emergency Assessment Measure (TEAM) questionnaire. The process was repeated post-feedback at both sites and at 6 weeks at the Thailand-Myanmar border site. Thailand-Myanmar border participants' individual confidence levels and baseline knowledge (using OSCE scoring) were assessed before team assessment and feedback at week 1 and repeated post-feedback and at 6 weeks. Focus group discussions (FGD) were held at each Thailand-Myanmar border clinic at week 1 (8 participants at each clinic). RESULTS Individual paired tests of OSCE scores showed significant improvement post-feedback at week 1 (p < 0.001) and week 6 (p < 0.001) compared to baseline OSCE scores. There was a trend for increased team OSCE scores compared to baseline at week 1 (p = 0.068) and week 6 (p = 0.109) although not significant. Thailand-Myanmar border TEAM scores demonstrated improvement post-feedback mainly in leadership, teamwork and task management which was sustained up to week 6. PNG showed an improvement mainly in teamwork and task management. The global rating of the teams' non-technical performance at both sites improved post feedback and at week 6 on the Thailand-Myanmar border site. Self-rated confidence scores by Thailand-Myanmar border participants increased significantly from baseline following training at week 1 (p = 0.020), and while higher at 6 weeks follow up than at baseline, this was not significant (p = 0.471). The FGD revealed majority of participants felt that watching the video recording of their performance and the video-based feedback contributed most to their learning. CONCLUSION Video-assisted feedback resulted in an improvement in clinical knowledge, confidence and quality of teamwork for managing medical emergencies in two low resource medical facilities in South East Asia and the South Pacific.
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Affiliation(s)
- Zainab Oseni
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110 Thailand
| | - Hla Hla Than
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110 Thailand
| | - Edyta Kolakowska
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110 Thailand
| | - Lauren Chalmers
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110 Thailand
| | - Borimas Hanboonkunupakarn
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400 Thailand
| | - Rose McGready
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, 63110 Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ UK
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Sarkany D, Deitte L. Providing Feedback: Practical Skills and Strategies. Acad Radiol 2017; 24:740-746. [PMID: 28237190 DOI: 10.1016/j.acra.2016.11.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 11/06/2016] [Accepted: 11/16/2016] [Indexed: 12/01/2022]
Abstract
Feedback is an essential component of education. It is designed to influence, reinforce, and change behaviors, concepts, and attitudes in learners. Although providing constructive feedback can be challenging, it is a learnable skill. The negative consequences of destructive feedback or lack of feedback all together are far-reaching. This article summarizes the components of constructive feedback and provides readers with tangible skills to enhance their ability to give effective feedback to learners and peers.
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Affiliation(s)
- David Sarkany
- Department of Radiology, Staten Island University Hospital Northwell Health, 475 Seaview Avenue, Staten Island, NY 10305.
| | - Lori Deitte
- Department of Radiology, Vanderbilt University, Nashville, Tennessee
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Affiliation(s)
- Najum S Qureshi
- Birmingham Women's Hospital - Obstetrics & Gynaecology; Birmingham UK
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Kornegay JG, Kraut A, Manthey D, Omron R, Caretta‐Weyer H, Kuhn G, Martin S, Yarris LM. Feedback in Medical Education: A Critical Appraisal. AEM EDUCATION AND TRAINING 2017; 1:98-109. [PMID: 30051017 PMCID: PMC6001508 DOI: 10.1002/aet2.10024] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 05/24/2023]
Abstract
OBJECTIVE The objective was to review and critically appraise the medical education literature pertaining to feedback and highlight influential papers that inform our current understanding of the role of feedback in medical education. METHODS A search of the English language literature in querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 327 feedback-related papers using either quantitative (hypothesis-testing or observational investigations of educational interventions), qualitative methods (exploring important phenomena in emergency medicine [EM] education), or review methods.Two reviewers independently screened each category of publications using previously established exclusion criteria. Six reviewers then independently scored the remaining 54 publications using a qualitative, quantitative, or review paper scoring system. Each scoring system consisted of nine criteria and used parallel scoring metrics that have been previously used in critical appraisals of education research. RESULTS Fifty-four feedback papers (25 quantitative studies, 24 qualitative studies, five review papers) met the a priori criteria for inclusion and were reviewed. Eight quantitative studies, nine qualitative studies, and three review papers were ranked highly by the reviewers and are summarized in this article. CONCLUSIONS This inaugural Council of Emergency Medicine Residency Directors Academy critical appraisal highlights 20 feedback in medical education papers that describe the current state of the feedback literature. A summary of current factors that influence feedback effectiveness is discussed, along with practical implications for EM educators and the next steps for research.
