Aurora Affiliations

Aurora Sinai Medical Center

Aurora St. Luke's Medical Center

Presentation Notes

Poster presented at 2019 AIAMC Annual Meeting, Tucson AZ.

Abstract

Introduction/Background

Feedback is an essential component of learning. In medical education, it can come in many forms ranging from clinical quality/patient experience metrics to faculty silence when a learner presents a patient’s differential diagnosis. Yet constructive feedback is usually among the lowest rated items on education/teaching evaluations. Historically the emphasis has been on developing teacher’s ability to give feedback – with teacher’s “pushing” feedback out to the learner who “wrong spots” all the reasons why the feedback is incorrect. Studies indicate that while feedback may be provided, it is often not actionable, lacking specific tactics/strategies for improvement. Consistent with the literature on well-being (competence, perceived autonomy/control, relationship/connection), recent studies shift the emphasis from learner as receiver to learner soliciting feedback. Soliciting feedback can shift the learner’s perspective to asking for feedback focused on achieving one of their valued competency goals with the teacher as an ally.

Hypothesis/Aim Statement

To evaluate if a brief, evidence-based training session highlighting the why and how of soliciting feedback would result in a commitment by learners to increase the frequency with which they directly asked for feedback.

Methods

Third year medical students (N=16) and residents from Family Medicine and Ob/Gyn (N=25) attended a 25-30 minute evidence-based session on soliciting feedback. The why, who, what, and how of soliciting feedback was briefly reviewed. Atul Grande’s “Personal Best” article highlighted the need for on-going feedback to optimize performance, be it as a professional athlete or a neurosurgeon. A 4-step model prepared learners to solicit actionable feedback: Ask, Clarify, Consider, Thanks (AC2T) with examples. Participants completed a brief survey which included two items focusing on how often they currently ask for feedback from their clinical teachers/preceptors/attendings and how often they now intended to ask for feedback [6-point scale frequency scale: 1= 0/times; 2= <1/month; 3=1-2/month; 4=1/week; 5=2-3/week; 6= > 5/week].

Results

All attendees completed the survey. Results for all attendees (combined) and by group are presented below as means with standard deviation in parentheses.

Frequency Solicit Feedback

Combined

M3 Students

Residents

How Often Currently Ask for Feedback

4.2 (1.0)

3.8 (0.8)

4.5 (1.1)

How Often Intend to Ask for Feedback

5.3 (0.7)

5.5 (0.6)

5.2 (0.7)

Commitment to Change (Difference)

1.1

1.7

0.7

Two residents comments highlight that just asking for feedback (e.g., “How am I doing?”) isn’t enough as they recognize the need to focus on all aspects of AC2T model: “Will work on how I ask (specifically) for it.” “I think I’m already pretty good at asking for feedback, but I’d love to have more actionable items!”

Conclusions

Attendees report that they currently solicit feedback. Post session AC2T they intend to increase the frequency of that solicitation to at least several times/week incorporating key elements to make feedback actionable to achieve their goals. As soliciting feedback is a risk, the intention to increase frequency after a brief training session is promising. Follow-up data will be gathered to determine the degree to which intentions were actualized.

Document Type

Poster


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