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.
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.
Authors: Lalena M Yarris; Judith A Linden; H Gene Hern; Cedric Lefebvre; David M Nestler; Rongwei Fu; Esther Choo; Joseph LaMantia; Patrick Brunett Journal: Acad Emerg Med Date: 2009-12 Impact factor: 3.451
Authors: Lalena M Yarris; Rongwei Fu; Joseph LaMantia; Judith A Linden; H Gene Hern; Cedric Lefebvre; David M Nestler; Janis Tupesis; Nicholas Kman Journal: Acad Emerg Med Date: 2011-05 Impact factor: 3.451
Authors: Kevin W Eva; Heather Armson; Eric Holmboe; Jocelyn Lockyer; Elaine Loney; Karen Mann; Joan Sargeant Journal: Adv Health Sci Educ Theory Pract Date: 2011-04-06 Impact factor: 3.853
Authors: Ryan F Coughlin; Alina Tsyrulnik; Michael Gottlieb; Jessica Bod; Ryan Barnicle; James Dziura; David Della-Giustina; Katja Goldflam Journal: AEM Educ Train Date: 2022-09-17