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Affiliation(s)
- Joshua G. Kornegay
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOR
| | - Aaron Kraut
- BerbeeWalsh Department of Emergency MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWI
| | - David Manthey
- Department of Emergency MedicineWake Forest University Baptist HealthWinston‐SalemNC
| | - Rodney Omron
- Department of Emergency MedicineJohns Hopkins School of MedicineBaltimoreMD
| | - Holly Caretta‐Weyer
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOR
| | - Gloria Kuhn
- Department of Emergency MedicineWayne State UniversityDetroitMI
| | - Sandra Martin
- Department of Emergency MedicineWayne State UniversityDetroitMI
| | - Lalena M. Yarris
- Department of Emergency MedicineOregon Health & Science UniversityPortlandOR
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McGhee J, Crowe C, Kraut A, Pierce A, Porat A, Schnapp B, Laurie A, Fu R, Yarris L. Do Emergency Medicine Residents Prefer Resident-initiated or Attending-initiated Feedback? AEM EDUCATION AND TRAINING 2017; 1:15-20. [PMID: 30051003 PMCID: PMC6001489 DOI: 10.1002/aet2.10006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/19/2016] [Accepted: 10/28/2016] [Indexed: 06/07/2023]
Abstract
BACKGROUND Real-time feedback is crucial to improving physician performance. Emerging theory suggests that learner-initiated feedback may be more effective in changing performance than attending-initiated feedback, but little is known about how residents perceive resident- versus attending-initiated feedback. OBJECTIVES The primary aim was to determine whether residents' satisfaction varied by learner-versus attending-initiated feedback encounters. We hypothesized that residents would be more satisfied with resident-initiated feedback. METHODS This was a multicenter study of five emergency medicine residency programs. We developed a milestones-based, real-time feedback intervention that provided behavioral anchors for ED subcompetencies and prompted a feedback discussion. The intervention was implemented at all sites for a 3-month period from March to November 2014. Residents were asked to initiate one card per shift; attendings were also invited to initiate encounters and, in either instance, asked to provide one specific suggestion for improvement. Residents confidentially rated their satisfaction with feedback on a 10-point scale. Reported satisfaction was categorized as "very satisfied" (score of 10) versus "less than very satisfied" (score < 10). Logistic regression was used to assess the difference in satisfaction between resident- versus attending-initiated feedback, and random effects were used to account for the clustering of repeated ratings within resident and by site. RESULTS A total of 785 cards was collected from five sites. Participation varied by site (range = 21-487 cards per site). Of the 587 cards with both feedback initiator and satisfaction data, 67% (396/587) were resident-initiated, and median satisfaction score was 10 (range = 4-10). There was no difference in the odds of being "very satisfied" by resident- vesus attending-initiated encounters (odds ratio = 1.08, 95% confidence interval = 0.41 to 2.83). CONCLUSIONS Our results suggest that residents are likely to be as satisfied with self-initiated feedback as attending-initiated feedback. Further research is needed to determine whether resident-initiated feedback is more likely to be incorporated into practice and result in objective performance improvements.
