Feedback With Performance Metric Scorecards Improves Resident Satisfaction but Does Not Impact Clinical Performance

Area of Science:

• Medical Education
• Emergency Medicine
• Healthcare Quality Improvement

Background:

• The Emergency Medicine Milestone Project provides a framework for resident competency assessment and feedback.
• Current milestones lack objective data on resident clinical efficiency and productivity.
• Milestone-based feedback has not demonstrably improved resident satisfaction.

Purpose of the Study:

• To evaluate if performance metric reports enhance emergency medicine resident satisfaction with feedback.
• To determine if performance metric reports improve resident clinical efficiency and productivity.

Main Methods:

• A three-phase stepped-wedge randomized pilot study involving emergency medicine residents.
• Residents received traditional feedback, or traditional feedback plus monthly performance metric reports.
• Resident satisfaction was assessed via Likert scale surveys; clinical performance was measured by patient treatment time and patient visits per hour.

Main Results:

• Residents receiving performance metric reports reported higher satisfaction with feedback quality (p=0.01).
• Ninety percent of residents liked the reports, and 74% felt better prepared for attending physician roles.
• Performance metric reports did not significantly impact patient treatment time or patient visits per hour.

Conclusions:

• Performance metric reports enhance resident satisfaction with feedback and aid in preparing for attending physician roles.
• Augmenting feedback with performance metric reports is a viable strategy for residency training programs.
• While not improving efficiency, these reports positively influence the resident learning experience.