A Feedback and Evaluation System That Provokes Minimal Retaliation by Trainees.

Area of Science:

• Medical Education
• Healthcare Administration
• Academic Medicine

Background:

• Grade inflation is a significant issue in US educational settings.
• Faculty may fear assigning lower clinical performance scores due to potential retaliation from trainees.
• This retaliation could manifest as trainees assigning lower teaching scores to faculty.

Purpose of the Study:

• To test the hypothesis that faculty assigning lower clinical performance scores to residents receive lower teaching scores in return.
• To investigate the extent of retaliation in a bidirectional confidential evaluation system.

Main Methods:

• A bidirectional confidential evaluation system was used.
• Data included 27,561 faculty evaluations of 188 anesthesia residents and 25,058 resident evaluations of 204 faculty members over nearly five years.
• Linear regression and mixed effects models analyzed the relationship between performance and teaching scores across different epochs.

Main Results:

• No significant relationship was found between faculty-assigned performance scores and received teaching scores across epochs (P ≥ 0.45).
• Mixed effects model analysis on complete dyads revealed a very small retaliation effect (effect sizes 0.10, 0.06, 0.12; P ≤ 0.01).

Conclusions:

• Faculty members can provide confidential evaluations and feedback to trainees.
• There is near-zero impact on faculty teaching scores from assigning lower performance evaluations.
• This finding supports honest and transparent evaluation practices in medical education.