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Affiliation(s)
| | | | | | - Ava Pierce
- University of Texas SouthwesternDallasTX
| | - Avital Porat
- Ichan School of Medicine at Mount SanaiNew YorkNY
| | | | | | - Rongwei Fu
- Oregon Health & Science UniversityPortlandOR
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Eppich WJ, Mullan PC, Brett-Fleegler M, Cheng A. “Let's Talk About It”: Translating Lessons From Health Care Simulation to Clinical Event Debriefings and Coaching Conversations. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2016. [DOI: 10.1016/j.cpem.2016.07.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kost A, Combs H, Smith S, Klein E, Kritek P, Robins L, Cianciolo AT, Butani L, Gigante J, Ramani S. A Proposed Conceptual Framework and Investigation of Upward Feedback Receptivity in Medical Education. TEACHING AND LEARNING IN MEDICINE 2015; 27:359-361. [PMID: 26507991 DOI: 10.1080/10401334.2015.1077134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED WGEA 2015 CONFERENCE ABSTRACT (EDITED). Faculty Perceptions of Receiving Feedback From Third-Year Clerkship Students. Amanda Kost, Heidi Combs, Sherilyn Smith, Eileen Klein, Patricia Kritek, and Lynne Robins. PHENOMENON: In addition to giving feedback to 3rd-year clerkship students, some clerkship instructors receive feedback, requested or spontaneous, from students prior to the clerkship's end. The concept of bidirectional feedback is appealing as a means of fostering a culture of respectful communication and improvement. However, little is known about how teachers perceive this feedback in practice or how it impacts the learning environment. APPROACH We performed 24 semistructured 30-minute interviews with 3 to 7 attending physician faculty members each in Pediatrics, Internal Medicine, Family Medicine, Surgery, Psychiatry, and Obstetrics and Gynecology who taught in 3rd-year required clerkships during the 2012-2013 academic year. Questions probed teachers' experience with and attitudes toward receiving student feedback. Prompts were used to elicit stories and obtain participant demographics. Interviews were audio-recorded, transcribed, and entered into Dedoose for qualitative analysis. Researchers read transcripts holistically for meaning, designed a coding template, and then independently coded each transcript. A constant comparative approach and regular meetings were used to ensure consistent coding between research team members. FINDINGS Participants ranged in age from 37 to 74, with 5 to 35 years of teaching experience. Seventy-one percent were male, and 83% identified as White. In our preliminary analysis, our informants reported a range of experience in receiving student feedback prior to the end of a clerkship, varying from no experience to having developed mechanisms to regularly request specific feedback about their programs. Most expressed openness to actively soliciting and receiving student feedback on their teaching during the clerkship although many questioned whether this process was feasible. Actual responses to receiving student feedback were mixed. Some reported having received feedback that motivated change, and others rejected the feedback they received on the grounds that it lacked validity or was inappropriate. Others expressed uncertainty about how they would react to student feedback. Faculty expressed a preference for receiving feedback about behaviors and items that were within their control. INSIGHTS: These findings suggest there is opportunity to pilot implementation of a structured student feedback mechanism, separate from teacher evaluations, in selected 3rd-year clerkships. Materials should developed to help faculty solicit, understand, and respond to student feedback and to help students frame and provide the kinds of feedback to teachers that will lead to suggested improvements. Both these endeavors have the potential to improve the clinical learning environment during 3rd-year clerkships through the cultivation of respectful communication and the encouragement of improvement in teaching efforts.
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Affiliation(s)
- Amanda Kost
- a Department of Family Medicine , University of Washington School of Medicine , Seattle , Washington , USA
| | - Heidi Combs
- b Psychiatry and Behavioral Science, University of Washington School of Medicine , Seattle , Washington , USA
| | - Sherilyn Smith
- c Department of Pediatrics , University of Washington School of Medicine , Seattle , Washington , USA
| | - Eileen Klein
- c Department of Pediatrics , University of Washington School of Medicine , Seattle , Washington , USA
| | - Patricia Kritek
- d Division of Pulmonary & Critical Care Medicine, University of Washington School of Medicine , Seattle , Washington , USA
| | - Lynne Robins
- e Department of Medical Education and Biomedical Informatics at the University of Washington School of Medicine , Seattle , Washington , USA
| | - Anna T Cianciolo
- f Department of Medical Education , Southern Illinois University School of Medicine , Springfield , Illinois , USA
| | - Lavjay Butani
- g Department of Pediatrics , University of California Davis Medical Center , Sacramento , California , USA
| | - Joseph Gigante
- h Department of Pediatrics , Vanderbilt University School of Medicine , Nashville , Tennessee , USA
| | - Subha Ramani
- i Department of Medicine , Harvard Medical School , Boston , Massachusetts , USA
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