Lauren Peccoralo1, Reena Karani, Lisa Coplit, Deborah Korenstein. 1. Division of General Internal Medicine, Samual M. Bronfman Department of Internal Medicine, Mount Sinai School of Medicine, New York, New York. Lauren.peccoralo@mssm.edu.
Abstract
BACKGROUND: Residents are often dissatisfied with feedback received on the wards, and hospital attendings are often uncomfortable and unskilled at giving feedback. OBJECTIVE: Determine the impact of a pocket card and feedback session on Internal Medicine (IM) residents' perceptions of feedback and attendings' comfort giving feedback. DESIGN: Prospective randomized trial using chi-square analysis. SETTING:Inpatient wards at 1 academic medical center. PARTICIPANTS: One hundred eleven IM residents and 36 attendings. INTERVENTION: We introduced a pocket feedback card, structured around the Accreditation Council for Graduate Medical Education competencies, and a feedback session to guide mid-rotation feedback. Control group attendings received the usual reminder to provide feedback. MEASUREMENTS: Attendings' and residents' survey responses, after the inpatient month, assessing attitudes towards feedback and qualitative interviews with intervention attendings. RESULTS: Intervention residents were more likely than controls to report sufficient and useful feedback from attendings. They reported more feedback regarding skills needing improvement and how to improve their skills (51.3% vs 25.5%, P = 0.02), and felt their clinical (61.5% vs 27.8%, P = 0.001) and professionalism/communication (51.3% vs 29.1%, P = 0.03) skills improved based on this feedback. Intervention attendings, as compared to controls, agreed that residents improved their professionalism/communication skills (76.9% vs 31.1%, P = 0.02) based on feedback. Most intervention attendings found the card and session acceptable and would use both in the future. CONCLUSIONS: A pocket feedback card and dedicated feedback session improved the quantity and quality of feedback delivered to IM residents by their attendings on the inpatient wards.
RCT Entities:
BACKGROUND: Residents are often dissatisfied with feedback received on the wards, and hospital attendings are often uncomfortable and unskilled at giving feedback. OBJECTIVE: Determine the impact of a pocket card and feedback session on Internal Medicine (IM) residents' perceptions of feedback and attendings' comfort giving feedback. DESIGN: Prospective randomized trial using chi-square analysis. SETTING: Inpatient wards at 1 academic medical center. PARTICIPANTS: One hundred eleven IM residents and 36 attendings. INTERVENTION: We introduced a pocket feedback card, structured around the Accreditation Council for Graduate Medical Education competencies, and a feedback session to guide mid-rotation feedback. Control group attendings received the usual reminder to provide feedback. MEASUREMENTS: Attendings' and residents' survey responses, after the inpatient month, assessing attitudes towards feedback and qualitative interviews with intervention attendings. RESULTS: Intervention residents were more likely than controls to report sufficient and useful feedback from attendings. They reported more feedback regarding skills needing improvement and how to improve their skills (51.3% vs 25.5%, P = 0.02), and felt their clinical (61.5% vs 27.8%, P = 0.001) and professionalism/communication (51.3% vs 29.1%, P = 0.03) skills improved based on this feedback. Intervention attendings, as compared to controls, agreed that residents improved their professionalism/communication skills (76.9% vs 31.1%, P = 0.02) based on feedback. Most intervention attendings found the card and session acceptable and would use both in the future. CONCLUSIONS: A pocket feedback card and dedicated feedback session improved the quantity and quality of feedback delivered to IM residents by their attendings on the inpatient wards.