Amy Miles1, Shiphra Ginsburg1,2, Matthew Sibbald3, Walter Tavares1,2,4, Chris Watling5, Lynfa Stroud1,2. 1. Department of Medicine, University of Toronto, Toronto, ON, Canada. 2. The Wilson Centre, University of Toronto, Toronto, ON, Canada. 3. Department of Medicine, Centre for Simulation-Based Learning, McMaster University, Hamilton, ON, Canada. 4. Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada. 5. Department of Oncology, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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.
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.
Authors: Titia S van Duin; Marco A de Carvalho Filho; Peter F Pype; Susanne Borgmann; Matts H Olovsson; A Debbie C Jaarsma; Marco A C Versluis Journal: Med Educ Date: 2022-01-09 Impact factor: 7.647
Authors: Varun Coelho; Andrew Scott; Elif Bilgic; Amy Keuhl; Matthew Sibbald Journal: Int J Environ Res Public Health Date: 2022-08-29 Impact factor: 4.614